Heat Adaptation Through Community-based Approaches and Research at SEACO: Structural and Behavioural Interventions (Heat Care)

NCT06744309 | Recruiting DMC

• 1 other identifier: MUHREC43232
• Study Type: interventional
• Target: 1,110
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to learn if structural and behavioral interventions can mitigate the health effects of extreme heat in rural Malaysian communities. The study focuses on implementing cool roofs (a passive cooling system) and heat literacy education to improve heat adaptation behaviors. The study is funded by Wellcome (Heat Adaptation award - 226737\_Z\_22\_Z) The main questions it aims to answer are:

• Does the implementation of cool roofs reduce indoor temperatures and related heat stress in rural households?
• Does heat literacy education improve community awareness and behaviors related to coping with extreme heat? Researchers will compare four groups: one receiving both cool roofs and heat literacy interventions, one receiving only the cool roof intervention, one receiving only heat literacy education, and a control group receiving neither intervention. Participants will be asked to:
• Have their roofs painted with UV-resistant white paint (for cool roof intervention groups).
• Participate in educational sessions and training on heat-related health risks and coping strategies (for heat literacy intervention groups).
• Participants will undergo assessments at baseline (T0), first follow-up (T1), second follow-up (T2), and third follow-up/endline (T3). The T1 assessment occurs after completion of behavioral intervention and prior to the structural intervention.
• Wear a Garmin Vivosmart 5 sensor for two weeks during each data collection period to monitor heart rate, physical activity, and sleep patterns.

Conditions

Climate Change; Heat; Weather; Heat Effect; Heat; Excess

Keywords

heat health; heat literacy; thermotolerance; Rising average temperature

Outcome Measures

Primary Outcomes (4)

• Indoor Air Temperature

  Assessed using an indoor data logger (SwitchBot) to measure air temperature within the household.

  36 months

• Step count (Physical Activity)

  Tracked using Garmin Vivosmart 5 sensors, recording steps and distance.

  36 months

• Sleep Duration

  This will be obtained using the Uppsala Sleep Inventory questionnaire which assess sleep duration.

  36 months

• Glycaemic Control

  HbA1c level which will be measured by the Hemocue® HbA1c 501 System.

  36 months

Secondary Outcomes (6)

• Depressive Symptoms

  36 months

• Psychological Distress

  36 months

• Heat-related Symptoms

  36 months

• Health-related Quality of Life

  36 months

• Indoor Thermal Comfort

  36 months

Other Outcomes (4)

• Heat Index

  36 months

• Blood Glucose Level

  36 months

• Sleep Inventory

  36 months

Study Arms (4)

Group A (Cool Roof and Heat Literacy Interventions)

ACTIVE COMPARATOR

Cool roof intervention: Roofs will be painted with UV-resistant paint to reduce thermal absorption. Heat literacy intervention: Participants will receive education and training on heat-related health risks and coping strategies. Participants will receive the behavioural intervention after the baseline and prior to T1. The structural cool-roof intervention will be implemented after T1.

Behavioral: Heat Literacy Intervention; Other: Structural (Cool Roof) Intervention

Group B (Cool Roof Intervention Only)

ACTIVE COMPARATOR

Cool Roof intervention: Roofs will be painted with UV-resistant white paint to reduce thermal absorption. Participants will receive the structural cool-roof intervention after T1 assessment.

Other: Structural (Cool Roof) Intervention

Group C (Heat Literacy Intervention Only)

ACTIVE COMPARATOR

-Heat literacy intervention: Participants will receive education and training on heat-related health risks and coping strategies. Participants will receive the behavioural intervention after the baseline (T0) follow by T1 assessment.

Behavioral: Heat Literacy Intervention

Group D (Control Group)

NO INTERVENTION

No intervention will be provided, serving as a control group for comparison. Participants will not receive any intervention but will undergo assessments at T0, T1, T2, and T3.

Interventions

Heat Literacy Intervention BEHAVIORAL

The behavioral intervention aims to improve heat literacy among participants through an 8-12 week education and training program. It includes four main modules: enhancing community awareness of hot weather, identification of high risk groups, recognizing and responding to heat-related illnesses, and teaching personal cooling strategies. Participants will use SwitchBot meters to monitor indoor temperature and humidity, access real-time weather information, and learn about heat wave warnings. They will receive educational materials, including infographics, videos, and one-to-one training from field staff. The content of intervention and delivery methods will be refined through co-design workshops with stakeholders and community members to ensure they are practical and culturally appropriate. The goal is to equip participants with the knowledge and skills to protect themselves from extreme heat, resulting in better heat adaptation behaviors and improved health outcomes.

Group A (Cool Roof and Heat Literacy Interventions); Group C (Heat Literacy Intervention Only)

Structural (Cool Roof) Intervention OTHER

The structural intervention in this study involves implementing cool roofs to reduce indoor temperature and mitigate the effects of extreme heat in rural Malaysian communities. Selected households will have their roofs painted with UV-resistant paint, which reflects direct sunlight and reduces thermal absorption. This intervention aims to decrease the amount of solar energy absorbed by the roof, thereby lowering indoor temperature and reducing the physiological heat strain on residents. By maintaining cooler indoor environment, the cool roof intervention seeks to alleviate the health risks associated with prolonged exposure to high temperature.

Group A (Cool Roof and Heat Literacy Interventions); Group B (Cool Roof Intervention Only)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged at least 18 years old
• Willing to participate in all study components
• Consent to roof painting and installation of heat and humidity measurement devices
• Consent to wear the supplied wearables (Garmin Vivosmart 5) for data collection
• No plans to relocate during the study period
• Possess a smartphone for receiving health education materials

You may not qualify if:

• Individuals belonging to one household with existing participants
• Bedridden individuals or those requiring assistance in movement
• Single-story house
• Built with brick or brick and wooden
• Roof made of zinc, ceramic/clay, or mixed, suitable for cool roof painting
• Minimal to no requirement for roof repair
• No plans for renovation during the study period
• Double-story houses, shops, or empty houses
• Houses with the facility to sprinkle water on the roof

Sponsors & Collaborators

• Monash University Malaysia: lead
• Monash University: collaborator
• Heidelberg University: collaborator
• Ministry of Health, Malaysia: collaborator

Study Sites (1)

South East Asia Community Observatory, Monash University Malaysia

Segamat, Johor, 85000, Malaysia

RECRUITING

MeSH Terms

Interventions

Methods

Intervention Hierarchy (Ancestors)

Investigative Techniques

Study Officials

• Tin Tin Su, MBBS, Dr.Med

  Monash University Malaysia

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Nurul Arneida, PhD

CONTACT

+60 122744634; nurul.arnieda@monash.edu

Nurul Syazwana Binti Dali, BSc

CONTACT

+60127674277; nurul.syazwana@monash.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: No, the study does not involve masking (blinding). Due to the nature of the interventions-cool roof installation and heat literacy education-it is not possible to blind the participants or the field team members (including researchers). However, the random selection and assignment of participants to intervention and control groups will be conducted by a statistician who is not part of the research team, ensuring an unbiased allocation process.
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: The study uses a 2 x 2 factorial two-stage randomized controlled trial design with delayed, response-independent randomization of the second factor (cool-roof). Participants, randomly selected from the SEACO database, will be divided into four groups: both interventions, cool roof only, heat literacy only, and control. Cool roofs involve painting roofs with UV-resistant white paint to reduce heat absorption, while heat literacy includes 8-12 weeks of education on heat awareness and personal cooling strategies. The primary research objective is to investigate the effects of behavioral and structural (cool-roof) interventions individually, and the potential effects of the combined intervention on the primary outcomes - indoor air temperature, physical activity (step count), sleep duration, glycemic control (HbA1c level) - and secondary outcomes, including mental health , reporting heat-related symptoms, health-related quality of life, indoor thermal comfort and heat adaptation practices

Study Record Dates

• First Submitted: December 11, 2024
• First Posted: December 20, 2024
• Study Start: December 26, 2024
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): July 1, 2028
• Last Updated: September 15, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

MY (1)