Assessing the Effectiveness of Heat Adaptation Digital Messages From Primary Care Providers to Their Patients on the Change in Behaviour for Heatwave-related Preparedness

NCT07024628 | Recruiting

• 1 other identifier: 24-25-02-055
• Study Type: interventional
• Target: 20,000
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Heathly Subjects; Primary Health Care; Climate Change; Public Health; Preventive Health Services (PREV HEALTH SERV); Environmental Exposure; Risk Reduction Behavior; Heat Stress Disorders; Heat Exposure

Keywords

primary care; digital messaging; heatwave; climate change; public health; CPIN

Outcome Measures

Primary Outcomes (1)

• Number of participants who report adopting at least one heat adaptation behaviour via self-report survey

  Participants will be asked: "Have you taken any action to prepare for a heat wave?" (yes/no).

  Assessed after a heatwave event, up to 2 years following enrollment.

Secondary Outcomes (1)

• Number of heat-adaptation behaviours self-reported by the participants.

  Assessed after a heatwave event, up to 2 years following enrollment.

Other Outcomes (4)

• Self-reported heatwave-related challenges: frequency of economic and lifestyle impacts

  Assessed after a heatwave event, up to 2 years following enrollment.

• Heatwave health risk and preparedness beliefs - Likert scores

  Assessed after a heatwave event, up to 2 years following enrollment.

• Frequency of social interactions during heatwaves

  Assessed after a heatwave event, up to 2 years following enrollment.

Study Arms (2)

Treated - receive heat adaptation digital messages

EXPERIMENTAL

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.

Other: Heat adaptation digital messaging

Control

ACTIVE COMPARATOR

Patients in the Control arm will receive messages not related to heat waves. These messages will be related to other environmental risks

Other: Non-heat-related digital messaging

Interventions

Heat adaptation digital messaging OTHER

Digital messages to equip and prepare patients for extreme heat events. 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.

Treated - receive heat adaptation digital messages

Non-heat-related digital messaging OTHER

Digital health promotion messages not related to heatwaves

Control

Eligibility Criteria

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

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• Hopital Montfort: lead
• Children's Hospital of Eastern Ontario Research Institute: collaborator

Study Sites (1)

Institut du Savoir Montfort

Ottawa, Ontario, K1K0M9, Canada

RECRUITING

MeSH Terms

Conditions

Risk Reduction Behavior; Heat Stress Disorders

Condition Hierarchy (Ancestors)

Behavior; Wounds and Injuries

Central Study Contacts

Rebecca A Tobin

CONTACT

613-746-4621; rebeccatobin@montfort.on.ca

William Hogg, Dr

CONTACT

whogg@uottawa.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: 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). There will be continuous recruitment through the study. Outcomes will be assessed after each heatwave. This means that participants enrolled at the start of the study will have a greater number of timepoints for data collection.

Study Record Dates

• First Submitted: May 28, 2025
• First Posted: June 17, 2025
• Study Start: April 1, 2025
• Primary Completion (Estimated): September 1, 2027
• Study Completion (Estimated): March 31, 2028
• Last Updated: June 17, 2025

Record last verified: 2025-05

Locations

CA (1)