Assessing the Effect of Cool Roofs on Health Using Smartwatches in Niue (REFLECT)

Aditi Bunker

Status

Enrolling

Conditions

Distance Walked

Active Minutes

Sleep Quantity

Awake Duration

Sleep Score

Moderate-intensity Activity Minutes

All-day Steps

Vigorous-intensity Activity Duration

Heart Rate

Time in Sleep Stages

Treatments

Other: Cool roof

Study type

Interventional

Funder types

Other

Identifiers

NCT06571019

226745/Z/22/Z (Other Grant/Funding Number)

3728161

Details and patient eligibility

About

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.

Full 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.

Enrollment

200 estimated patients

Sex

All

Ages

18+ years old

Volunteers

Accepts Healthy Volunteers

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.