A Cluster Randomised Controlled Trial (cRCT) Evaluating the Effects of Cool Roofs on Health, Environmental and Economic Outcomes in Niue
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 288
- 试验地点
- 2
- 主要终点
- Depression
研究概览
简要总结
Ambient air temperatures in the Pacific have broken record highs in 2024. Solutions are needed to build heat resilience in communities and adapt to increasing heat from climate change. Sunlight-reflecting cool roof coatings may passively reduce indoor temperatures and energy use to protect home occupants from extreme heat. Occupants living in poor housing conditions in the Pacific are susceptible to increased heat exposure.
Heat exposure can instigate and worsen numerous physical, mental and social health conditions. The worst adverse health effects are experienced in communities that are least able to adapt to heat exposure. By reducing indoor temperatures, cool roof use can promote physical, mental and social wellbeing in household occupants.
The long-term research goal of the investigators is to identify viable passive housing adaptation technologies with proven health benefits to reduce the burden of heat stress in communities affected by heat in Niue. To meet this goal, the investigators will conduct a cluster-randomized controlled trial to establish the effects of cool roof use on health, indoor environment and economic outcomes in Niue.
详细描述
Increasing heat exposure from climate change is causing and exacerbating heat-related illnesses in millions worldwide - particularly in low resource settings. June 2024 was the 13th consecutive hottest month on record globally - shattering previous records. Heat exposure can instigate and worsen health conditions including cardiovascular, metabolic, endocrine and respiratory disease, heat-related illnesses, pregnancy complications, and mental health conditions. Adaptation is essential for protecting people from increasing heat exposure. The built environment, especially homes, are ideal for deploying interventions to reduce heat exposure and accelerate adaptation efforts. However, there currently is a lack of evidence on a global scale - generated through empirical studies - guiding the uptake of interventions to reduce heat stress in low resource settings.
Pacific Islands and other small island developing states are among the most vulnerable to the adverse impacts of climate change and are likely to experience increases in ambient air temperature over the coming decades. People in Niue are exposed to heat and humidity year-round. The Pacific Islands have a large burden of non-communicable diseases (NCDs), with nearly three-quarters of deaths due to NCDs. The combined burden of heat and NCDs places Pacific Island populations at greater risk of adverse health effects from heat extremes.
Sunlight-reflecting cool roof coatings passively reduce indoor temperatures and lower energy use, offering protection to home occupants from extreme heat. The investigators therefore aim to conduct a cluster-randomized controlled trial investigating the effects of cool-roof use on health, environmental and economic outcomes in Niue.
The trial will quantify whether cool roofs are an effective passive home cooling intervention with beneficial health effects for vulnerable populations in Niue. Findings will inform regional policy responses on scaling cool roof implementation to protect people from increasing heat exposure driven by climate change.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- Double (Investigator, Outcomes Assessor)
盲法说明
Trial participants will be aware of the intervention to which they have been allocated, and the research fieldworkers will be aware of the intervention allocation. The trial steering committee members and trial statistician will remain blinded until the end of trial period and data collection.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Participant criteria:
- •Consenting adults aged 18 years and over.
- •Expected to be available to participate in the study for at least nine months in the next 12 months.
- •Household criteria:
- •House has a metal roof.
- •House is single-story.
排除标准
- •Household criteria:
- •Unstable house structure that does not permit the application of cool roof materials.
- •Inaccessible by the research team.
- •Significant roof damage defined as any penetrative roof defect that results in a hole in the roof OR over 25% of the roof rusted.
结局指标
主要结局
Depression
时间窗: Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
Self-reported presence and frequency of symptoms of depression assessed using aggregate score of the Patient Health Questionnaire 9 (PHQ-9).
Resting heart rate
时间窗: Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
Resting heart rate in beats per minute measured as the average of three readings in the left arm over one hour using Blip portable automated sphygmomanometers.
Blood glucose control
时间窗: Two measurements will be taken: one at baseline and one in the last month of three consecutive hottest months.
Three month average of blood glucose in mmol/mol measured as glycosylated hemoglobin (HbA1c) using capillary blood and the HemoCue® HbA1c 501 System.
次要结局
- Heat-related symptoms(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Hospitalization(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Systolic Blood Pressure(Eight measurements will be taken: one at baseline and seven over 12 months, covering the three consecutive hottest months and four alternate months.)
- Inner Ear Canal Temperature(Eight measurements will be taken: one at baseline and seven over 12 months, covering the three consecutive hottest months and four alternate months.)
- Food insecurity(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Health-related quality of life(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Diet quality(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Physician diagnosed heat-related illnesses(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Indoor thermal comfort(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Coping ability(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Cognition(Eight measurements: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Life satisfaction(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Healthcare provider utilization(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Diastolic Blood Pressure(Eight measurements will be taken: one at baseline and seven over 12 months, covering the three consecutive hottest months and four alternate months.)
- Dehydration(Eight measurements will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Aggression(Eight measurements: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Productivity(Eight measurements will be taken: one at baseline and seven over 12 months, covering the three consecutive hottest months and four alternate months.)
- Household energy expenditure(Eight measurements will be taken: one at baseline and seven over 12 months, covering the three consecutive hottest months and four alternate months.)
- Sleep quality(Eight measurements: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.)
- Indoor air temperature(Measurements at 15 minute intervals for 12 months.)
- Indoor relative humidity(Measurements at 15 minute intervals for 12 months.)
- Indoor heat index(Measurements at 15 minute intervals for 12 months.)
研究者
Aditi Bunker
Co-principal investigator
University of Auckland, New Zealand