Heat Smart: Empowering Primary Care Providers to Safeguard Vulnerable Populations Against Extreme Heat
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 20,000
- 试验地点
- 2
- 主要终点
- Number of participants who report adopting at least one heat adaptation behaviour via self-report survey
研究概览
简要总结
Extreme heat events pose a significant health threat in Canada, as demonstrated by the 2021 heat wave that claimed over 600 lives in Western Canada. Most heat-related deaths occur indoors and are preventable. Primary care providers (PCPs), who serve 88% of Canadians, are uniquely positioned to identify and support at-risk individuals. Heat Smart, in alignment with Heat Alert and Response Systems (HARS), aims to bridge the gap between primary care and public health to enhance community resilience and reduce health inequities related to extreme heat events.
This randomized control trial in Eastern Ontario will examine whether patients receiving tailored digital health messages from their family physician or nurse practitioner change their behaviour to protect themselves from extreme heat-related illness. The Heat Smart study will:
- Assess risk: Analyze electronic medical records and patient surveys to identify vulnerable individuals.
- Deliver tailored messages: Send personalized digital guidance via e-mail or text, offering heat safety advice and local resource information in English and French.
- Issue early warning alerts: Notify at-risk patients of upcoming heat events, prompting action.
- Evaluate impact: Use surveys and health data to measure effectiveness in reducing heat-related health impacts.
Short-term outcomes include increased awareness and preparedness among patients about heat-related health risks. Long-term goals involve scaling the intervention across Canada to reduce heat-related illnesses, enhance social connectedness, and decrease healthcare utilization.
详细描述
Primary Hypothesis
The study will test the following primary hypothesis: "Patients who receive tailored digital health promotion messages from their primary care providers will perform more heat adaptive proactive behaviours to protect themselves from heat-related illness compared to those who do not receive such messages."
Secondary Hypotheses
- Patients receiving Heat Smart messages will demonstrate greater engagement in specific heat preparedness activities, such as creating heat safety plans and forming networks among friends, neighbours, and relatives (patient survey data).
- Patients in the intervention group will experience lower rates of heat-related healthcare utilization, as measured by primary care provider visits, emergency department visits and filling prescription drugs during heat events (ICES data).
- The intervention will be effective across different socio-demographic subpopulations, including older adults, individuals with chronic illnesses, and socially isolated individuals.
- The integration of primary care into HARS will enhance public health system coordination and improve response strategies for extreme heat events.
This study employs a cluster randomized controlled trial (RCT) to evaluate the impact of a heat adaptation digital messages intervention. Only primary care practices with at least 2 participating practitioners will be included in the study, where each PCP will act as a patient cluster. For each practice, the Primary Care Providers will be randomly assigned, and all their adult patient panel will either receive heat smart adaptation digital messages (the exposed group) or non-heat wave health promotion digital messages (the control group).
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
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
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
- •The Heat Smart randomized controlled trial study will recruit patients and primary care providers (PCPs) from Eastern Ontario. The inclusion criteria ensure that the intervention reaches at-risk individuals while being scalable across different patient populations:
- •Primary Care Patients:
- •Adults (18 years and older)
- •Patients must be registered with a participating PCP.
- •They must have had at least one visit with their PCP in the past two years to ensure active engagement.
- •Participants must have an active email, cell phone or messaging service (SMS) to receive Heat Smart digital messages.
- •Patients must be able to understand and consent to participate in the study.
- •Patients must be able to communicate in at least one of the official languages (English, French).
- •Participants will be recruited from PCP located in two Eastern Ontario public health districts: the Eastern Ontario Health Unit and Ottawa Public Health (including urban, rural, and Indigenous communities such as Akwesasne).
- •Primary Care Providers:
- •Must be a licensed Family Physician (FP) or Nurse Practitioner (NP) in a practice of at least 2 PCPS.
- •The providers must be offering comprehensive primary care to a panel of patients (not solely urgent care or walk-in services).
- •Must work in a computerized primary care clinic with an electronic medical record system.
- •Must expect to remain in practice for at least 24 months.
- •Must be located in Eastern Ontario.
- •Must be willing to use the Canadian Primary Care Information Network (CPIN) to deliver Heat Smart messages and surveys.
- •Must be using Cliniconex or Qualtrics as a practice tool for communication enabling outreach before the patients are invited to consent to participate in the study.
排除标准
- •Patients who do not read French or English will be excluded from the study as they will not be able to give informed consent or to fill out the surveys. Patients who do not have an email address or text messaging service will be excluded for the same reason. Minors, patients with dementia and people who cannot read and write in English or French will not be eligible because the automated approach to surveying patients makes it impractical to properly obtain their consent.
研究组 & 干预措施
Treated - receive heat adaptation digital messages
Patients in the Treated arm will receive messages to equip and prepare them for extreme heat events. The intervention is multifaceted: the first message will to encourage patients to prepare by creating a heat safety plan, and to form Check-in Companion groups among friends, neighbours, and relatives as well as to connect patients with existing key infrastructure that can be vital during heat events (ex: cooling stations and public facilities with air conditioning).
When a heat-advisory is announced, additional messages will be sent to alert patients in the Treated group to activate their heat safety plans.
干预措施: Heat adaptation digital messaging (Other)
Control
Patients in the Control arm will receive messages not related to heat waves. These messages will be related to other environmental risks
干预措施: Non-heat-related digital messaging (Other)
结局指标
主要结局
Number of participants who report adopting at least one heat adaptation behaviour via self-report survey
时间窗: Assessed after a heatwave event, up to 2 years following enrollment.
Participants will be asked: "Have you taken any action to prepare for a heat wave?" (yes/no).
次要结局
- Number of heat-adaptation behaviours self-reported by the participants.(Assessed after a heatwave event, up to 2 years following enrollment.)