Understanding COPD Patients' Perspectives on Utilizing Strategies to Limit Their Exposure to Wildfire Smoke.

Background: A translation gap exists in how patients with chronic obstructive pulmonary disease (COPD) utilize mitigation strategies to limit exposure to wildfire smoke. This study examines patients’ points of view about barriers and facilitators of strategy uptake. Methods: We performed semistructured, virtual interviews with members of Kaiser Permanente Northern California until thematic saturation. We recruited participants aged ≥65 in the lowest quartile of socioeconomic status because they are disproportionately exposed to air pollution with fewer resources to mitigate exposure. Qualitative analysis was performed using inductive and deductive approaches. Results: Of 90,696 adults, we interviewed 31 in January 2025. Participants were racially and ethnically diverse (19% Black, 10% Hispanic, 3% Native American, 68% non-Hispanic White), from 10 counties. Three major themes were: (1) patients tended to get wildfire and air quality information from internet and smartphone apps, not clinical encounters, but expressed openness to receiving information from clinicians, (2) there appeared to be modifiable barriers to uptake of mitigation strategies, such as education and supplying equipment (e.g., masks, air cleaners), and (3) patients preferred real-time alerts sent to their phones from trusted sources, such as health care entities, to change their behavior during periods of poor air quality. Conclusion: By understanding patients’ perspectives about their relationship with wildfire smoke, we gained practical information to begin designing interventions to protect patients’ health during periods of poor air quality.