ArticleTrials2024
The effects of cool roofs on health, environmental, and economic outcomes in rural Africa: study protocol for a community-based cluster randomized controlled trial.
Article in Trials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Why Engage Communities in Biomedical Research?Bioethics · 2026Article
- Assessing the Impact of Cool Roofs on Health and Wellbeing: A Scoping Review.Current environmental health reports · 2026Article
- Effectiveness and feasibility of residential passive heat adaptation interventions on reducing indoor temperature in low-income communities in Africa: a systematic review.Environmental research, health : ERH · 2026Review
- "The heat really troubles us": community perspectives on a cool roof intervention, Umlazi, KwaZulu-Natal, South Africa.Frontiers in climate · 2026Article
- Acceptability of cool roofs: a qualitative study in Nouna, Burkina Faso.BMC public health · 2025Article
- Integrating gender in health interventions for adapting to extreme heat in low- and middle-income countries: a scoping review.BMJ public health · 2025Article
- Heat stress causes economic and welfare disparities across agroecological zones in Burkina Faso.Communications earth & environment · 2025Article
- Article
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Authors and funding
20 authors at 9 institutions in 7 countries.
Funding
Abstract
backgroundHigh ambient air temperatures in Africa pose significant health and behavioral challenges in populations with limited access to cooling adaptations. The built environment can exacerbate heat exposure, making passive home cooling adaptations a potential method for protecting occupants against indoor heat exposure.
methodsWe are conducting a 2-year community-based stratified cluster randomized controlled trial (cRCT) implementing sunlight-reflecting roof coatings, known as "cool roofs," as a climate change adaptation intervention for passive indoor home cooling. Our primary research objective is to investigate the effects of cool roofs on health, indoor climate, economic, and behavioral outcomes in rural Burkina Faso. This cRCT is nested in the Nouna Health and Demographic Surveillance System (HDSS), a population-based dynamic cohort study of all people living in a geographically contiguous area covering 59 villages, 14305 households and 28610 individuals. We recruited 1200 participants, one woman and one man, each in 600 households in 25 villages in the Nouna HDSS. We stratified our sample by (i) village and (ii) two prevalent roof types in this area of Burkina Faso: mud brick and tin. We randomized the same number of people (12) and homes (6) in each stratum 1:1 to receiving vs. not receiving the cool roof. We are collecting outcome data on one primary endpoint - heart rate, (a measure of heat stress) and 22 secondary outcomes encompassing indoor climate parameters, blood pressure, body temperature, heat-related outcomes, blood glucose, sleep, cognition, mental health, health facility utilization, economic and productivity outcomes, mosquito count, life satisfaction, gender-based violence, and food consumption. We followed all participants for 2 years, conducting monthly home visits to collect objective and subjective outcomes. Approximately 12% of participants (n = 152) used smartwatches to continuously measure endpoints including heart rate, sleep and activity. DISCUSSION: Our study demonstrates the potential of large-scale cRCTs to evaluate novel climate change adaptation interventions and provide evidence supporting investments in heat resilience in sub-Saharan Africa. By conducting this research, we will contribute to better policies and interventions to help climate-vulnerable populations ward off the detrimental effects of extreme indoor heat on health.
trial registrationGerman Clinical Trials Register (DRKS) DRKS00023207. Registered on April 19, 2021.
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