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Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Climate Change | Research

Building climate resilience: awareness of climate change adaptation in German outpatient medical practices

Authors: Nicola Alexandra Litke, Regina Poß-Doering, Valeska Fehrer, Martina Köppen, Stephanie Kümmel, Joachim Szecsenyi, Michel Wensing

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Background

Climate change is seen as the biggest health threat of the twenty-first century. Making outpatient medical practices resilient is therefore crucial to protect vulnerable groups and maintain quality of care. Awareness is a precondition for action. This study aims to explore awareness (knowledge, experience and attention) of climate change adaptation among stakeholders of outpatient medical practices.

Methods

Semi-structured interviews and focus groups with stakeholders of outpatient medical practices were conducted. The qualitative data were analysed in a two-step Thematic Analysis process.

Results

In total, n = 40 stakeholders participated in two focus groups and 26 interviews. The findings show a mixed degree of awareness in outpatient medical practices. The spectrum ranged from a passive role with curative acting only, handing over responsibility to others and a low perceived self-efficacy to a proactive and responsible implementation of adaptation strategies. Participants who saw the need and responsibility of climate change adaptation in medical practices perceived low additional workload. In general, implementation of climate change adaptation measures and general awareness of climate change adaptation appeared to be depending on a certain tension for change and a higher self-efficacy.

Conclusion

Medical practices, and specifically primary care, plays a crucial role in climate change adaptation, and awareness needs to be increased further in order to cope with consequences of climate change. To facilitate this, there should be a strong emphasis on climate change adaptation strategies being part of outpatient care provider roles rather than being perceived as an “add-on” to already high workloads.
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Literature
1.
go back to reference Josh Karliner, Slotterback S. Health Care's Climate Footprint. 2019. Josh Karliner, Slotterback S. Health Care's Climate Footprint. 2019.
2.
go back to reference Haines A, Ebi K. The imperative for climate action to protect health. N Engl J Med. 2019;380(3):263–73.CrossRefPubMed Haines A, Ebi K. The imperative for climate action to protect health. N Engl J Med. 2019;380(3):263–73.CrossRefPubMed
3.
go back to reference Herrmann A, Sauerborn R. General practitioners’ perceptions of heat health impacts on the elderly in the face of climate change-a qualitative study in Baden-Württemberg, Germany. Int J Environ Res Public Health. 2018;15(5):843.CrossRefPubMedPubMedCentral Herrmann A, Sauerborn R. General practitioners’ perceptions of heat health impacts on the elderly in the face of climate change-a qualitative study in Baden-Württemberg, Germany. Int J Environ Res Public Health. 2018;15(5):843.CrossRefPubMedPubMedCentral
4.
go back to reference Romanello M, Di Napoli C, Drummond P, Green C, Kennard H, Lampard P, et al. The 2022 report of the Lancet Countdown on health and climate change: health at the mercy of fossil fuels. Lancet (London, England). 2022;400(10363):1619–54.CrossRefPubMed Romanello M, Di Napoli C, Drummond P, Green C, Kennard H, Lampard P, et al. The 2022 report of the Lancet Countdown on health and climate change: health at the mercy of fossil fuels. Lancet (London, England). 2022;400(10363):1619–54.CrossRefPubMed
5.
go back to reference World Health Organization. WHO guidance for climate-resilient and environmantally sustainable health care facilities. Geneva; 2020. World Health Organization. WHO guidance for climate-resilient and environmantally sustainable health care facilities. Geneva; 2020.
6.
go back to reference Bikomeye JC, Rublee CS, Beyer KMM. Positive externalities of climate change mitigation and adaptation for human health: a review and conceptual framework for public health research. Int J Environ Res Public Health. 2021;18(5):2481.CrossRefPubMedPubMedCentral Bikomeye JC, Rublee CS, Beyer KMM. Positive externalities of climate change mitigation and adaptation for human health: a review and conceptual framework for public health research. Int J Environ Res Public Health. 2021;18(5):2481.CrossRefPubMedPubMedCentral
7.
go back to reference Prior JH, Connon IL, McIntyre E, Adams J, Capon A, Kent J, et al. Built environment interventions for human and planetary health: integrating health in climate change adaptation and mitigation. Pub Health Res Pract. 2018;28(4):1–5.CrossRef Prior JH, Connon IL, McIntyre E, Adams J, Capon A, Kent J, et al. Built environment interventions for human and planetary health: integrating health in climate change adaptation and mitigation. Pub Health Res Pract. 2018;28(4):1–5.CrossRef
8.
go back to reference United Nations Climate Change. Climate Action Pathway: Climate Resilience, Vision and Summary. Global Climate Action, Marrakech Partnership. 2021. United Nations Climate Change. Climate Action Pathway: Climate Resilience, Vision and Summary. Global Climate Action, Marrakech Partnership. 2021.
9.
go back to reference Iturriza M, Labaka L, Ormazabal M, Borges M. Awareness-development in the context of climate change resilience. Urban Climate. 2020;32. Iturriza M, Labaka L, Ormazabal M, Borges M. Awareness-development in the context of climate change resilience. Urban Climate. 2020;32.
10.
go back to reference Litke N, Weis A, Koetsenruijter J, Fehrer V, Koeppen M, Kuemmel S, et al. Building resilience in German primary care practices: a qualitative study. BMC primary care. 2022;23(1):221.CrossRefPubMedPubMedCentral Litke N, Weis A, Koetsenruijter J, Fehrer V, Koeppen M, Kuemmel S, et al. Building resilience in German primary care practices: a qualitative study. BMC primary care. 2022;23(1):221.CrossRefPubMedPubMedCentral
11.
go back to reference World Health Organization. Operational Framework for building climate resilient health systems. Geneva: Sitzerland; 2015. World Health Organization. Operational Framework for building climate resilient health systems. Geneva: Sitzerland; 2015.
12.
go back to reference Fehrer V, Poß-Doering R, Weis A, Szecsenyi J, Wensing M, Litke N. Climate change mitigation: qualitative analysis of environmental impact-reducing strategies in German primary care. European J Gen Pract. 2023;29(1):2232946.CrossRef Fehrer V, Poß-Doering R, Weis A, Szecsenyi J, Wensing M, Litke N. Climate change mitigation: qualitative analysis of environmental impact-reducing strategies in German primary care. European J Gen Pract. 2023;29(1):2232946.CrossRef
13.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
14.
go back to reference Berger N, Lindemann A-K, Böl G-F. Wahrnehmung des Klimawandels durch die Bevölkerung und Konsequenzen für die Risikokommunikation. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2019;62(5):612–9.CrossRefPubMed Berger N, Lindemann A-K, Böl G-F. Wahrnehmung des Klimawandels durch die Bevölkerung und Konsequenzen für die Risikokommunikation. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2019;62(5):612–9.CrossRefPubMed
15.
go back to reference Nikendei C. Klima, Psyche, Psychosomatische Medizin und Psychotherapie : Klima, Psyche, Psychosomatische Medizin und Psychotherapie2022; 17(1):[16–21 pp.]. Available from: https://elibrary.klett-cotta.de/article/https://doi.org/10.21706/aep-17-1-16. Nikendei C. Klima, Psyche, Psychosomatische Medizin und Psychotherapie : Klima, Psyche, Psychosomatische Medizin und Psychotherapie2022; 17(1):[16–21 pp.]. Available from: https://​elibrary.​klett-cotta.​de/​article/​https://​doi.​org/​10.​21706/​aep-17-1-16.
16.
go back to reference Nightingale AJ, Gonda N, Eriksen SH. Affective adaptation = effective transformation? Shifting the politics of climate change adaptation and transformation from the status quo. WIREs Clim Change. 2022;13(1):e740.CrossRef Nightingale AJ, Gonda N, Eriksen SH. Affective adaptation = effective transformation? Shifting the politics of climate change adaptation and transformation from the status quo. WIREs Clim Change. 2022;13(1):e740.CrossRef
17.
go back to reference Parker CL, Wellbery CE, Mueller M. The changing climate: managing health impacts. Am Fam Physician. 2019;100(10):618–26.PubMed Parker CL, Wellbery CE, Mueller M. The changing climate: managing health impacts. Am Fam Physician. 2019;100(10):618–26.PubMed
18.
go back to reference World Health Organization. Heat-Health Action Plans. 2008. World Health Organization. Heat-Health Action Plans. 2008.
19.
go back to reference Berry P, Enright PM, Shumake-Guillemot J, Villalobos Prats E, Campbell-Lendrum D. Assessing health vulnerabilities and adaptation to climate change: a review of international progress. Int J Environ Res Public Health. 2018;15(12):2626.CrossRefPubMedPubMedCentral Berry P, Enright PM, Shumake-Guillemot J, Villalobos Prats E, Campbell-Lendrum D. Assessing health vulnerabilities and adaptation to climate change: a review of international progress. Int J Environ Res Public Health. 2018;15(12):2626.CrossRefPubMedPubMedCentral
20.
go back to reference Goshua A, Gomez J, Erny B, Burke M, Luby S, Sokolow S, et al. Addressing climate change and its effects on human health: a call to action for medical schools. Acad Med. 2021;96(3):324–8.CrossRefPubMed Goshua A, Gomez J, Erny B, Burke M, Luby S, Sokolow S, et al. Addressing climate change and its effects on human health: a call to action for medical schools. Acad Med. 2021;96(3):324–8.CrossRefPubMed
21.
go back to reference Blättner B, Janson D, Roth A, Grewe HA, Mücke H-G. Gesundheitsschutz bei Hitzeextremen in Deutschland: Was wird in Ländern und Kommunen bisher unternommen? Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2020;63(8):1013–9.CrossRefPubMed Blättner B, Janson D, Roth A, Grewe HA, Mücke H-G. Gesundheitsschutz bei Hitzeextremen in Deutschland: Was wird in Ländern und Kommunen bisher unternommen? Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2020;63(8):1013–9.CrossRefPubMed
24.
go back to reference Álvarez-Nieto C, Richardson J, Navarro-Perán MÁ, Tutticci N, Huss N, Elf M, et al. Nursing students’ attitudes towards climate change and sustainability: a cross-sectional multisite study. Nurse Educ Today. 2022;108:105185.CrossRefPubMed Álvarez-Nieto C, Richardson J, Navarro-Perán MÁ, Tutticci N, Huss N, Elf M, et al. Nursing students’ attitudes towards climate change and sustainability: a cross-sectional multisite study. Nurse Educ Today. 2022;108:105185.CrossRefPubMed
25.
go back to reference Martinez GS, Kendrovski V, Salazar MA, de’Donato F, Boeckmann M. Heat-health action planning in the WHO European Region: Status and policy implications. Environ Res. 2022;214(1):113709.CrossRefPubMed Martinez GS, Kendrovski V, Salazar MA, de’Donato F, Boeckmann M. Heat-health action planning in the WHO European Region: Status and policy implications. Environ Res. 2022;214(1):113709.CrossRefPubMed
26.
go back to reference World Health Organization. WHO report on the global tobacco epidemic 2021: addressing new and emerging products Geneva; 2021. World Health Organization. WHO report on the global tobacco epidemic 2021: addressing new and emerging products Geneva; 2021.
27.
go back to reference Reser JP, Swim JK. Adapting to and coping with the threat and impacts of climate change. Am Psychol. 2011;66(4):277–89.CrossRefPubMed Reser JP, Swim JK. Adapting to and coping with the threat and impacts of climate change. Am Psychol. 2011;66(4):277–89.CrossRefPubMed
28.
go back to reference Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: a systematic review of empirical tests. Soc Sci Med. 1982;2022(292):114523. Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: a systematic review of empirical tests. Soc Sci Med. 1982;2022(292):114523.
29.
go back to reference Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRefPubMed Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRefPubMed
Metadata
Title
Building climate resilience: awareness of climate change adaptation in German outpatient medical practices
Authors
Nicola Alexandra Litke
Regina Poß-Doering
Valeska Fehrer
Martina Köppen
Stephanie Kümmel
Joachim Szecsenyi
Michel Wensing
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Climate Change
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10664-2

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