Health-risk perception and its mediating effect on protective behavioral adaptation to heat waves

Ensuring spontaneously adjusting behaviors of the public in their daily life in response to heat waves is an important aspect of successful public health intervention under climate change. However, the current response behavior guidance released by the government is insufficient because of the limited understanding of public perceptions of heat-related risk and the motivating factors for the public's diverse adaptive behaviors. Here, we conducted a survey on the behavioral adaptations of 3065 urban residents in response to heat waves in Jinan, which is a typical city suffering from a hot climate. We provided evidence on the current state of residents' perception of heat waves and the mechanism of how risk perception mediates individual behavioral intentions upon exposure to high ambient temperatures. We found that the mediating effects of risk perception varied significantly with respect to different types of adaptive behaviors. Concern behaviors appeared be motivated completely by the mediating effects of perceived concern (b = 0.45, p < 0.01 for concerns about health guidelines; b = 0.36, p < 0.01 for concerns about the weather forecast) and severity (b = 0.11, p < 0.01 for concerns about health guidelines), while outdoor activity could be consciously adjusted according to temperature changes without those mediating effects (p > 0.05). Indoor cooling behaviors and transportation behaviors are partially mediated by risk perception (b = -0.04, p < 0.01; b = 0.08, p < 0.01; b = 0.08, p < 0.01 for indoor fan usage, use of air-conditioned buses, and use of private cars, respectively). The conclusions could help determine more targeted and detailed interventions to enhance public behavioral adjustments, including participation in adaption to and emergency preparedness for extreme temperature under the ongoing climate changes.