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      Development and Validation of a Behavioural Index for Adaptation to High Summer Temperatures among Urban Dwellers

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          Abstract

          One of the consequences of climate change is the growing number of extreme weather events, including heat waves, which have substantial impacts on the health of populations. From a public health standpoint, it is vital to ensure that people can adapt to high heat, particularly in cities where heat islands abound. Identifying indicators to include in a parsimonious index would help better differentiate individuals who adapt well to heat from those who do not adapt as well. This study aimed at developing and validating a summer heat adaptation index for residents of the 10 largest cities in the province of Québec, Canada. A sample of 2000 adults in 2015 and 1030 adults in 2016 completed a telephone questionnaire addressing their adoption (or non-adoption) of behaviours recommended by public health agencies to protect themselves during periods of high temperature, and their perceptions of how high summer heat affects their mental and physical health. Item analysis, confirmatory factor analysis, multiple correspondence analysis, measurement invariance analyses and criterion-validity analyses were used to develop a 12-behaviour heat adaptation index for distinguishing between individuals who adapt well to high temperatures and those who do not adapt as well. The results indicated that the measurement and the factor structure of the index were invariant (equivalent) across the two independent samples of participants who completed the questionnaire at different times one year apart, an important prerequisite for unambiguous interpretation of index scores across groups and over time. The results also showed that individuals who perceived more adverse effects on their physical or mental health adopted more preventive behaviours during periods of high temperatures and humidity conditions compared to those who felt lesser or no effects. This study thus presents support for the validity of the index that could be used in future studies to monitor preventive behaviours adoption during summer periods of high temperature.

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          Heat stress and public health: a critical review.

          Heat is an environmental and occupational hazard. The prevention of deaths in the community caused by extreme high temperatures (heat waves) is now an issue of public health concern. The risk of heat-related mortality increases with natural aging, but persons with particular social and/or physical vulnerability are also at risk. Important differences in vulnerability exist between populations, depending on climate, culture, infrastructure (housing), and other factors. Public health measures include health promotion and heat wave warning systems, but the effectiveness of acute measures in response to heat waves has not yet been formally evaluated. Climate change will increase the frequency and the intensity of heat waves, and a range of measures, including improvements to housing, management of chronic diseases, and institutional care of the elderly and the vulnerable, will need to be developed to reduce health impacts.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                21 July 2017
                July 2017
                : 14
                : 7
                : 820
                Affiliations
                [1 ]Faculty of Education, Université Laval, Québec, QC G1V0A6, Canada; maxime.caron@ 123456fse.ulaval.ca (M.C.); marie-pier.carrier@ 123456fse.ulaval.ca (M.-P.C.); johann.jacob@ 123456fse.ulaval.ca (J.J.)
                [2 ]Faculty of Medicine, Université Laval, Québec, QC G1V0A6, Canada; denis.talbot@ 123456fmed.ulaval.ca (D.T.); jean-sebastien.renaud@ 123456fmed.ulaval.ca (J.-S.R.); pierre.gosselin@ 123456inspq.qc.ca (P.G.)
                [3 ]Populations Health and Optimal Health Practices, CHU of Québec—Université Laval Research Center, Québec, QC G1S4L8, Canada
                [4 ]Department of Psychology, Concordia University, Montréal, QC H3B1R6, Canada; alexandre.morin@ 123456concordia.ca
                [5 ]Institut National de la Santé Publique, Direction de la Santé Environnementale et de la Toxicologie, Québec, QC G1V5B3, Canada
                [6 ]Consortium on Regional Climatology and Adaptation to Climate Change, Montréal, QC H3A1B9, Canada
                Author notes
                [* ]Correspondence: Pierre.Valois@ 123456fse.ulaval.ca ; Tel.: +1-418-656-2131 (ext. 2070)
                Author information
                https://orcid.org/0000-0003-0431-3314
                Article
                ijerph-14-00820
                10.3390/ijerph14070820
                5551258
                28754017
                e2984fb8-f7aa-446d-acc6-fa34181a5aef
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 04 May 2017
                : 17 July 2017
                Categories
                Article

                Public health
                adaptation index,climate change,heat wave,preventive health behaviours
                Public health
                adaptation index, climate change, heat wave, preventive health behaviours

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