Heat waves and climate change: Applying the health belief model to identify predictors of risk perception and adaptive behaviours in Adelaide, Australia

Heat waves are considered a health risk and they are likely to increase in frequency, intensity and duration as a consequence of climate change. The effects of heat waves on human health could be reduced if individuals recognise the risks and adopt healthy behaviours during a heat wave. The purpose of this study was to determine the predictors of risk perception using a heat wave scenario and identify the constructs of the health belief model that could predict adaptive behaviours during a heat wave. A cross-sectional study was conducted during the summer of 2012 among a sample of persons aged between 30 to 69 years in Adelaide. Participants' perceptions were assessed using the health belief model as a conceptual frame. Their knowledge about heat waves and adaptive behaviours during heat waves was also assessed. Logistic regression analyses were performed to determine the predictors of risk perception to a heat wave scenario and adaptive behaviours during a heat wave. Of the 267 participants, about half (50.9%) had a high risk perception to heat waves while 82.8% had good adaptive behaviours during a heat wave. Multivariate models found that age was a significant predictor of risk perception. In addition, participants who were married (OR = 0.21; 95% CI, 0.07-0.62), who earned a gross annual household income of >=$ 60,000 (OR = 0.41; 95% CI, 0.17-0.94) and without a fan (OR = 0.29; 95% CI, 0.11-0.79) were less likely to have a high risk perception to heat waves. Those who were living with others (OR = 2.87; 95% CI, 1.19-6.90) were more likely to have a high risk perception to heat waves. On the other hand, participants with a high perceived benefit (OR = 2.14; 95% CI, 1.00-4.58), a high "cues to action" (OR = 3.71; 95% CI, 1.63-8.43), who had additional training or education after high school (OR = 2.65; 95% CI, 1.25-5.58) and who earned a gross annual household income of >=$ 60,000 (OR = 2.66; 95% CI, 1.07-6.56) were more likely to have good adaptive behaviours during a heat wave. The health belief model could be useful to guide the design and implementation of interventions to promote adaptive behaviours during heat waves