Development and pilot of the BC Wildfire Smoke and Extreme Heat Action Plan: empowering patients with climate health readiness.

Globally, wildfire smoke and extreme heat events are increasing in frequency and intensity. Western Canada, including the Province of British Columbia (BC), is impacted annually by these events, resulting in the accelerated development of public health messaging and emergency preparedness. It is particularly important to reach, educate and empower individuals who are highly susceptible to climate events, such as those with respiratory diseases, through targeted communication strategies delivered by trusted sources. We aimed to develop an evidence-informed action plan (AP) tool and pilot integration into clinical encounters with patients living with asthma and chronic obstructive pulmonary disease (COPD).The project team developed a draft tool-a BC Wildfire Smoke and Extreme Heat AP document inspired by the concept of an Asthma AP-along with a guide to support healthcare providers in addressing questions during patient counselling sessions. Iterative feedback from trained patient partners, clinicians and knowledge translation specialists was incorporated to refine messaging and delivery. Use of the tool was piloted in clinical encounters between certified respiratory educators (CREs) and patients living with asthma and COPD in two regional health authorities. Additional process and content feedback was gathered via questionnaires and focus groups.Patients (project participants) reported that AP tool use increased their understanding and preparedness for wildfire smoke and extreme heat events. While the plan was positively received by providers in a CRE role, time constraints and staffing capacity were highlighted as barriers to implementation. Suggested improvements included strengthened public awareness, preseason deployment and enhancement of content and delivery. Additional quality improvement cycles are needed to increase readability, accessibility and actionability.