How would you respond when your cellular phone sends you an alert of air pollution near your own home? A new study examined who changed their behavior and who stayed oblivious. The results showed one main conclusion: in order to bring about change in public behavior there is a need to heighten their senses of personal danger and the fact that there is very good reason for concern.
When you are planning to go outside for a run or walk with the kids to the park, you probably don't pay attention to the level of air pollution. However, if you receive an alert to your cellular phone whenever air pollution exceeds a certain level, would you change your behavior accordingly? Would you choose to go somewhere else, or stay at home or even prefer to run on a treadmill at the gym?
A new study made by student Dana Ziv, under the direction of Dr. Hagai Levine and Dr. Osnat Keidar at the School of Public Health in the Hebrew University-Hadassah examined precisely this question. Can a smartphone app actually change our behavior and cause us to reduce our exposure to polluted air? "Air pollution causes considerable distress and mortality worldwide, there is no doubt that major steps must be taken in order to reduce air pollution," says Dr. Hagai Levine. "But the question that we faced in this study is what the public, as individuals, can do, how can we personally reduce our own exposure to air pollution"? Dana Ziv is the first graduate in the new MBA public health course that specializes in environmental health, headed by Dr. Levine.
Is my street polluted?
The Ministry of Environmental Protection publishes daily data on air quality across the country, which can be viewed on the ministry's website or via their call center. "The problem is that this data is only accessible if you take the trouble to log on to the website and particularly examine it or alternatively call the call center, something that most people don't do," says Levine. "Furthermore this data doesn't provide information on my current location, but only for the whole region. Additionally, the data doesn't provide concrete recommendations as to what exactly I should do if there is a medium or high percentage of pollution. In other words, in most cases, this data doesn't really enable the public to change their actual behavior patterns. "
To check whether receiving direct recommendations directly to smart phones influences behavior change, the researchers co-operated with BreezeoMeter’s app. The app provides an index of information on the air quality anywhere in the country and warns when the pollution level rises above a certain level. The app. also provides recommendations when air pollution is high, depending on the users profile for example, athletes, parents, children, pregnant women etc. " BreezeoMeter has created a high-resolution application that works, almost at street level," says Levine.
The researchers turned to the people who signed up to download the application, even before it was available to the general public, and asked them to answer the following question, "Had they ever changed their behavior following a warning about air quality"? Three months later, researchers asked them a similar question. This time the question was, "During the last three months had they changed their behavior following a warning about air quality"? According to the responses they received, the researchers examined what causes people to change their behavior and avoid air pollution or, alternatively, ignore the information.
Wake Up Call
According to the research, one of the most influential factors on behavior change is the perception of personal risk, in other words, how you think air pollution personally affects you. "Everyone understands that, in principle, air pollution causes illness and even death. But does it personally endanger me? People tend to say, 'So what if there is pollution, I'm fit, I'm strong, I can go for a run outside and nothing will happen to me'. People have a low perception of personal risk and getting them to change their behavior is difficult. Anyone who says 'There's pollution out there, if I run now it will harm my health', has a high perception of risk, and will, most probably, refrain from going for a run outside when air pollution is high", explains Levine.
Incidentally, on the subject of exercise, Levine demonstrates how an app like this can help us make the right behavioral decision. "Of course I recommend regular exercise, which is good for health in many ways. However, it's important to know that whoever chooses to run at the side of a busy road is exposed to a much higher level of air pollution than normal. This is due to the fact that during intensive physical activity, the volume of breathing increases substantially, and the quantity of particles inhaled subsequently increases. According to the US Cardiologist's Association, if you engage in strenuous exercise where there's severe air pollution, you are doing yourself more harm than good. This is an example that shows how important is it to know and assess air pollution in a given area, and of course transmit this information to the general public. "
An additional discovery in this research found that women tended to change their behavior to a greater extent due to air pollution alerts. "The fact that this study shows a difference in the response of men and women to warnings emphasizes the need for personally directed notifications according to gender, state of health, family status (with / without children) and so on. And the need consider, certainly in an app that can be customized, how to develop a program adapted for both males and females," says Levin. "How to engage in promoting health via an application in a scientific, accurate manner and how to individually address the message, is an innovative and fascinating subject that has great potential."
Awareness Changes Behavior
One hundred and fifty nine people answered the questionnaire before using the app, of whom 105 reported of previous changes in behavior due to receiving an air pollution warning. Three months later 45 answered the questionnaire, of whom 14 reported behavior change after receiving a warning during the last three months. "The survey is small scale, so the result is not significant," says Levine, "many of the people who responded to the first stage didn't really use the app or even download it (mainly due to technical reasons), therefore it cannot be said that there is an unequivocal connection between behavior modification and use of the app. Nevertheless, it certainly shows the potential in conveying information in this way to influence behavior change. By the way, the data showed that from those who answered the questionnaire that did download the app, more were prone to change their behavior".
"In addition, the study helps to better understand which notifications need to be provided to the public in order to lead to behavioral change," adds Levine. "It shows that one of the important things is to increase the awareness of personal risk, to highlight that air pollution is not just a general issue, but something that can affect and harm our personal health, at least at the level of exposure to infection. Once one understands the issue, they become more aware and willing to change their behavior".
Finally, Dr. Levine concludes, "Whilst we believe in creating a personal tool that influences and affects individual behavior, a very important part of the change is to increase air pollution awareness amongst the general public. This awareness will lead to significant steps in proper planning of land use, use of public transport, reducing car usage and reducing coal usage in power plants etc. These measures will have an impact on air pollution reduction itself and ultimately impact on reducing our exposure to it. "
The total results were presented at the "Health and Environment Developments and Innovations" conference that took place in Tel Aviv on April 11th, 2016.