Grantee Research Project Results

Final Report: Participatory Design of Effective Risk Communication about Wildfire Smoke for Hard-to-Reach Populations.

EPA Grant Number: R840239
Title: Participatory Design of Effective Risk Communication about Wildfire Smoke for Hard-to-Reach Populations.
Investigators: Neuhauser, Linda , Ivey, Susan L , Su, Jason
Institution: University of California - Berkeley
EPA Project Officer: Chung, Serena
Project Period: September 1, 2021 through February 29, 2024 (Extended to February 28, 2025)
Project Amount: $988,740
RFA: Interventions and Communication Strategies to Reduce Health Risks of Wildland Fire Smoke Exposures (2021) RFA Text |  Recipients Lists
Research Category: Air Quality and Air Toxics , Wildfires

Objective:

The objective of this research was to address gaps in risk communication for hard-to-reach and at-risk populations. This objective was accomplished by the following aims: 1) Created new, more precise modeling of CA wildfire smoke risk data; 2) Conducted needs assessment of wildfire smoke risk communication; 3) Used participatory design to develop/revise risk communications and dissemination strategies for hard-to-reach populations; and 4) Tested effectiveness of new/revised risk communications and dissemination strategies.

The results of this Year 4 (and final) report activities are expected to improve California’s risk assessment and risk management capabilities related to wildfire smoke exposure. Dissemination of these results could improve risk assessment and management capability in other U.S. states.

Summary/Accomplishments (Outputs/Outcomes):

Aim 1. This objective was intended to create more accurate estimates of wildfire smoke exposure, especially in areas without high-accuracy air quality monitors. The Health Research for Action (HRA) Center has utilized the Stochastic Time-Inverted Lagrangian Transport (STILT) modeling framework to estimate PM2.5 concentrations across California communities. This approach tracks theoretical particles backward in time from a specified receptor location and time, using meteorological wind fields and velocities to identify upstream influence areas (footprints) and estimate wildfire pollutant concentrations. In Year 2, HRA secured funding from Oracle to establish a cloud-based modeling platform. This enabled the development of highresolution wildfire PM2.5 dispersion and exposure models for vulnerable populations in California, including the Hmong community, agricultural workers in Fresno, the Yurok Tribe, and the Deaf and Hard-of-Hearing community in Alameda County. These efforts aimed to characterize exposure levels in at-risk communities lacking access to regulatory air quality monitors. In Year 3, we refined the STILT model by calibrating it with data from government regulatory monitors, which measured wildfire smoke concentrations simultaneously with our modeled estimates. A manuscript describing the methodology and findings was submitted to a selected peer-reviewed journal. The manuscript is currently undergoing revisions and will be submitted to a peer-reviewed journal in 2025. This research highlights the utility of STILT and similar dispersion models in identifying high-risk populations, informing public health strategies, and guiding policy interventions to mitigate wildfire smoke–related health risks.

Aim 3. HRA assembled a stakeholder advisory committee (SAC) in Year 1. The SAC continued meeting in Year 2 regarding communication needs of their respective communities related to wildfire smoke and undertook project activities to co-develop improved communications for each community (Appendix A). A partner from the Yurok Tribal Nation joined the SAC in Year 2 and advised us on needs of that tribe related to wildfire smoke exposure and recommended ways to get out information about prescribed burns/“cultural burning” to a broader audience. In Year 3, we continued to meet with stakeholders on specific project deliverables. We met with The Fresno Center to discuss the Hmong brochure-magnet materials, with Hmong Cultural Center of Butte County (HCCBC) to review the brochure-magnet materials (in Hmong) and the wildfire smoke risk communication video with community members and worked with stakeholders from Deaf/Hard-of-Hearing communities to discuss survey results and future directions.

In Years 1 and 2, HRA and design firm IDEO developed and held an in-person design thinking workshop (September 2022) to brainstorm ways to educate their respective communities about the health hazards of wildfire smoke and apply the design thinking process to generate ideas for educational materials and their dissemination. We also presented a continuing medical education (CME) workshop on health effects of wildfire smoke with a focus on cardiovascular and pulmonary impact to a statewide collaborative, the Right Care Initiative, in Year 1 including pre-post knowledge surveys, showing positive results. In Year 2, we disseminated a video of the Year 1 CME webinar about the health impacts of wildfire smoke and ways to counsel patients to reduce their exposure to a statewide network of health professionals (physicians, pharmacists, quality improvement personnel from healthcare organizations, and public health departments). See Year 2 report appendices for copies of the survey results and link to the webinar video.

Ideas generated during the design thinking workshop and subsequent meetings with community representatives led to the creation of several communications materials in Year 2 and Year 3. These resources included: an easy-to-read leaflet in English about how best to manage breathing problems (including for people with asthma) when wildfire smoke is present; a brochure in the Hmong language about checking air quality which includes a refrigerator magnet containing a QR code for the AirNow website; an animated video in the Hmong language about how to avoid wildfire smoke; and a chapter about wildfire smoke safety in the widely distributed First 5 CA Parent Guide (English/Spanish). Each of these materials has been tested by members of its intended audience to ensure their suitability and ease of use.

Beginning in Year 2 and through Year 3, we engaged in an activity not previously proposed in the project plan. Based on the priority identified by our Deaf and Hard-of-Hearing partners during and after the design thinking workshop, we created and conducted a statewide survey with county and city Offices of Emergency Services (OES) regarding the accessibility of emergency information about wildfire smoke. This activity was also a response to a new state law (AB 619) enacted after the start of this Project in Year 1. AB 619 requires that the California Department of Public Health develop an Air Quality Health Plan with guidance to the 58 counties about how to reduce exposure to wildfire smoke and other air pollutants. The counties must then create their own air quality plans and report that information to the state. Because the state did not have needed information about the county and city-level accessibility of emergency air quality communication, we decided to fill that gap with a survey of city and county-level OES regarding the accessibility of their emergency communications to the public. We drafted the survey with the participation of our Deaf-and Hard-of-Hearing partners/stakeholders and relevant state officials. We analyzed survey responses in Year 3 and shared the findings with our Deaf and Hard-of-Hearing partners for their interpretation.

Results showed that rural OES were much less likely than urban OES to provide emergency communications accessible to people with disabilities, including Deaf and Hard of Hearing residents, due to capacity and resource barriers. For example, rural OES were less likely to provide communications using American Sign Language. In Year 4, we submitted a manuscript entitled “Mapping the Urban and Rural Divide in Deaf & Disability-Accessible Climate Risk Communication Methods in California’s Offices of Emergency Services” about this survey study to Journal of Contingencies and Crisis Management and acceptance is expected soon. We have shared the study results with our disability stakeholder partners, other partner stakeholder groups, and with the California Department of Public Health staff to incorporate into their development of the state Air Quality Health Plan.

In Year 3, HRA printed 5,500 copies of the “How’s the Air” Hmong-language brochure and magnet. Five thousand of those were sent to The Fresno Center, a non-profit serving mainly farmworkers from Hmong and Spanish-speaking communities. They have been distributing them at center and community events. The remaining five hundred were sent to the Hmong Cultural Center of Butte County (HCCBC), which distributed them to community members at its center and local Hmong events. HRA also worked with the HCCBC to develop a content strategy for its Hmong-language motion graphics video, “Staying Safe from Wildfire Smoke.” HRA suggested that the HCCBC decide upon an online location for the video and use their social media channels to raise awareness of the video and wildfire issues. We also helped them optimize the video for search using search engine optimization (SEO). The video is now hosted on HCCBC’s YouTube page and has been shared on several social media channels. The Wildfire Smoke and Chronic Breathing Problems leaflet, which was developed in English, has been distributed to a number of organizations for wider dissemination. These organizations are: statewide California Breathing, the Alameda County Public Health Department, and Carbon Health Clinics.

Aim 2. As part of the needs assessment of wildfire smoke communications, HRA previously completed an environmental scan of 19 key wildfire smoke communication resources developed by local, state, and federal public health organizations that are relevant for Californians. (See Year 1 and Year 2 Reports). In Year 1, HRA conducted a scoping review of peer-reviewed literature for publications on materials or programs used to reach lay audiences with messages/risk communications about wildfire smoke and identified a large gap in published literature about wildfire smoke risk communications created with and for vulnerable populations. In Year 2, HRA published a review article about these findings (“Publications” section below).

Aim 4. In Year 3, we began process and qualitative evaluation activities with our Hmong partners to explore distribution processes and reactions from their Hmong-speaking audiences. Results showed that Hmong partners appreciated the intensive participatory process used and the quality of the resulting communications which have been widely disseminated. In addition, we completed the OES survey and shared the findings with our collaborators in the Deaf and Hard-of-Hearing communities and with the CA Department of Public Health. The results are being used to inform the state’s Air Quality Health Plan. The above evaluative activities continued until the end of this project on February 28, 2025.

Project Lessions Learned:

Key lessons learned in this project were:

• More precise modelling of wildfire smoke exposure is needed. The STILT model created in this project helps fill that gap.
• There are major gaps in providing risk communication about wildfire smoke exposure that is aligned with the literacy, language, culture and access and function needs of populations.
• Selecting and using intensive participatory design with representatives of intended audiences is critical to creating and disseminating understandable and actionable communications.
• Flexibility is needed to adjust the original proposed project plan as feasible technological modeling procedures and audience communication needs become better understood during participatory design and testing phases progress.

Publications/Presentations

For this Project, we had proposed completing two manuscripts. We decided to add one more as
listed here:

1. We published an article on the Year 1 literature review. We submitted the manuscript in September 2023, and it was published in Year 3 (January 2024). Cite as follows: Vien, M.H., Ivey, S.L., Boyden, H., Holm, S., Neuhauser, L. A scoping review of wildfire smoke risk communications: issues, gaps, and recommendations. BMC Public Health 24, 312 (2024). https://doi.org/10.1186/s12889-024-17681-0.

2. We completed a manuscript on STILT modeling: Sage, E. V., Su, J., Vien, M. H., Remais, J. V., Ivey, S. L., Hostler, J., Neuhauser, L. Assessing wildfire smoke exposure for vulnerable communities in California using an advanced wildfire smoke dispersion modeling technique. (2024). (Undergoing Revision).

3. We submitted the following manuscript about the OES survey, made final revisions and expect acceptance soon: Engelman, A., Lin, C., Vien, M., Ivey, S., Farinha, S., Neuhauser, L. Mapping the Urban and Rural Divide in Deaf & Disability-Accessible Climate Risk Communication Methods in California’s Offices of Emergency Services. Journal of Contingencies and Crisis Management (2025). (Under review).

Future Activities
Aim 1. Submit and publish revised manuscript on STILT modeling. Explore ways to incorporate this model into other wildfire smoke exposure work.

Aims 3 and 4: Continue to explore ways to expand the dissemination of the communication materials to other relevant stakeholder groups beyond our current partners, such as with public health departments, and other community and healthcare organizations on communication needs. Continue our work with the CA Department of Public Health to interpret and integrate the findings of our statewide survey on accessibility of emergency communication into their statewide Air Quality Health Plan.

Journal Articles on this Report : 2 Displayed | Download in RIS Format

Publications Views

Other project views:	All 4 publications	2 publications in selected types	All 2 journal articles

Publications

Type	Citation	Project	Document Sources
Journal Article	Engelman A, Lin C, Vien M, Ivey SL, Farinha S, Neuhauser L. Mapping the urban and rural divide in deaf & disability-accessible climate risk communication methods in California's Offices of Emergency Services. Journal of Contingencies and Crisis Management. 2025;33(3):e70073.	R840239 (Final)	Abstract: Wiley Abstract HTML Exit
Journal Article	Vien MH, Ivey SL, Boyden H, Holm S, Neuhauser L. A scoping review of wildfire smoke risk communications:issues, gaps, and recommendations. BMC Public Health. 2024;24(1):312.	R840239 (2024) R840239 (Final)	Full-text: Springer Nature - Full text HTML Exit

Supplemental Keywords:

Community-based, smoke exposure, air quality, risk management, emergency preparedness, environmental justice

Relevant Websites:

We have posted information about the project on our Health Research for Action website. See: Wildfire Smoke Communications - Health Research for Action Exit . We will continue to disseminate information from the project to organizations who may be interested in posting materials on their websites.

Progress and Final Reports:

Original Abstract

2022 Progress Report

2023 Progress Report

2024 Progress Report