# Promoting Risk Reduction Among Young Adults with Asthma During Wildfire Smoke Events

> **NIH NIH R21** · WASHINGTON STATE UNIVERSITY · 2020 · $229,482

## Abstract

Project Summary
Exposure to unprecedented levels of wildfire smoke is increasing cardiopulmonary mortality and is especially
catastrophic in people with asthma. Little evidence exists on the effectiveness of air quality (AQ) alerts on
objective measures of risk reduction behavior and health outcomes. Evidence shows that young adults are less
likely to adhere to AQ alerts than older adults, yet young adulthood is a time when habits are formed in chronic
illness management. The Environmental Protection Agency's (EPA) Smoke Sense smart phone application
(app) is an innovative risk reduction intervention based on the health belief model and theory of planned
behavior. The app invites users to record their smoke observations and health symptoms, play educational
trivia games, earn badges, and explore what other users are reporting. Smoke Sense connects AQ exposure
data with users' symptoms, thus framing risk reduction messages as personally relevant. Although Smoke
Sense has almost 25,000 users, its impact on health outcomes has not been tested. Preliminary data suggests
that users' engagement in health protective behaviors was driven in response to symptoms rather than as
preventive courses of action. In a high-risk asthma population, prevention is paramount. Smoke Sense Plus is
an intervention that builds on the Smoke Sense app, with value-added activities, such as notifying participants
to review their asthma action plan, monitoring lung function weekly via mobile spirometry and subscribing to a
social network to share strategies to minimize exposure. The purpose of this study is to assess the feasibility of
the Smoke Sense interventions among young adults with asthma and pilot test the interventions compared to a
control group. Sixty young adults aged 18-26 with asthma will be recruited through local universities. They will
be randomized to 1 of 3 groups for a 3-month study period during wildfire season. Study aims are to:
 1) Establish the feasibility (recruitment, enrollment, retention rates), acceptability (intervention
engagement, fidelity, usability, attitude) and barriers and facilitators of adopting the technology of the Smoke
Sense interventions and use of portable devices in young adults with asthma;51
 2) Explore the preliminary impact of the Smoke Sense interventions on lung function,20 asthma control,21
and asthma quality of life.22 These primary outcomes will be assessed using objective measures (spirometry)
and validated, self-report tools. Secondary outcomes will be anxiety,23 exposure reduction behaviors (e.g. stayed
indoors, wore a mask),24 and symptom mitigating behaviors (use of medication, unscheduled health care
appointments), measured via self-report and a Global Positioning System device. Outcome by group will be
summarized. Preliminary evidence of treatment effect and its variance will be examined for a future clinical trial;
 3) Explore potential mediators (medication adherence, self-management skills, stress) and moderato...

## Key facts

- **NIH application ID:** 9950673
- **Project number:** 1R21NR019071-01
- **Recipient organization:** WASHINGTON STATE UNIVERSITY
- **Principal Investigator:** Julie M Postma
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $229,482
- **Award type:** 1
- **Project period:** 2020-04-15 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9950673

## Citation

> US National Institutes of Health, RePORTER application 9950673, Promoting Risk Reduction Among Young Adults with Asthma During Wildfire Smoke Events (1R21NR019071-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9950673. Licensed CC0.

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