Structural Heat Adaptation and Education in Urban Setting

NCT06991543 | Recruiting

• 2 other identifiers: 11548226752/Z/22/Z
• Study Type: interventional
• Target: 7,128
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to understand whether simple, low-cost interventions, such as improved home cooling, practical advice, and minor home modifications, can help protect people's health and improve quality of life during periods of extreme heat in densely populated, low-income neighborhoods of Karachi, Pakistan. Key Questions the Study Seeks to Answer:

• Answer questions about their health, living conditions, and how they cope with heat
• Have small temperature sensors placed inside their homes
• Some participants may wear a lightweight wristband that tracks sleep and heart rate
• In selected households, cooling improvements will be made, such as adding shade, applying reflective roof paint, or enhancing airflow Purpose: This study seeks to identify affordable and effective strategies to help families stay safe during extreme heat, and to use these insights to support other vulnerable communities facing similar challenges.

Conditions

Quality of Life; Heat Illness

Keywords

heat illness; behaviour modification; personal cooling; Structural modification; heat adaptation; prevention; quality of life

Outcome Measures

Primary Outcomes (2)

• Number of Participants with Heat-Related Illness

  Heat-related illness is defined as any condition resulting from prolonged heat exposure, including heat stroke, heat exhaustion, heat syncope, heat cramps, or heat rash. Data will be collected through weekly household surveillance, and community group reports

  from baseline to 24 months

• Quality of Life Enhancement

  Change in the WHOQOL-BREF overall score (mean of domain scores) during two consecutive peak summer and winter seasons

  4 month, 7 month, 16 month, 19 month

Secondary Outcomes (5)

• All-cause mortality (Number of Deaths from Any Cause)

  from baseline to 24 months

• Number of Participants with At Least One Hospital Visit During Study Period

  During summer months for 2 years

• Number of Participants Hospitalized for at Least 24 Hours

  During summer months for 2 years

• Change in Self-Reported Thermal Comfort Score

  from baseline to 24 months

• Change in Indoor Heat Index

  From intervention delivery to 24 months

Other Outcomes (5)

• Personalized Heat Exposure (°C)

  During summer months for 2 years

• Change in Heart Rate (Beats per Minute)

  During summer months for 2 years

• Sleep quality

  During summer months for 2 years

Study Arms (2)

Resilience and Heat Adaptation Bundle

EXPERIMENTAL

Intervention Arm: Resilience and Heat Adaptation Bundle (ReHAB): The ReHAB consists of three components; community education and awareness, personal lifestyle and cooling behavior modification, and participatory local structural and environmental heat mitigation solutions. The behavioral and educational interventions will be delivered through community mobilization whereas structural interventions will encompass modifications in the existing structures to lower the indoor ambient temperature and reduce heat effects.

Behavioral: Community education and awareness, and personal lifestyle and cooling behavior modification; Other: Participatory local structural and environmental heat mitigation solutions

Control

NO INTERVENTION

The control arm will not receive any intervention.

Interventions

Community education and awareness, and personal lifestyle and cooling behavior modification BEHAVIORAL

This component of the ReHAB will be achieved through community mobilization, which will encompass awareness and motivational activities throughout the intervention duration. Community groups (CGs) will be formed in each of the 11 clusters. Both male and female CGs will be formed separately and will be responsible for community mobilization activities, surveillance for primary outcome. Each CG will comprise of 6-8 members and will be a diverse group of people with varying qualifications, including local government members, local elders/elites, religious leaders, and prominent male and female members of the community. they could also name their respective CGs to enhance association, identity, and affiliation. These CGs will facilitate culturally tailored workshops, dissemination of early warnings regarding heat waves, awareness sessions, and door-to-door outreach focused on heat-health fundamentals. CGs will also maintain simple logbooks to track any incidence of heat related illness.

Also known as: behavioral change, early warning system

Resilience and Heat Adaptation Bundle

Participatory local structural and environmental heat mitigation solutions OTHER

Participatory local structural and environmental heat mitigation solutions will be delivered through community participatory approach where the community and project will share the cost of intervention to improve ownership. This contribution can be monetary or non-monetary, for example, provision of labor or supplies. The modifications include: 1. Paints (Solar Reflective Paints, Lime Paints) 2. Shading (Façade, Roof) 3. Energy Sufficiency (Solar Panels with complete accessories) 4. Community Shading (Plantation, Street Shading, Field Shading space) 5. Ventilation (Windows, Wind catchers)

Resilience and Heat Adaptation Bundle

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• All households within the selected clusters who provide consent.

You may not qualify if:

• Households planning to move away from the study site within the next 6 months
• Individuals with severe mental or physical health conditions that preclude participation

Sponsors & Collaborators

• University College, London: collaborator
• Aga Khan University: lead
• London School of Hygiene and Tropical Medicine: collaborator

Study Sites (1)

Bilal Colony

Karachi, Pakistan

RECRUITING

MeSH Terms

Conditions

Heat Stress Disorders

Interventions

Behavior Therapy

Condition Hierarchy (Ancestors)

Wounds and Injuries

Intervention Hierarchy (Ancestors)

Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• jai K Das

  Institute for global health and development, Aga Khan University.

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Jai K Das

CONTACT

+922134864717; jai.das@aku.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor, Associate Director, Institute for Global Health and Development

Model Details: Cluster Randomized Controlled Trial

Study Record Dates

• First Submitted: May 6, 2025
• First Posted: May 28, 2025
• Study Start: January 1, 2026
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): December 1, 2027
• Last Updated: January 27, 2026

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Access Criteria: Upon reasonable request.

Locations

PA (1)