Abstract
Background: Evidence of the effectiveness of intervention against extreme heat remains unclear, especially among children, one of the vulnerable populations. This study aimed to evaluate the effectiveness of a primary school-based intervention program against heatwave and climate change in China to provide evidence for development of policies for adaptation to climate change. Methods: Two primary schools in Dongtai City, Jiangsu Province, China, were randomly selected as intervention and control schools (CTR registration number: ChiCTR2200056005). Health education was conducted at the intervention school to raise students’ awareness and capability to respond to extreme heat during May to September in 2017. Knowledge, attitude, and practice (KAP) of students and their parents at both schools were investigated by questionnaire surveys before and after intervention. The changes in KAP scores after intervention were evaluated using multivariable difference-in-difference (DID) analysis, controlling for age, sex, etc. Results: The scores of knowledge, attitude, and practice of students and their parents increased by 19.9% (95%CI: 16.3%, 23.6%) and 22.5% (95%CI: 17.8%, 27.1%); 9.60% (95%CI: 5.35%, 13.9%) and 7.22% (95%CI: 0.96%, 13.5%); and 9.94% (95%CI: 8.26%, 18.3%) and 5.22% (95%CI: 0.73%, 9.71%), respectively, after intervention. The KAP score changes of boys were slightly higher than those of girls. Older students had higher score changes than younger students. For parents, the higher the education level, the greater the score change, and change in scores was greater in females than in males. All the health education activities in the program were significantly correlated with the changes in KAP scores of primary school students after intervention, especially those curricula with interesting activities and experiential learning approaches. Conclusions: Heat and health education program in primary school was an effective approach to improve cognition and behavior for both students and their parents to better adapt to heatwaves and climate change. The successful experience can be generalized to respond to the increasing extreme weather/climate events in the context of climate change, such as heatwaves, and other emergent occasions or public health education, such as the control and prevention of COVID-19.
Highlights
Global climate change, with increased frequency, intensity, and duration of extreme heat events, has and will continue to lead to more morbidity and mortality of heat-relatedInt
The male students accounted for 52.9% and 53.1%, respectively, before and after intervention at the intervention school, whereas the percentage of male students at the control school was
It is notable in this study that we evaluated the influence of implementing intervention in primary school students on the KAP of their parents
Summary
With increased frequency, intensity, and duration of extreme heat events, has and will continue to lead to more morbidity and mortality of heat-relatedInt. With increased frequency, intensity, and duration of extreme heat events, has and will continue to lead to more morbidity and mortality of heat-related. Res. Public Health 2022, 19, 2532 diseases and injuries [1]. Children are a vulnerable population to climate change due to immature physiological and cognitive functions, poor acquired functional immune response, higher exposure per unit body weight, and spending more time outdoors [3,4]. The impacts of climate change on children’s health include direct and indirect adverse effects of extreme weather events, increased heat stress, reduced air quality, altered disease patterns of climate-related infections, and water, food, and nutrition insecurity in vulnerable areas [5,6]
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