A Critical Intervention for Sustainable Health: Climate Change Awareness Among Nurse Managers

This study aimed to evaluate the effectiveness of a nurse-led educational program designed to improve nurse managers' awareness, knowledge, and attitudes regarding climate change and its health impacts.

Climate change is one of the most urgent global public health challenges, jeopardizing key determinants of health such as air quality, access to safe drinking water, food security, and adequate housing. As frontline healthcare providers, nurses are uniquely positioned to identify environmental health risks and promote climate-resilient healthcare practices. Despite this critical role, evidence suggests that nurses' awareness and preparedness for climate-related health threats are insufficient. Therefore, strengthening climate literacy among nurse leaders is essential to enhance adaptation capacity in health systems.

This study used a pretest-posttest experimental design with hospital-level randomization and included 108 nurse managers working in two public hospitals in Istanbul. Participants were randomly assigned to intervention and control groups. The study was conducted between March and June 2025, with data collection carried out between April and May 2025. Data were collected using a Descriptive Information Form and the Climate Change Awareness Scale (CCAS). The intervention group received 90 min of face-to-face training, including theoretical content, case-based learning, and interactive assessment, whereas the control group received a 90-min lecture after data collection on climate change and its health impacts, followed by a brief question-and-answer session. Measurements were taken at baseline, immediately after the intervention, and 1 month later. Data were analyzed using Friedman and Wilcoxon signed-rank tests.

The intervention group demonstrated significant improvements in total and subscale CCAS scores at the postintervention time point compared with baseline and the control group (p < 0.05). Although a slight decrease was observed at the 1-month follow-up, scores remained higher than pretest levels. In the control group, although small differences were observed in certain subscales in the between-group comparisons, no statistically significant within-group changes were observed between the pretest, posttest, and follow-up scores.

The findings suggest that structured and nurse-led climate training for nurse managers has the potential to strengthen climate-related awareness and preparedness capacity.

Even short-term training increases nurse managers' awareness of climate change and health.

ClinicalTrials.gov identifier: NCT06905548.