Knowledge, awareness, and practice (KAP) of Thai paediatricians in their child advocacy role regarding the health effects of particulate matter on children

• Thai pediatricians have high PM 2.5 knowledge but lack insights on some effects. • Public confidence in PM 2.5 issues is low among Thai pediatricians. • Training is needed to improve pediatricians’ public communication on PM 2.5 . • Pediatricians advocate for PM 2.5 action through awareness, guidelines, and collaboration. The impact of fine particulate matter (PM 2.5 ) airway pollution is common in many large cities globally but is particularly prevalent in Asia. Paediatricians have been involved in a front role of child advocacy, but little is known about the knowledge, awareness, and practice (KAP) of PM 2.5 among them. This survey assessed the KAP of PM 2.5 among Thai paediatricians and explored links to improve PM 2.5 health protection in children. The electronic questionnaire was given to paediatricians across various regions of Thailand. Out of 400 respondents, 399 participated. Results showed high self-evaluated knowledge of PM, PM 10 and PM 2.5 . Recognition of PM 2.5 impact on children's health, such as asthma, sinusitis, and recurrent infections, was notable. Less understood were the effects of abortion, congenital anomalies, and obesity. Over 90% agreed their communities faced PM 2.5 problems and advocating for PM 2.5 protection was a paediatrician's role, but 55% felt confident in community communication about PM 2.5 . Based on the recommendations of the Royal College of Paediatricians of Thailand (RCPT), the practice score indicated that 94% could advise on PM 2.5 prevention. Knowledge, awareness, and practice related to PM 2.5 issues were associated with each other. Age, subspecialty graduation, advocacy role agreement, and awareness of PM 2.5 in their community were also linked to confidence in public communication with PM 2.5 issues. In conclusion, associations between knowledge, awareness, and practice related to PM 2.5 were observed among Thai paediatricians. While awareness and general knowledge were high, confidence in community communication was relatively low. Recommendations include improving public communication skills and providing environmental health learning opportunities during training and continuing education.