The effects of cool roofs on health, environmental, and economic outcomes in rural Africa: study protocol for a community-based cluster randomized controlled trial.

Autor: Bunker A; Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany. aditi.bunker@uni-heidelberg.de., Compoaré G; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso., Sewe MO; Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.; Department of Public Health and Clinical Medicine, Sustainable Health Section, Umeå University, Umeå, Sweden., Laurent JGC; Environmental Health and Occupational Health Sciences Institute, School of Public Health, Rutgers University, Rutgers, USA., Zabré P; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso., Boudo V; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso., Ouédraogo WA; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso., Ouermi L; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso., Jackson ST; Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany., Arisco N; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA., Vijayakumar G; Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany., Yildirim FB; Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany., Barteit S; Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany., Maggioni MA; Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments, Berlin, Germany.; Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy., Woodward A; Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand., Buonocore JJ; Department of Environmental Health, Boston University School of Public Health, Boston, USA., Regassa MD; Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany., Brück T; Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany.; Thaer-Institute, Humboldt-University of Berlin, Berlin, Germany.; International Security and Development Center (ISDC), Berlin, Germany., Sié A; Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso., Bärnighausen T; Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA.; Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa.
Jazyk: angličtina
Zdroj: Trials [Trials] 2024 Jan 16; Vol. 25 (1), pp. 59. Date of Electronic Publication: 2024 Jan 16.
DOI: 10.1186/s13063-023-07804-0
Abstrakt: Background: High ambient air temperatures in Africa pose significant health and behavioral challenges in populations with limited access to cooling adaptations. The built environment can exacerbate heat exposure, making passive home cooling adaptations a potential method for protecting occupants against indoor heat exposure.
Methods: We are conducting a 2-year community-based stratified cluster randomized controlled trial (cRCT) implementing sunlight-reflecting roof coatings, known as "cool roofs," as a climate change adaptation intervention for passive indoor home cooling. Our primary research objective is to investigate the effects of cool roofs on health, indoor climate, economic, and behavioral outcomes in rural Burkina Faso. This cRCT is nested in the Nouna Health and Demographic Surveillance System (HDSS), a population-based dynamic cohort study of all people living in a geographically contiguous area covering 59 villages, 14305 households and 28610 individuals. We recruited 1200 participants, one woman and one man, each in 600 households in 25 villages in the Nouna HDSS. We stratified our sample by (i) village and (ii) two prevalent roof types in this area of Burkina Faso: mud brick and tin. We randomized the same number of people (12) and homes (6) in each stratum 1:1 to receiving vs. not receiving the cool roof. We are collecting outcome data on one primary endpoint - heart rate, (a measure of heat stress) and 22 secondary outcomes encompassing indoor climate parameters, blood pressure, body temperature, heat-related outcomes, blood glucose, sleep, cognition, mental health, health facility utilization, economic and productivity outcomes, mosquito count, life satisfaction, gender-based violence, and food consumption. We followed all participants for 2 years, conducting monthly home visits to collect objective and subjective outcomes. Approximately 12% of participants (n = 152) used smartwatches to continuously measure endpoints including heart rate, sleep and activity.
Discussion: Our study demonstrates the potential of large-scale cRCTs to evaluate novel climate change adaptation interventions and provide evidence supporting investments in heat resilience in sub-Saharan Africa. By conducting this research, we will contribute to better policies and interventions to help climate-vulnerable populations ward off the detrimental effects of extreme indoor heat on health.
Trial Registration: German Clinical Trials Register (DRKS) DRKS00023207. Registered on April 19, 2021.
(© 2024. The Author(s).)
Databáze: MEDLINE
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