Air pollution awareness among the population and the role of nurses in primary healthcare: a mixed-methods study in Almaty city, Kazakhstan

Abstract

Background

Air pollution is a crucial public health issue that should be prioritized to support Sustainable development goals and Universal health coverage. The aim is to study the awareness of the population on the influence of the air pollution to their health.

Methods

Cross-sectional study was conducted in 2024. A questionnaire developed in Kazakh and Russian languages, which was disseminated with the support of the Almaty city Health Department. The respondents’ answers were divided into five age groups to determine which groups is most informed about the influence of the air pollution to their health. The chi-squared test was used for categorical data. A qualitative study was conducted in 2024–2025 among 24 nurses from all eight districts of Almaty, on focusing their awareness of health policies, current practices, and training needs related to air pollution and public health education. Interviews were analyzed thematically using a structured matrix to identify key challenges, contextual factors, and actionable recommendations, with three researchers independently coding and validating the findings.

Results

1195 conducted survey, where the largest number were female, and graduated universities. The awareness of air pollution increases with age, with older individuals being more informed about indoor pollution whereas younger population outdoor. Younger groups prefer seeking information via social media and scientific articles, while older groups (> 50) prefer traditional methods. The findings reveal that while nurses recognize the importance of educating patients about air pollution, they face significant challenges due to limited training, lack of formal programs, and absence of ready-to-use educational materials.

Conclusion

Primary healthcare professionals should combine digital and traditional methods to effectively engage all age groups with tailored information on air pollution and health. Given the population’s willingness to adopt climate-related behavior changes, there is a clear need for practical training and guidelines to support nurses in delivering targeted, preventive education and improving public responsiveness to environmental health risks.