Abstract

A series of non-stratified focus groups (N = 4) with young people (N = 30) in North Macedonia explored attitudes related to pollution—a wicked problem tied to global health and particularly relevant to low- and middle-income countries. These qualitative data were analyzed through the framework of the transtheoretical model (TTM) of behavior change and revealed key insight into knowledge levels regarding the causes of pollution, what behaviors young people believed would reduce pollution, and what they believed to be personal barriers and motivators for engaging in those behaviors. Nine subthemes were identified, which may be categorized under four overarching themes: (1) Cultural Knowledge and Awareness, (2) Resource Barriers, (3) Beliefs Regarding Responsibility, and (4) Motivators: Working Together. In particular, as the young people discussed their motivations to make changes, they emphasized the idea of working together as organized citizen groups or informal collections of people helping create solutions to the pollution problem. Recommendations for intervention development, rooted in this insight and aligned with the theoretical foundations of the study, are proposed.