Table 2 Results of reviews, survey studies qualitative interview studies and economic analysis
From: Is planned adaptation to heat reducing heat-related mortality and illness? A systematic review
Reference | Type of evaluation | Methods | Results |
|---|---|---|---|
Mattern et al. 2000 [62] | Case-only survey | Standardized questionnaire | 34 respondents. At pretest 67% of respondents knew whom to contact during heat for assistance, post-intervention 94% knew whom to contact. 6% knew about the City of Philadelphia hotline at pretest, 29% at post-test. 76% monitored temperature daily, 21% monitored temperature during hot days |
Ebi et al. 2004 [61] | Economic cost-effectiveness evaluation | Multiple linear regression, estimation of lives saved, estimation of benefits | 2.6 lives saved on average for each warning day plus three day lag (not significant). Estimated value of $6.12mill. per life = $468 mill. saved with 117 lives saved over 3 years. Costs for system $210.000 |
Kishonti et al. 2006 [54] | State of knowledge on heat, the warning system, protective behavior | Quantitative telephone survey | Sample size 2500. Awareness of heat: persons between 30 and 59Â years of age mentioned at least two health impacts of heat. 27% of respondents saw hypertension as risk, 11% heat stroke, 22% CVD. 25% of interviewees had seen the communication campaign, of whom 78% saw it on TV, 57% in the newspaper and 41% on the street. 59% of respondents had heard of heat alarm |
Bouchama et al. 2007 [74] | Systematic review and meta-analysis on risk and protective factors for heat-related deaths | Systematic review and meta-analysis | Protective factors: home air condition (OR 0.23 95% CI 0.1-0.6), visiting cool environments (OR 0.34 95% CI 0.2-0.5), increased social contact (OR 0.40 95% CI 0.2-0.8), taking extra showers (OR 0.32, 95% CI 01.-1.1), use of fans (OR 0.60 95% CI 0.4-1.1) |
Kalkstein and Sheridan 2007 [34] | State of knowledge on heat, the warning system, protective behavior | Quantitative survey | 201 respondents, 14 of age 65+. 90.2% of females knew about the heat warning system, 75.3% of males knew about the system. 25% felt heat was dangerous. Of those aware of heat warnings, 49.7% altered behavior, 47.3% did not |
Sheridan 2007 [66] | State of knowledge on heat, protective behavior, available cooling systems in the house | Quantitative telephone survey | 908 respondents across all cities. In the four cities, most people learned about heat warnings on television (Dayton: 89%, Philadelphia: 84%, Phoenix: 92%, Toronto: 64%). 46% of respondents altered their behavior during heat, varying significantly across cities (p = 0.003). Use of air conditioning self-restricted due to concerns about costs |
Abrahamson et al. 2009 [35] | State of knowledge on heat-related health risks and protective behavior | Semi-structured interviews with topic guide, 1 data collection wave summer of 2007 | 73 respondents, mean age 81 years (range 72–90) in London; mean age 80 (range 75 to 94) in Norwich. Themes identified: perception of vulnerability to heat; behavior change during heat; knowledge of protection measures; perception of usefulness of heat wave plan. No consensus on usefulness of heat wave plan components. Most respondents adjust their behavior during heat. Few respondents perceived of themselves at risk |
Kosatsky et al. 2009 [71] | State of knowledge on heat, protective behavior | Quantitative, questionnaire based face-to-face interviews | 238 respondents. 86% know about risks of high night time temperature, 94% know about health risks for lung and heart disease patients. 80% listen to weather forecasts, mid-summer 93% had heard a heat advisory. 71% use a fan, 87% do less strenuous activities in heat. 73% have air condition at home, those with air condition reported more additional behavior changes than those without |
Bassil and Cole 2010 [73] | Systematic review of all study types | Systematic review and expert elicitation | Narrative results: most studies evaluate heat warning systems, awareness and perception. If effects measured then often as regression analysis. Methodological challenges |
Oakman et al. 2010 [72] | State of knowledge on heat, heat warnings, protective behavior | Quantitative telephone survey | 328 interviews, 63% knew of health warnings: of these 74% saw it on TV, 42% on radio, 15% in newspapers. 96.1% of respondents used air condition in hot weather, 94% drank water, 90% stayed indoors |
Bittner and Stößel 2012 [50] | State of knowledge on heat, protective behavior, heat warnings | Questionnaire-based interviews, qualitative analysis with framework approach | 20 respondents. Themes: vulnerability, changes in daily routine, sources of information, content of advice received, activity level and health status. Individual vulnerability not always perceived. Controversial role of the GP. 19 respondents stated they changed behavior |
Gupta et al. 2012 [75] | Systematic review of RCTs, and experimental designs with controls | Systematic review according to Cochrane guidelines | No studies with rigorous experimental designs found |
Toloo et al. 2013 [44] | Systematic review of any heat warning evaluation | Systematic review of databases | Six articles asserted that post-intervention expected deaths were reduced. High study heterogeneity. One economic assessment. Eight studies assessed awareness, including one qualitative study |