Impacts of social and environmental perceptions on preparedness and knowledge of air pollution risk: A study of adolescent males in an urbanized, high-density city

•Socio-environmental perceptions modified awareness among adolescent males.•Perceptions impacted overall preparedness but not overall knowledge.•Complex mechanism between specific items of perception, preparedness, and knowledge.•Adolescents with perceivably low environmental knowledge should be targeted. Adolescent males are often considered as less medically vulnerable, resulting in less community healthcare but stronger influences of environmental awareness (preparedness and knowledge) on self-preventive strategies of air pollution risk. However, socio-environmental experiences can alter subjective understandings of the environment, thereby modifying their environmental awareness. A two-stage analysis was applied to evaluate the impacts of socio-environmental perceptions on the preparedness and knowledge of air pollution risk among 551 adolescent males. In the first stage, we evaluated the impacts on the overall preparedness and knowledge with Gaussian regressions, and in the second stage, we evaluated specific preparedness and knowledge with binomial regressions. First-stage analyses showed that socio-environmental perceptions impacted overall preparedness but not overall knowledge. Particularly, perceivably low environmental knowledge of oneself negatively influenced overall preparedness, and a perceivably large household positively influenced overall preparedness. The second-stage analyses further implied a complex mechanism between perception, preparedness, and knowledge. Specifically, poor outdoor air quality surrounding the home and perceivably low environmental knowledge of oneself negatively influenced specific preparedness for caring for family members. Perceivably low environmental knowledge of oneself also negatively influenced preparedness for outdoor air pollution and knowledge of visibility, wearing masks, cardiovascular diseases, and mortality risk. Poor indoor environment negatively influenced preparedness of wearing a mask. However, participating in few sports activities negatively influenced preparedness for wearing mask, and knowledge of wearing masks, greenhouse gases, and tropospheric ozone, but positively influenced preparedness for outdoor activities during hazy days. Perceivably low school grade positively influenced knowledge of tropospheric ozone. Perceivably low environmental knowledge of the parents and a large household also positively influenced specific preparedness. Poor indoor air quality at home positively influenced kn