Study on Intervention Effect of Heat-related Health Risk Early Warning Digital Technology for School-age Children

NCT07643571 | Not Yet Recruiting

• 1 other identifier: NIEH202643
• Study Type: interventional
• Target: 200
• Locations: 0 countries
• Sites: N/A

Brief Summary

This cluster randomized trial is conducted in Beijing primary schools to evaluate the efficacy of a WeChat mini-program-based high-temperature early warning intervention on the physical and cognitive health of school-age children. Six participating schools are randomly assigned to two parallel groups. The intervention group receives tiered heat alerts and guided self-health monitoring via the mini-program. The control group follows standard daily school and family routines, with no dedicated digital high-temperature early-warning intervention. The primary outcome is children's executive function after a 2.5-month follow-up. A range of secondary indicators related to physical status, mental health and health behaviors are assessed concurrently to quantify the intervention's benefits in mitigating adverse health outcomes caused by high temperatures.

Conditions

Cardiovascular Diseases; Respiratory Diseases; Mental Health Disorders; Heat Illness; Neurocognitive Impairment

Keywords

Heat stress; heat early warning; digital intervention; WeChat mini-program; school-age children; executive function; Wisconsin Card Sorting Test; cognitive function; cluster randomized controlled trial; children's physical health; heat-related disease; climate change

Outcome Measures

Primary Outcomes (1)

• The primary outcome is the comprehensive total score of children's executive function constructed based on the Wisconsin Card Sorting Test (WCST)

  The only primary outcome of this study is the composite score of cognitive executive function derived from the Wisconsin Card Sorting Test (WCST) via the TOPSIS method. All WCST absolute indicators and sub-dimensions are sub-indicators instead of independent outcomes. The WCST indicators are grouped into three sub-dimensions: conceptual thinking (Total Correct, Total Errors, Nonperseverative Errors, Conceptual Level Responses, Categories Completed), perseveration (Perseverative Responses, Perseverative Errors), and set maintenance (Failure to Maintain Set). Negative indicators are converted using the formula (x' = Max(x) - x). After Z-score normalization, the decision matrix is established, positive and negative ideal solutions are identified, and Euclidean distances and relative closeness are computed. The resulting relative closeness value is taken as the final composite score of cognitive executive function, the single primary outcome of this study.

  at 2.5 months of intervention.

Secondary Outcomes (30)

• Systolic Blood Pressure

  at 2.5 months of intervention

• Diastolic Blood Pressure

  at 2.5 months of intervention

• Heart Rate

  at 2.5 months of intervention

• Forced Expiratory Volume in 1 second (FEV1)

  at 2.5 months of intervention

• Forced Vital Capacity (FVC)

  at 2.5 months of intervention

Study Arms (2)

Control Group

NO INTERVENTION

The control group does not receive the mini-program-based high-temperature health risk early warning intervention.

WeChat Mini-program Heat Health Early Warning Intervention Group

EXPERIMENTAL

Participants receive tiered yellow, orange and red heat risk alerts and heat protection guidance via the WeChat Mini Program once alerts are issued due to high temperatures. Teachers and parents share health promotion tips with enrolled children. Mandatory mini-program check-ins and routine health monitoring are implemented throughout the 2.5-month intervention.

Other: WeChat Mini-program Based Heat Health Risk Early Warning Intervention

Interventions

WeChat Mini-program Based Heat Health Risk Early Warning Intervention OTHER

This study implements a digital early warning intervention targeting children's high-temperature health risks. During the intervention period, when the high-temperature health risk level reaches yellow, orange or red, relevant risk information, health tips and heat protection education materials are released to parents and head teachers via the WeChat mini-program. Parents or teachers pass on the warning information to participating children. During non-summer periods, Beijing's high-temperature early warning information is pushed to head teachers and parents via the WeChat mini-program; during summer vacation, location-specific early warning information is sent to parents. All recipients are required to pass on the information to children promptly upon receipt.

WeChat Mini-program Heat Health Early Warning Intervention Group

Eligibility Criteria

• Age: 9 Years - 11 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Willing to participate in the study.
• Possess adequate facilities and qualified teaching staff.
• The school and teachers maintain good cooperation.
• Class size is no less than 35 students.
• All participating classrooms are equipped with air conditioners.
• Fourth-grade primary school students aged 9 to 11, of all genders.
• Voluntary participation by students and their parents, good compliance, and signed informed consent.
• At least one adult family member has an internet-enabled mobile device.
• Good general health with no history of severe physical or mental disorders.
• Local permanent residents with a residency of no less than 6 months.

You may not qualify if:

• Participants who are unable or refuse to complete required examinations.
• Students receiving psychological or psychiatric treatment that may confound the study results.
• Those currently enrolled in other interventional clinical studies that may affect outcome assessment.

Sponsors & Collaborators

• Centers for Disease Control and Prevention, China: lead

Related Publications (10)

• Lei J, Sun Q, Chen R, Zhu Y, Zhou L, Xue X, Fang J, Du Y, Wang Y, Li T, Kan H. Respiratory Benefits of Multisetting Air Purification in Children: A Cluster Randomized Crossover Trial. JAMA Pediatr. 2025 Feb 1;179(2):122-128. doi: 10.1001/jamapediatrics.2024.5049.

  PMID: 39621320 RESULT

• Wang Y, Sun Y, Ban J, Fang J, Sun Q, Du Y, Liu Y, Dong H, Wang Q, Chen C, Zhang Y, Ma R, Chen R, Kan H, Li T. Cognitive benefits of air purification among schoolchildren: A randomized, double-blind, crossover trial. Innovation (Camb). 2026 Feb 5;7(5):101304. doi: 10.1016/j.xinn.2026.101304. eCollection 2026 May 4.

  PMID: 42100097 RESULT

• Pan CY, Tsai CL, Chu CH, Sung MC, Huang CY, Ma WY. Effects of Physical Exercise Intervention on Motor Skills and Executive Functions in Children With ADHD: A Pilot Study. J Atten Disord. 2019 Feb;23(4):384-397. doi: 10.1177/1087054715569282. Epub 2015 Feb 2.

  PMID: 25646023 RESULT

• Assari S, Zare H. Extreme Heat Exposure is Associated with Lower Learning, General Cognitive Ability, and Memory among US Children. Open J Neurosci. 2025;3(1):10-22. doi: 10.31586/ojn.2025.1277. Epub 2025 Jan 10.

  PMID: 40027445 RESULT

• Perera F, Nadeau K. Climate Change, Fossil-Fuel Pollution, and Children's Health. N Engl J Med. 2022 Jun 16;386(24):2303-2314. doi: 10.1056/NEJMra2117706. No abstract available.

  PMID: 35704482 RESULT

• Romanello M, Napoli CD, Green C, Kennard H, Lampard P, Scamman D, Walawender M, Ali Z, Ameli N, Ayeb-Karlsson S, Beggs PJ, Belesova K, Berrang Ford L, Bowen K, Cai W, Callaghan M, Campbell-Lendrum D, Chambers J, Cross TJ, van Daalen KR, Dalin C, Dasandi N, Dasgupta S, Davies M, Dominguez-Salas P, Dubrow R, Ebi KL, Eckelman M, Ekins P, Freyberg C, Gasparyan O, Gordon-Strachan G, Graham H, Gunther SH, Hamilton I, Hang Y, Hanninen R, Hartinger S, He K, Heidecke J, Hess JJ, Hsu SC, Jamart L, Jankin S, Jay O, Kelman I, Kiesewetter G, Kinney P, Kniveton D, Kouznetsov R, Larosa F, Lee JKW, Lemke B, Liu Y, Liu Z, Lott M, Lotto Batista M, Lowe R, Odhiambo Sewe M, Martinez-Urtaza J, Maslin M, McAllister L, McMichael C, Mi Z, Milner J, Minor K, Minx JC, Mohajeri N, Momen NC, Moradi-Lakeh M, Morrissey K, Munzert S, Murray KA, Neville T, Nilsson M, Obradovich N, O'Hare MB, Oliveira C, Oreszczyn T, Otto M, Owfi F, Pearman O, Pega F, Pershing A, Rabbaniha M, Rickman J, Robinson EJZ, Rocklov J, Salas RN, Semenza JC, Sherman JD, Shumake-Guillemot J, Silbert G, Sofiev M, Springmann M, Stowell JD, Tabatabaei M, Taylor J, Thompson R, Tonne C, Treskova M, Trinanes JA, Wagner F, Warnecke L, Whitcombe H, Winning M, Wyns A, Yglesias-Gonzalez M, Zhang S, Zhang Y, Zhu Q, Gong P, Montgomery H, Costello A. The 2023 report of the Lancet Countdown on health and climate change: the imperative for a health-centred response in a world facing irreversible harms. Lancet. 2023 Dec 16;402(10419):2346-2394. doi: 10.1016/S0140-6736(23)01859-7. Epub 2023 Nov 14.

  PMID: 37977174 RESULT

• Ebi KL, Capon A, Berry P, Broderick C, de Dear R, Havenith G, Honda Y, Kovats RS, Ma W, Malik A, Morris NB, Nybo L, Seneviratne SI, Vanos J, Jay O. Hot weather and heat extremes: health risks. Lancet. 2021 Aug 21;398(10301):698-708. doi: 10.1016/S0140-6736(21)01208-3.

  PMID: 34419205 RESULT

• He M, Xiang F, Zeng Y, Mai J, Chen Q, Zhang J, Smith W, Rose K, Morgan IG. Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China: A Randomized Clinical Trial. JAMA. 2015 Sep 15;314(11):1142-8. doi: 10.1001/jama.2015.10803.

  PMID: 26372583 RESULT

• Liu Z, Gao P, Gao AY, Lin Y, Feng XX, Zhang F, Xu LQ, Niu WY, Fang H, Zhou S, Li WH, Yuan JH, Xu CX, Wu N, Li HJ, Wen LM, Patton GC, Wang HJ, Wu YF. Effectiveness of a Multifaceted Intervention for Prevention of Obesity in Primary School Children in China: A Cluster Randomized Clinical Trial. JAMA Pediatr. 2022 Jan 1;176(1):e214375. doi: 10.1001/jamapediatrics.2021.4375. Epub 2022 Jan 4.

  PMID: 34747972 RESULT

• Shinde S, Weiss HA, Varghese B, Khandeparkar P, Pereira B, Sharma A, Gupta R, Ross DA, Patton G, Patel V. Promoting school climate and health outcomes with the SEHER multi-component secondary school intervention in Bihar, India: a cluster-randomised controlled trial. Lancet. 2018 Dec 8;392(10163):2465-2477. doi: 10.1016/S0140-6736(18)31615-5. Epub 2018 Nov 22.

  PMID: 30473365 RESULT

MeSH Terms

Conditions

Cardiovascular Diseases; Respiratory Tract Diseases; Heat Stress Disorders

Condition Hierarchy (Ancestors)

Wounds and Injuries

Central Study Contacts

Tiantian Li, PhD

CONTACT

010-50930213; litiantian@nieh.chinacdc.cn

TianTian LI, Study Director

CONTACT

010-50930213; litiantian@nieh.chinacdc.cn

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: June 3, 2026
• First Posted: June 11, 2026
• Study Start: June 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: June 11, 2026

Record last verified: 2026-06