What drives adaptive behaviours during heatwaves? A systematic review with a meta-analysis

Global warming will lead to more frequent and intense heatwaves across all regions of the world in the coming decades. Adaptation at the individual level plays a key role in helping populations cope with these extreme events. This study undertakes a systematic review of the academic literature on the determinants of heat-adaptive behaviours (HABs) following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A Boolean algorithm was used on two online databases (PubMed and Web of Science Core Collection) to retrieve 73 relevant, quantitative, peer-reviewed papers. All included studies focus on high-income economies (<i>N</i> = 48) or middle-income economies (MIEs, <i>N</i> = 25). A meta-analysis was performed on 34 studies using a random-effects model, with an emphasis on heat-related perceptions (perceived efficacy, risk and threat) and heat-related knowledge (HRK), as these variables are the most likely levers of behavioural change. Perceived efficacy, HRK, perceived threat and gender (i.e. being female) are positively associated with the adoption of HABs. A moderation analysis reveals heterogeneity in the effect of these variables by country income group, with low HRK and perceived threat constituting stronger barriers to HABs in MIEs. This study also highlights various gaps in the current literature, regarding the populations studied, the statistical methods used, and the lack of standardization of HABs and perception concepts. Heat-adaptive behaviours (HABs) are influenced by both psychological and non-psychological factors. Information and communication campaigns may be designed to influence the determinants of psychological factors and use them as adaptation levers.Policymakers should implement information campaigns to underline the characteristics and adverse health effects of heatwaves, as well as reminding people of ways to cope with heatwaves, especially in middle-income economies (MIEs).Information and prevention campaigns in MIEs should clearly highlight the frequency and severity of the health hazards associated with heatwaves in order to improve public awareness of these risks.Information campaigns based on simple infographics showing the most effective HABs and reminding people of the efficacy of HABs to reduce heatwave health risks may be especially impactful in high-income economies. Heat-adaptive behaviours (HABs) are influenced by both psychological and non-psychological factors. Information and communication campaigns may be designed to influence the determinants of psychological factors and use them as adaptation levers. Policymakers should implement information campaigns to underline the characteristics and adverse health effects of heatwaves, as well as reminding people of ways to cope with heatwaves, especially in middle-income economies (MIEs). Information and prevention campaigns in MIEs should clearly highlight the frequency and severity of the health hazards associated with heatwaves in order to improve public awareness of these risks. Information campaigns based on simple infographics showing the most effective HABs and reminding people of the efficacy of HABs to reduce heatwave health risks may be especially impactful in high-income economies.

未来数十年间，全球变暖将导致全球各区域热浪事件愈发频发且强度加剧。个体层面的适应措施，是助力民众应对此类极端事件的关键一环。本研究遵循《系统评价与元分析优先报告条目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）指南，针对热适应行为（heat-adaptive behaviours, HABs）影响因素的学术文献开展系统综述。本研究通过布尔算法，在PubMed与Web of Science核心合集两大在线数据库中检索，共获取73篇符合纳入标准的定量同行评议论文。纳入本综述的研究均聚焦于高收入经济体（样本量*N*=48）或中等收入经济体（middle-income economies, MIEs，样本量*N*=25）。本研究采用随机效应模型，对34项研究开展元分析，重点关注热相关认知（感知效能、风险感知与威胁感知）及热相关知识（heat-related knowledge, HRK）——上述变量被认为是推动行为改变的最关键杠杆。感知效能、热相关知识、威胁感知与性别（即女性群体）均与热适应行为的采用呈正相关关系。调节效应分析显示，上述变量的影响效应因国家收入组别而异：在中等收入经济体中，热相关知识匮乏与威胁感知低下是阻碍热适应行为实施的更显著障碍。本研究同时指出了当前该领域文献存在的诸多不足：包括研究对象覆盖范围有限、统计方法应用不统一，以及热适应行为与认知概念缺乏标准化定义等问题。热适应行为同时受心理与非心理两类因素影响。可通过设计信息传播活动，干预心理因素的影响路径，并将其作为适应策略的调控杠杆。政策制定者应开展信息宣传活动，阐明热浪的特征及其对健康的不利影响，并向民众普及热浪应对方法，在中等收入经济体中尤需如此。中等收入经济体的信息与预防宣传活动，应明确阐明热浪相关健康危害的发生频率与严重程度，以提升公众对该类风险的认知水平。在高收入经济体中，采用展示高效热适应行为的简易信息图表、并提醒民众热适应行为可降低热浪健康风险的宣传活动，往往能取得更佳效果。热适应行为同时受心理与非心理两类因素影响。可通过设计信息传播活动，干预心理因素的影响路径，并将其作为适应策略的调控杠杆。政策制定者应开展信息宣传活动，阐明热浪的特征及其对健康的不利影响，并向民众普及热浪应对方法，在中等收入经济体中尤需如此。中等收入经济体的信息与预防宣传活动，应明确阐明热浪相关健康危害的发生频率与严重程度，以提升公众对该类风险的认知水平。在高收入经济体中，采用展示高效热适应行为的简易信息图表、并提醒民众热适应行为可降低热浪健康风险的宣传活动，往往能取得更佳效果。