Wildfire Smoke Exposure During Pregnancy: Consensus-Building to Co-Create a Community-Engaged Study.

Relative to other Oregon counties, Klamath County experiences worse air quality due to wildfire smoke, as well as elevated rates of infant mortality and low birthweight. Klamath County Public Health (KCPH) raised concerns that wildfire smoke is a contributor to poor infant health. Thus, we built a multidisciplinary team and designed a community-engaged research (CEnR) project to capture community and individual-level exposure to wildfire smoke contaminants, alongside perinatal health outcomes. Through partnerships, we identified 24 individuals across academic, public health, and community organizations that met five times over three months to develop a study design. We initially used a modified Delphi method, but adjusted our approach to find multidisciplinary areas of agreement across a highly diverse team. Our team used structured meetings, surveys, and iterative feedback to build consensus on a study design. KCPH and our community partners reviewed and approved all proposed activities to ensure community input was integrated. The resultant study, trialed in Klamath County, included the use of environmental, residential, and personal samplers and health surveys with a cohort of pregnant individuals during the wildfire season. We discuss the advantages and challenges of building a multidisciplinary CEnR study in a rural county disproportionately impacted by wildfire smoke and infant mortality.