Laying the Foundation for Building a Resilient KPNC Community in the Face of Worsening Air Quality Due to Wildfire Smoke

Inclusion Criteria: * KPNC patients * enrolled in Care Plus * non-smoking * oxygen-dependent * adults aged ≥65 years old * have had membership for at least 1 year prior to data extraction not counting \</=3mo gaps) * have known COPD (at least 2 encounters with COPD ICD codes over a 3 year period in the 10 years prior to data extraction using the following ICD codes: ICD-9 491.21, 491.22, 491.8, 491.9, 492.8, 493.2, 493.21, 493.22, 496 and ICD-10 J44.1, J44.0, J41.8, J44.9, J42)15 * have picked up at least 1 controller inhaler at the pharmacy within 1 year prior to data extraction * at least 2 exacerbations of COPD treated in any setting (outpatient or acute care) within 1 year before to data extraction. Exclusion Criteria: * with \<1 year of continuous membership prior to the date they entered the cohort, allowing for 3-month, non-contiguous gaps * any diagnosis with any of the past or present problems: blindness, dementia, deaf or hearing impaired, hospice admission, "tracheostomy" procedure code or problems and/or attached to a ventilator * hearing, visually, physically, memory, and/or speech impaired * those on the "Do Not Call" list * non-English speakers.