A Quantitative Study Investigating the Attitudes toward Protective Behaviors against Outdoor PM2.5 Air Pollution Among Adults Living in Nanjing City, China

High PM2.5-related mortality and morbidity has become a public health concern in China. To date, there have been few studies investigating individual implementation and use of protective behaviors to counter outdoor PM2.5 air pollution levels in China. This study, therefore, aimed to investigate adults’ attitudes toward evidence-based protective behaviors against outdoor PM2.5 air pollution, the results of which might inform health educators and health promotion specialists about what they should emphasize when educating communities about protective behaviors in the PM2.5 air pollution days. Utilizing the purposing sampling method, a WeChat-based survey was conducted among 300 adult participants living in B residential area in Yuhuatai district of Nanjing, which is a representative city of high urbanization level and PM2.5 air pollution in China. The survey included total 16 items assessing participants’ background information, attitudes toward four evidence-based protective behaviors against PM2.5 air pollution, and knowledge regarding possibly effective protective approaches specifically related to Chinese medicine in the PM2.5 air pollution. The results showed that the importance adults in Nanjing attached to wearing N95 respirator when walking outside, putting air filter (HEPA) at home, and avoiding unprotected outdoor sports activities in the PM2.5 air pollution was greater than closing all the doors, windows, and many openings in the PM2.5 air pollution. Regarding comparison of attitudes between pre- and post-controlled COVID-19 periods, the value adults gave to closing all the doors, windows, and many openings in the PM2.5 air pollution was higher during pre-COVID-19 period, whereas the opposite of circumstance took place when referring to other three protective behaviors. Regarding comparison of attitudes between biographic variables, adults aged 18-50 (including 50) attached greater importance to all the four protective behaviors than those aged 50+. In addition, adults having the habit of checking daily AQI ranked the behaviors of avoiding outdoor sports activities and wearing N95 respirator when walking outside in the PM2.5 air pollution in a higher position than those not. Implications for future research and practice are discussed, based on a critique of the present work.