Background

Heatwaves form a serious public health threat, especially for vulnerable groups. Interventions such as active outreach programs, exposure reduction measures and monitoring and mapping of at-risk groups are increasingly implemented across the world but little is known about their effect.

Objectives

To assess how vulnerable groups are identified and reached in heat health interventions, to understand the effectiveness and efficiency of those interventions, and to identify research gaps in existing literature.

Methods

We performed a literature search in relevant scientific literature databases and searched with a four element search model for articles published from 1995 onward. We extracted data on intervention measures, target group and evaluation of effectiveness and efficiency.

Results

We identified 23 eligible studies. Patterns exist in type of interventions 1) to detect and 2) to influence extrinsic and intrinsic risk and protective factors. Results showed several intervention barriers related to the variety and intersection of these factors, as well as the self-perception of vulnerable groups, and misconceptions and unfavorable attitudes towards intervention benefits. While modest indications for the evidence on the effectiveness of interventions were found, efficiency remains unclear.

Discussion

Interventions entailed logical combinations of measures, subsumed as packages. Evidence for effective and efficient intervention is limited by the difficulty to determine effects and because single measures are mutually dependent. Interventions prioritized promoting behavioral change and were based on behavioral assumptions that remain untested and mechanisms not worked out explicitly.

Conclusions

Multifaceted efforts are needed to tailor interventions, compiled in heat health warning systems and action plans for exposure reduction and protection of vulnerable populations, to fit the social, economic and geographical context. Besides adequately addressing relevant risk and protective factors, the challenge is to integrate perspectives of vulnerable groups. Future research should focus on intervention barriers and improving the methods of effectiveness and efficiency evaluation.

中文翻译：

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易受热浪影响以及对公共卫生干预措施的影响–范围界定审查

背景

热浪构成了严重的公共卫生威胁，尤其是对弱势群体而言。积极的外展计划，减少接触的措施以及对危险人群的监测和制图等干预在世界范围内越来越多地实施，但对其效果知之甚少。

目标

评估在热卫生干预措施中如何识别和确定弱势群体，了解这些干预措施的有效性和效率，并找出现有文献中的研究空白。

方法

我们在相关的科学文献数据库中进行了文献检索，并使用四元素检索模型对1995年以后发表的文章进行了检索。我们提取了有关干预措施，目标群体以及有效性和效率评估的数据。

结果

我们确定了23项合格研究。干预类型中存在以下模式：1）检测和2）影响外部和内在风险以及保护因素。结果表明，与这些因素的多样性和交叉性，弱势群体的自我感知，对干预收益的误解和不良态度有关的几种干预障碍。尽管发现了适度的迹象表明干预的有效性，但效率仍不清楚。

讨论

干预需要采取措施的逻辑组合，这些措施被归为一揽子措施。有效和有效干预的证据受到确定效果的困难以及单一措施相互依赖的限制。干预措施优先考虑促进行为改变，并基于尚待检验且未明确制定出机制的行为假设。

结论

需要采取多方面的努力来调整干预措施，以将其纳入热健康预警系统和行动计划中，以减少接触和保护脆弱人群，以适应社会，经济和地理环境。除了充分解决相关的风险和保护因素外，挑战还在于整合弱势群体的观点。未来的研究应着重于干预障碍并改善有效性和效率评估的方法。