Particulate matter air pollution is the leading environmental risk factor of cardiovascular disease and is increasing in the Western United States due to more frequent and severe wildfires. Older adults are particularly susceptible to both air pollution exposures and the development of cardiovascular disease, and the older adult population in the United States is rapidly growing. Given the converging threats of worsening air quality and an aging population, this clinical trial will evaluate a novel, multifaceted indoor air quality intervention to improve cardiovascular health outcomes among older adults in the wildfire-impacted state of Montana.
55-79 years of age one primary residence (5+ days per week)
have an electronic device, email address, and reliable internet at home for survey submission
current smoking of any kind or living in a household with someone who currently smokes
current use of a portable air cleaner unit at home
plans to move in the next year
previous physician-diagnosed cardiovascular disease (coronary heart disease [myocardial infarction], stroke, or heart failure)
Parallel
Air Improvement and Real-time Monitoring for Wellness through Interactive Strategies and Education (AIRWISE)
BehavioralThe AIRWISE intervention consists of a 3-pronged approach grounded in the Health Belief Model (HBM) to improve residential indoor air quality through education, equipment, and behavioral cues. To reinforce cues to action, AIRWISE uses alerts from air quality sensors, prompting timely behavioral responses. Specifically, indoor and outdoor air quality alerts act as behavioral cues to promote active engagement and reference a decision matrix with specific recommendations based indoor and outdoor air quality. Recommendations on the decision matrix include simple strategies to reduce air pollution exposures, including increasing use and fan speed of portable air cleaners, opening or closing windows to change ventilation, and changing activities such as physical activity, cooking, and cleaning. This integrated approach promotes sustained behavior change by aligning with all key HBM constructs.
Portable Air Cleaner (PAC) Control
Other interventionParticipants will use two PACs in their home according to manufacturer recommendations. PAC Control group participants will not receive further education on air quality or recommendations on PAC use, nor will they receive additional equipment or outdoor AQI alerts. Control participants will use and maintain the PACs at their own discretion.
Predicting Risk of CVD EVENTs (PREVENT) Score
Validated cardiovascular disease (CVD) risk score called Predicting Risk of CVD EVENTs (PREVENT). The score is a percentage ranging from 0 to 100 that indicates percentage risk of developing CVD, with higher scores indicating higher risk of developing CVD.
Life's Essential 8 (LE8) Score
Validated metric of cardiovascular health called Life's Essential 8 (LE8). The score ranges from 0 to 100, with higher scores indicating better cardiovascular health and lower risk of adverse cardiovascular outcomes.
Indoor PM2.5
Fine particulate matter (PM2.5), or particles that are less than 2.5 micrometers in aerodynamic diameter and a primary component of air pollution
Indoor VOCs
Volatile Organic Compounds (VOCs), a component of air pollution
Glycated hemoglobin
A measure of blood sugar levels measured through venous blood draw and used to calculate the primary PREVENT outcome
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