| dc.description.abstract | Air pollution is a common irritant trigger for asthma exacerbations. Self-management is pivotal in asthma treatment and encompasses symptom tracking, trigger awareness, medication adherence, and seeking healthcare when exacerbation risks rise. Broadly, health-seeking behaviors denote efforts to access health-related knowledge and resources to enhance health status. This retrospective study assessed the connection between health-seeking behavior and air quality, employing the frequency of patient portal messages sent from patients to physicians to gauge health-seeking behavior. Furthermore, we examined the patient message content during periods of elevated air pollution exposure. Subjects included all adult asthmatic patients who visited a Vanderbilt University Medical Center (VUMC) clinic after January 1, 2018. VUMC is a quaternary academic medical center in Nashville, Tennessee. Patient messages were extracted from My Health at Vanderbilt, VUMC’s patient portal, spanning January 1, 2018, to July 1, 2022. From VUMC's electronic health records (EHR), we gathered demographic and medical data. The Environmental Protection Agency (EPA) provided us with Air Quality Index (AQI) data, which we aggregated based on county and date. We used Spearman’s correlation test to determine the relationship strength between aggregated message counts and air quality across three time spans: daily, weekly, and monthly. Finally, we categorized message content and performed a narrative review of messages sent specifically concerning respiratory symptoms and conditions. Spearman’s correlation coefficient between messages and AQI ranged from 0.32 to 0.41 for monthly data analyses, indicating moderate correlation. For daily and weekly data analyses, correlation coefficients were between 0.13 and 0.17, signifying weak correlation. All these tests yielded statistical significance (p < 0.05). Messages relating to respiratory symptoms or conditions constituted 7% of total messages, and environmental complaints were identified. Our findings reflect a relationship between asthma patient portal messaging and air quality, which was stronger in the monthly data analysis. In addition, we found that patients commonly communicated about environmental factors that contribute to air pollution. | |
