Pilot study of a community-based PM2.5 educational intervention: impacts on behavior, exposure, and pulmonary function

Particulate matter (PM) is a recognized Group 1 carcinogen and is also associated with adverse cardiopulmonary and neurological outcomes. However, community-based strategies to reduce exposure among vulnerable populations remain limited in Korea. This pilot study evaluated the feasibility and effectiveness of a structured, nurse-delivered educational intervention to improve protective behaviors, reduce indoor PM2.5, and enhance pulmonary function among older adults. A cluster non-randomized controlled trial, involving 59 participants (intervention group, n = 30; control group, n = 29; aged ≥ 65 years), was conducted within the Municipal Home Visit Health Management Program in Incheon, South Korea. The intervention group received a standardized education module based on the Health Belief Model, practical training, and text message alerts, whereas the controls received usual care. Outcomes, including awareness, protective behaviors, indoor air quality (continuous PM monitoring), and spirometry parameters, were measured at baseline and at 6 weeks. The intervention group showed significant improvements in predicted FEV1% (84.6 ± 26.2 to 95.8 ± 23.6, p = 0.008) and FEV6% (77.2 ± 23.0 to 88.9 ± 21.2, p = 0.012). Indoor PM2.5 concentrations during the final week of monitoring were lower in the intervention group than in controls (11.1 ± 5.7 µg/m3 vs. 19.6 ± 15.8 µg/m3; p = 0.010), with a significantly lower exceedance rate (1.63 vs. 8.91 events, p = 0.042). Behavioral outcomes improved more in the intervention group, although most differences were not statistically significant. In this 6-week pilot trial, a brief community-based educational intervention integrated into routine home-visit nursing services was feasible, well-received, and associated with short-term improvements in indoor air quality and selected pulmonary function indices among older adults. These preliminary findings warrant confirmation in larger and longer trials before scalable participatory education programs can be recommended for sustained reduction of PM2.5-related health risks. Clinical Research Information Service (CRIS) KCT0009917, Registered 8 November 2024.