Clinical trial NCT06571019: Assessing the Effect of Cool Roofs on Health Using Smartwatches in Niue
Official title: A Randomized Controlled Trial (RCT) Evaluating the Effects of Cool Roofs on Health Outcomes Using Smartwatches in Niue
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Heart Rate
All-day Steps
Distance Walked
Active Minutes
Moderate-intensity Activity Minutes
Vigorous-intensity Activity Duration
Sleep Quantity
Time in Sleep Stages
Awake Duration
Sleep Score
Keywords: Hot Temperature
Humidity
Housing
Wearable
Smartwatch
Heart rate
Cardiovascular
Physical activity
Sleep
Cool roof
Heat stress
Lead sponsor: University of Auckland, New Zealand
Sponsor class: OTHER
Collaborators: name: Heidelberg University
name: London School of Hygiene and Tropical Medicine
name: Rutgers University
name: Secretaría de Educación Pública, México
name: University of Ouagadougou, Burkina Faso
name: Indian Institute of Public Health, India
name: Labfront
name: Cognifit
name: Resene
name: Habitat for Humanity
name: The Tindall Foundation
name: Pacific Community
name: Wellcome Trust
First posted: 2024-08-26
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: Ambient air temperatures in the Pacific have broken record highs in 2024. Solutions are needed to build heat resilience in communities and adapt to increasing heat from climate change. Sunlight-reflecting cool roof coatings may passively reduce indoor temperatures and energy use to protect home occupants from extreme heat. Occupants living in poor housing conditions in the Pacific are susceptible to increased heat exposure.

Heat exposure can instigate and worsen numerous physical, mental and social health conditions. The worst adverse health effects are experienced in communities that are least able to adapt to heat exposure. By reducing indoor temperatures, cool roof use may promote heart health, sleep and physical activity in household occupants.

The long-term research goal of the investigators is to identify viable passive housing adaptation technologies with proven health benefits to reduce the burden of heat stress in communities affected by heat in Niue. To meet this goal, the investigators will conduct a randomized controlled trial to establish the effects of cool roof use on heart rate, sleep and physical activity in Niue.

Detailed description: Increasing heat exposure from climate change is causing and exacerbating heat-related illnesses in millions worldwide - particularly in low-resource settings. June 2024 was the 13th consecutive hottest month on record globally - shattering previous records. Heat exposure can instigate and worsen health conditions, including cardiovascular, metabolic, endocrine and respiratory disease, heat-related illnesses, pregnancy complications, and mental health conditions. Adaptation is essential for protecting people from increasing heat exposure. The built environment, especially homes, is ideal for deploying interventions to reduce heat exposure and accelerate adaptation efforts. However, there currently is a lack of evidence on a global scale - generated through empirical studies - guiding the uptake of interventions to reduce heat stress in low-resource settings.

Pacific Islands and other small island developing states are among the most vulnerable to the adverse impacts of climate change and are likely to experience increases in ambient air temperature over the coming decades. People in Niue are exposed to heat and humidity year-round. The Pacific Islands have a large burden of non-communicable diseases (NCDs), with nearly three-quarters of deaths due to NCDs. The combined burden of heat and NCDs places Pacific Island populations at greater risk of adverse health effects from heat extremes.

Sunlight-reflecting cool roof coatings passively reduce indoor temperatures and lower energy use, offering protection to home occupants from extreme heat. The investigators therefore aim to conduct a randomized controlled trial investigating the effects of cool roofs on heart rate, sleep and physical activity using smartwatches in Niue.

The trial will quantify whether cool roofs are an effective passive home cooling intervention with beneficial health effects for vulnerable populations in Niue. Findings will inform regional and global policy responses on scaling cool roof implementation to protect people from increasing heat exposure driven by climate change.

Eligibility criteria: Inclusion Criteria:

Participant criteria:

* Consenting adult aged 18 years and over.
* Expected to be available to participate in the study for at least nine months in the next 12 months.
* Willing and able to wear a smartwatch.

Household criteria:

* House has a metal roof.
* House is single-story.

Exclusion Criteria:

Participant criteria:

* One participant per household
* Does not have a smartphone with an internet connection that can connect to the smartwatch.

Household criteria:

* Unstable house structure that does not permit the application of cool roof materials.
* Inaccessible by the research team.
* Significant roof damage defined as any penetrative roof defect that results in a hole in the roof OR over 25% of the roof rusted.

Primary outcomes:
measure: Heart rate
timeFrame: Smartwatches will be worn for two consecutive weeks per month. Eight measurement points will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
Secondary outcomes:
measure: All-day steps
timeFrame: Smartwatches will be worn for two consecutive weeks per month. Eight measurement points will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
measure: Active minutes
timeFrame: Smartwatches will be worn for two consecutive weeks per month. Eight measurement points will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
measure: Distance walked
timeFrame: Smartwatches will be worn for two consecutive weeks per month. Eight measurement points will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
measure: Moderate-intensity activity minutes
timeFrame: MeasuSmartwatches will be worn for two consecutive weeks per month. Eight measurement points will be taken: one at barements will be taken continuously for 12 months. Participants will be asked to wear their smartwatch for at least two weeks every month.
measure: Vigorous-intensity activity duration
timeFrame: Smartwatches will be worn for two consecutive weeks per month. Eight measurement points will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
measure: Sleep quantity
timeFrame: Smartwatches will be worn for two consecutive weeks per month. Eight measurement points will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
measure: Time in sleep stages
timeFrame: Smartwatches will be worn for two consecutive weeks per month. Eight measurement points will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
measure: Awake duration
timeFrame: Smartwatches will be worn for two consecutive weeks per month. Eight measurement points will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
measure: Sleep score
timeFrame: Smartwatches will be worn for two consecutive weeks per month. Eight measurement points will be taken: one at baseline and seven over 12 months, covering three consecutive hottest months and four alternate months.
Other outcomes:
Locations:
city: Auckland
country: Niue
facility: University of Auckland
Study officials:
affiliation: University of Auckland, New Zealand
name: Collin Tukuitonga, Sir. Dr.
role: PRINCIPAL_INVESTIGATOR
References: