Factors influencing health behaviours in response to the air quality health index: a cross-sectional study in Hamilton, Canada

Research associating adverse health effects with air pollution exposure is robust. Public health authorities recognize the need to implement population health strategies that protect public health from air pollution exposure. The Air Quality Health Index (AQHI) is a public health initiative that is intended to protect the public's health from exposure to air pollution. The aim of this research was to identify and explain factors influencing AQHI adoption at the individual level and to establish intervention strategies. A cross-sectional survey with both quantitative and qualitative questions was administered in Hamilton, Ontario, Canada, during the months of June to October 2012. Logistic regression and the Health Belief Model are used to explore the data. Demographics (gender, age, education, and area of residence), knowledge/understanding, and individual risk perceptions (neighbourhood air effects on health) were found to be significant predictors of AQHI adoption. The perceived benefits of AQHI adoption included protection of health for self and those cared for via familial and (or) occupational duties, whereas the perceived barriers of AQHI adoption included lack of knowledge about where to check and lack of time required to check and follow AQHI health messages. Also, self-efficacy was uncovered as a factor influencing AQHI adoption. Accordingly, increases in AQHI adoption could be achieved via increasing AQHI knowledge among low socioeconomic status females, communicating the benefits of AQHI adoption to “at-risk” populations and implementing supports for males to follow AQHI health messages.