Correlates of hot day air-conditioning use among middle-aged and older adults with chronic heart and lung diseases: the role of health beliefs and cues to action.

Extreme ambient heat is a serious public health threat, especially for the elderly and persons with pre-existing health conditions. Although much of the excess mortality and morbidity associated with extreme heat is preventable, the adoption of effective preventive strategies is limited. The study reported here tested the predictive power of selected components of the Health Belief Model for air-conditioning (AC) use among 238 non-institutionalized middle-aged and older adults with chronic heart failure and/or chronic obstructive pulmonary disease living in Montréal, Canada. Respondents were recruited through clinics (response rate 71%) and interviews were conducted in their homes or by telephone. Results showed that 73% of participants reported having a home air conditioner. The average number of hours spent per 24-hour period in air-conditioned spaces during heat waves was 14.5 hours (SD = 9.4). Exploratory structural equation modeling showed that specific beliefs about the benefits of and drawbacks to AC as well as internal cues to action were predictive of its level of use, whereas the perceived severity of the effects of heat on health was not. The findings are discussed in light of the need to adequately support effective response to extreme heat in this vulnerable population.

Interactive links between theory of mind, peer victimization, and reactive and proactive aggression.

This study investigated the relation between theory of mind and reactive and proactive aggression, respectively, as well as the moderating role of peer victimization in this context. The 574 participants were drawn from a longitudinal study of twins. Theory of mind was assessed before school entry, when participants were 5 years old. Reactive and proactive aggression as well as peer victimization were assessed a year later in kindergarten. Results from multilevel regression analyses revealed that low theory of mind was related to a high level of reactive aggression, but only in children who experienced average to high levels of peer victimization. In contrast, a high theory of mind was related to a high level of proactive aggression. Again, this relation was especially pronounced in children who experienced high levels of peer victimization. These findings challenge the social skills deficit view of aggression and provide support for a multidimensional perspective of aggressive behavior.

Heat awareness and response among Montreal residents with chronic cardiac and pulmonary disease.

OBJECTIVES: Persons affected by chronic heart and lung disease risk illness and death through exposure to extreme ambient heat. Here we describe their knowledge and awareness of the risks, and the degree to which they practice the protective behaviours recommended by public health and meteorological authorities. METHODS: Over the course of a hot Montreal summer, chronic cardiac and/or pulmonary insufficiency patients were recruited sequentially on site or by telephone from among attendees at five Montreal university hospital clinics. A one-hour face-to-face structured interview was completed by 238 patients, of whom 78% were at least 60 years of age. RESULTS: Participants were well informed about extreme heat and its impact on health. Most see themselves as vulnerable to heat, recall extreme heat advisories, and all adopt at least one recommended protective measure. Of the participants, 68% spend time in an air-conditioned space during extreme heat episodes, and more than 75% reduce their physical activity and drink extra fluids. A small minority resists recourse to air conditioning: of those without, 32% have "little confidence in buying an air conditioner" even if so advised by their caregivers, and 25% would refuse to overnight in an air-conditioned shelter during a prolonged heat wave. CONCLUSIONS: These chronically ill respondents perceive themselves as susceptible to extreme heat, have confidence in prevention, and almost all adopt recommended protective behaviours. A minority resists protective messaging.