What drives parents’ use of air quality indexes during wildfire smoke events: predictors of index knowledge, frequent checking, and following health guidance

Wildfire smoke poses a serious and growing health threat to communities in the United States (US), Canada, and beyond. Some populations—including children—are especially susceptible. Air Quality Indexes (AQIs) can inform parents about local air quality during smoke events and offer guidance on actions that protect children. In July–August 2023, parents from Oregon, Washington, California, and British Columbia (BC) (n = 2100) participated in an online cross-sectional study. Binary and ordinal logistic regression models were used to examine geographic, demographic, and psychosocial predictors of three dependent variables: knowledge of where to check AQI information, frequent checking of AQI information during wildfire seasons, and adherence to AQI health messages around reducing/rescheduling outdoor physical activity. Smoke-exposure analysis indicated widespread potential exposures to wildfire smoke across all four jurisdictions. Nonetheless, parents in BC, on average, were less likely to report knowing where to check AQI information, checked less frequently, and were less likely to adhere to AQI guidance than parents in the three US states. Adherence to AQI health messages did not differ by jurisdiction in the presence of other covariates, suggesting parents are equally likely to follow AQI guidance when they know where to find it and check it. Other consistent predictors of the three dependent variables included experience with prior smoke-related health impacts, smoke risk perceptions, and use of internet/mobile applications as sources of smoke information. These findings indicate that increased promotion of AQIs may benefit parents in some regions during wildfires. Future evaluations of smoke education initiatives could help health agencies share effective practices across jurisdictions and target interventions to increase AQI adoption.