Experiences with household mold and perceptions of microbiome engineering to mitigate mold.

Background: Mold, biologically defined as fungal mold, is frequently identified as a household concern, especially in humid and coastal regions where conditions favor growth. Yet, the ways residents recognize, experience, and manage mold in their daily lives remain understudied. In recent years, emerging mold-control strategies, such as microbiome-engineering technologies, are increasing in application and attracting the interest of homeowners. However, these technologies raise important questions about community perceptions, trust, and acceptance. Understanding how people navigate everyday mold management and views on novel interventions is essential for guiding effective, market-relevant, socially-responsive solutions. Methods: This qualitative study draws on 22 interviews with residents of eastern North Carolina, an area with climate conditions that favor fungal molds. Using the Health Belief Model (HBM) as a framework, we explored participants' conceptualizations of mold, perceived health and structural impacts, prevention strategies, and views on microbiome-engineering remediation technologies. Results: Residents understood mold in diverse ways, as a fungus, a dampness-driven growth, and a sensory presence tied to smell and sight. Mold was linked to respiratory illness, systemic health effects, property damage, and financial burdens. Participants employed layered strategies such as ventilation, dehumidification, cleaning, and occasional professional remediation, though cost, trust, and perceived effectiveness of these strategies remained barriers. Analysis through the HBM revealed high perceived severity of the mold problem and related health illness but underestimation of susceptibility due to reliance on visible cues. Reactions to microbiome-engineered tools showed cautious interest: while residents acknowledged potential benefits, they expressed concerns about unintended consequences, invisibility, and loss of control. Conditional acceptance was contingent on rigorous testing, transparent regulation, and proven safety and efficacy. Conclusion: Mold is experienced by Eastern NC residents not only as a biological contaminant but as a lived, socio-environmental challenge shaped by health, housing, and financial vulnerabilities. Participants in this study indicated serious health concerns related to mold, including after specific events such as large storms and flooding. Acceptance of microbiome-engineering solutions will depend on building trust, addressing equity, and ensuring accessibility. By bridging environmental science, social science, and residents' lived experiences, policies and technologies can more effectively strengthen resilience against one of the most persistent risks in the built environment.