What makes physicians implement climate change and heat adaptation measures in outpatient practices? A mixed-methods
J Nieder1, C Quitmann1, S Hueber2
1Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
Public Health
|November 11, 2025
Summary
Physicians implement few climate change adaptation measures due to low self-efficacy and response efficacy. Improving these factors, like providing clear guidelines, is crucial for healthcare adaptation to climate change impacts.
Area of Science:
- Environmental Health
- Medical Practice Management
- Climate Change Adaptation
Background:
- Climate change poses significant health risks, necessitating adaptation within the healthcare sector.
- Physicians in outpatient settings play a key role in implementing climate change adaptation strategies.
Purpose of the Study:
- To identify behavioral determinants among physicians for implementing climate change adaptation measures, focusing on heat.
- To assess the influence of Protection Motivation Theory (PMT) constructs on adaptation measure implementation.
Main Methods:
- A sequential explanatory mixed-methods design was used, combining an online survey with focus group discussions (FGDs).
- Data were collected from physicians in Germany using Protection Motivation Theory (PMT) to analyze behavioral determinants for eight adaptation measures.
- Statistical analyses included descriptive statistics, logistic regressions, and qualitative content analysis for FGDs.
Main Results:
- Physicians implemented an average of three out of eight proposed adaptation measures.
- Self-efficacy significantly predicted adjusting medication, schedules, and building protection from heat.
- Response efficacy predicted educating staff, informing patients, and advising on active cooling; FGDs revealed time constraints and patient adherence as key influences.
Conclusions:
- Physicians' self-efficacy and response efficacy are critical for implementing climate change adaptation measures.
- Clear guidelines and further research into the effectiveness of individual adaptation strategies are needed to enhance healthcare resilience to climate change.
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