Digital heat-adaptation messages from your primary care provider to help prepare for heatwaves

Heat Smart: Empowering Primary Care Providers to Safeguard Vulnerable Populations Against Extreme Heat

This trial will test whether tailored digital messages sent by your family doctor or nurse practitioner help adult patients in Eastern Ontario change behaviors to protect themselves during heatwaves.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 20000 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Hopital Montfort (Academic / other)
• Locations: 1 site (Ottawa, Ontario)
• Trial ID: NCT07024628 on ClinicalTrials.gov

What this trial studies

This cluster randomized controlled trial in Eastern Ontario randomizes primary care providers and their patients to receive either tailored heat-adaptation digital messages or non-heat-related messages. Patients are identified using electronic medical records and surveys to find those vulnerable to extreme heat and must be adults registered with participating PCPs who can receive email or SMS. The intervention delivers personalized messages from the patient’s own PCP and measures behavior change through patient surveys and heat-related healthcare use through administrative data (including primary care and emergency visits and prescription fills). Practices must have at least two participating practitioners and analysis will examine effects across sociodemographic subgroups and integration with local heat alert systems.

Who should consider this trial

Good fit: Adults (18+) who are registered with a participating primary care provider in Eastern Ontario, have had a visit in the past two years, can receive digital messages in English or French, and can consent to participate.

Not a fit: People without regular primary care, without access to email or SMS, those unable to act on advice due to severe mobility or economic barriers, or those outside the study region are unlikely to benefit.

Why it matters

Potential benefit: If successful, the intervention could help patients adopt more protective behaviors during heatwaves and reduce heat-related illness and healthcare visits.

How similar studies have performed: Digital messaging interventions for other preventive behaviors have shown modest improvements in engagement, but direct evidence for PCP-delivered heat-adaptation messaging is limited and this application is relatively novel.

Eligibility criteria

Inclusion Criteria:

The Heat Smart randomized controlled trial study will recruit patients and primary care providers (PCPs) from Eastern Ontario. The inclusion criteria ensure that the intervention reaches at-risk individuals while being scalable across different patient populations:

Primary Care Patients:

* Adults (18 years and older)
* Patients must be registered with a participating PCP.
* They must have had at least one visit with their PCP in the past two years to ensure active engagement.
* Participants must have an active email, cell phone or messaging service (SMS) to receive Heat Smart digital messages.
* Patients must be able to understand and consent to participate in the study.
* Patients must be able to communicate in at least one of the official languages (English, French).
* Participants will be recruited from PCP located in two Eastern Ontario public health districts: the Eastern Ontario Health Unit and Ottawa Public Health (including urban, rural, and Indigenous communities such as Akwesasne).

Primary Care Providers:

* Must be a licensed Family Physician (FP) or Nurse Practitioner (NP) in a practice of at least 2 PCPS.
* The providers must be offering comprehensive primary care to a panel of patients (not solely urgent care or walk-in services).
* Must work in a computerized primary care clinic with an electronic medical record system.
* Must expect to remain in practice for at least 24 months.
* Must be located in Eastern Ontario.
* Must be willing to use the Canadian Primary Care Information Network (CPIN) to deliver Heat Smart messages and surveys.
* Must be using Cliniconex or Qualtrics as a practice tool for communication enabling outreach before the patients are invited to consent to participate in the study.

Exclusion Criteria:

Patients who do not read French or English will be excluded from the study as they will not be able to give informed consent or to fill out the surveys. Patients who do not have an email address or text messaging service will be excluded for the same reason. Minors, patients with dementia and people who cannot read and write in English or French will not be eligible because the automated approach to surveying patients makes it impractical to properly obtain their consent.

Where this trial is running

Ottawa, Ontario

• Institut du Savoir Montfort — Ottawa, Ontario, Canada (Recruiting)

Study contacts

• Study coordinator: Rebecca A Tobin

Conditions Heathly Subjects; Primary Health Care; Climate Change; Public Health; Preventive Health Services; Environmental Exposure; Risk Reduction Behavior; Heat Stress Disorders