Introduction As the global climate changes, heat waves are having a disproportionate impact on seniors and other socially vulnerable groups. In order to mitigate the threats of extreme heat, it is critical to develop and promote resources for coping during these events. A better understanding of the role of risk perceptions and the factors that influence them is needed in order to improve public responses to threatening events, particularly among seniors. Methods This mixed-methods study examined risk perceptions and coping practices in seniors using qualitative interviews (n = 15) and a survey (n = 244) of seniors across Waterloo Region, Ontario. Results Seniors showed relatively accurate risk tracking as indicated by the link between measures of actual risk and perception of personal risk. While vulnerability to heat is often believed to be associated with inaccurate perceptions of risk, within our sample, vulnerability appears more strongly related to social location and access to resources. Participants described social connections as important resources for resilience, but the stigma surrounding vulnerability, and other social norms, as barriers to seeking support. Conclusion The positive relationship between participants’ risk perceptions and actual risk for negative consequences of extreme heat was an important finding, given that problems of emergency preparedness and risk reduction are often framed as issues of awareness of risk, rather than social location and inequality. Along with increased public resources for coping with extreme heat, communicating about resources, fostering social connections and reducing stigma may be important leverage points for increasing the resiliency of seniors to heat waves.

This study aimed to address knowledge gaps related to the prevention and management of mental health responses among those with a condition that presents risk of severe COVID-19 infection. A scoping review that mapped English and Chinese-language studies (2019–2020) located in MEDLINE (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Sociological Abstracts, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Airiti Library was undertaken. Search terms related to COVID-19, mental health, and physical health were used and articles that included all three of these factors were extracted (n = 77). With the exception of one hospital-based pilot study, there were no intervention studies targeting mental health in those at risk of severe COVID-19 infection. Promising practices such as integrated care models that appropriately screen for mental health issues, address health determinants, and include use of digital resources were highlighted. Patient navigator programs, group online medical visits, peer support, and social prescribing may also support those with complex needs. Future policies need to address digital health access inequities and the implementation of multi-integrated health and social care. Furthermore, research is needed to comprehensively assess multi-integrated interventions that are resilient to public health crises.

The 2020 global outbreak of COVID-19 exposed and heightened threats to mental health across societies. Research has indicated that individuals with chronic physical health conditions are at high risk for suffering from severe COVID-19 illness and from the adverse consequences of public health responses to COVID-19, such as social isolation. This paper reports on the findings of a rapid realist review conducted alongside a scoping review to explore contextual factors and underlying mechanisms or drivers associated with effective mental health interventions within and across macro–meso–micro systems levels for individuals with chronic physical health conditions. This rapid realist review extracted 14 qualified studies across 11 countries and identified four key mechanisms from COVID-19 literature—trust, social connectedness, accountability, and resilience. These mechanisms are discussed in relation to contextual factors and outcomes reported in the COVID literature. Realist reviews include iterative searches to refine their program theories and context–mechanism–outcome explanations. A purposive search of pre-COVID realist reviews on the study topic was undertaken, looking for evidence of the robustness of these mechanisms. There were differences in some of the pre-COVID mechanisms due to contextual factors. Importantly, an additional mechanism—power-sharing—was highlighted in the pre-COVID literature, but absent in the COVID literature. Pre-existing realist reviews were used to identify potential substantive theories and models associated with key mechanisms. Based on the overall findings, implications are provided for mental health promotion policy, practice, and research.

Introduction Les changements climatiques mondiaux entraînent des vagues de chaleur qui ont une incidence disproportionnée sur les personnes âgées et divers autres groupes socialement vulnérables. Afin d’atténuer les risques associés aux épisodes de chaleur extrême, il est essentiel d’élaborer et de promouvoir des ressources permettant de faire face à ces épisodes. Une meilleure compréhension du rôle de la perception des risques et des facteurs qui les influencent permettra d’améliorer les réactions du public aux événements menaçants, en particulier chez les personnes âgées. Méthodologie Cette étude à méthodologie mixte visait à examiner la perception des risques et les pratiques d’adaptation des personnes âgées en effectuant des entrevues qualitatives (n = 15) et une enquête (n = 244) auprès de personnes âgées de la région de Waterloo (Ontario). Résultats Les personnes âgées ont fait preuve d’une connaissance relativement précise des risques, comme l’indique le lien entre les mesures du risque réel et la perception de leur risque personnel. Alors que l’on associe souvent la vulnérabilité à la chaleur à une perception inexacte du risque, dans notre échantillon, cette vulnérabilité semble plus fortement liée à la situation sociale et à l’accès aux ressources. Les participants ont cité les liens sociaux comme des ressources importantes pour la résilience et ont mentionné la stigmatisation entourant la vulnérabilité ainsi que d’autres normes sociales comme des obstacles à la recherche de soutien. Conclusion L’une de nos constatations importantes est la relation positive entre la perception des risques par les participants et le risque réel de subir les conséquences négatives d’une chaleur extrême, alors que les problèmes de préparation aux situations d’urgence et de réduction des risques sont souvent présentés comme des questions de sensibilisation aux risques plutôt que de situation sociale et d’inégalité. Outre l’augmentation des ressources publiques pour composer avec la chaleur extrême, la communication sur les ressources, la promotion des liens sociaux et la réduction de la stigmatisation peuvent s’avérer des aspects cruciaux dans l’augmentation de la résilience des personnes âgées face aux vagues de chaleur.

No abstract