Heat Waves and Climate Change: Applying the Health Belief Model to Identify Predictors of Risk Perception and Adaptive Behaviours in Adelaide, Australia

Abstract

Heat waves are considered a health risk and they are likely to increase in frequency, intensity and duration as a consequence of climate change. The effects of heat waves on human health could be reduced if individuals recognise the risks and adopt healthy behaviours during a heat wave. The purpose of this study was to determine the predictors of risk perception using a heat wave scenario and identify the constructs of the health belief model that could predict adaptive behaviours during a heat wave. A cross-sectional study was conducted during the summer of 2012 among a sample of persons aged between 30 to 69 years in Adelaide. Participants’ perceptions were assessed using the health belief model as a conceptual frame. Their knowledge about heat waves and adaptive behaviours during heat waves was also assessed. Logistic regression analyses were performed to determine the predictors of risk perception to a heat wave scenario and adaptive behaviours during a heat wave. Of the 267 participants, about half (50.9%) had a high risk perception to heat waves while 82.8% had good adaptive behaviours during a heat wave. Multivariate models found that age was a significant predictor of risk perception. In addition, participants who were married (OR = 0.21; 95% CI, 0.07–0.62), who earned a gross annual household income of ≥$60,000 (OR = 0.41; 95% CI, 0.17–0.94) and without a fan (OR = 0.29; 95% CI, 0.11–0.79) were less likely to have a high risk perception to heat waves. Those who were living with others (OR = 2.87; 95% CI, 1.19–6.90) were more likely to have a high risk perception to heat waves. On the other hand, participants with a high perceived benefit (OR = 2.14; 95% CI, 1.00–4.58), a high “cues to action” (OR = 3.71; 95% CI, 1.63–8.43), who had additional training or education after high school (OR = 2.65; 95% CI, 1.25–5.58) and who earned a gross annual household income of ≥$60,000 (OR = 2.66; 95% CI, 1.07–6.56) were more likely to have good adaptive behaviours during a heat wave. The health belief model could be useful to guide the design and implementation of interventions to promote adaptive behaviours during heat waves.

An adaptation index to high summer heat associated with adverse health impacts in deprived neighborhoods

“…Finally, when considered as a passive variable, air conditioning is only weakly associated with the heat adaptation index. A similar conclusion has also been recently reported by an Australian study (Akompab et al 2013), in which air conditioning in the home did not influence the total scores allocated to various adaptive behaviors to heat.…”

“…Consequently, not being compelled to go out cannot be the only hypothesis explaining the age differences observed. The Australian study (Akompab et al 2013) is informative in this regard. Two psychosocial determinants of the Health Belief Model (HBM) have been associated with the total scores allocated to various adaptive behaviors to heat, namely a greater perception of the benefits to their health and knowing the signs that action should be taken.…”

Managing health impacts of heat in South East Queensland, Australia

“…Literature reveals that there is great variability across groups at risk, that poor understandings of community-related factors can constrain the effectiveness of heatwave management plans, and that better understanding of perceptions of risk and barriers to behavioral change enables tailored health protection measures. 15,18,22,24,30,31,46 Following this evidence from the literature, heatwave management in SEQ could benefit from greater engagement with vulnerable groups to increase understanding of perceptions of risk and barriers to behavioral change, and tailor heatwave management accordingly.…”

“…15,19,29 Additionally, perceptions of heatwave risks often differ across policy makers and cultural and demographic groups. 22,30 Those that are more vulnerable or at risk might not necessarily see themselves as such. 31 As a result, developments in heatwave management have pointed to benefits of engaging with vulnerable groups and/or communities on a local level to better understand their perceptions of risk and tailor health protection measures.…”

“…In comparison, Australians may exhibit a number of adaptive behaviors during a heatwave such as drinking plenty of water, listening to daily weather forecasts, wearing a hat when going outside, seeking protection of shady areas when outdoors, and/or going for a swim or to an air-conditioned places to cool down. 30 Although SEQ residents are accustomed to its subtropical climate and warm temperatures, there remains significant health risks associated with heat, particularly for vulnerable groups. 21,[36][37][38] For example, heatwaves and increased ambient heat in Brisbane, the largest city in SEQ, have been found to have acute effects on morbidity, mortality, emergency hospital admissions and emergency ambulance calls, particularly for elderly people.…”