Implementing community-based heat-health interventions for older adults: a comparative case study of two NGO delivery models in Hong Kong
Year: 2026
Type: article
Abstract: Background Extreme heat is an increasing threat to the health and wellbeing of older adults, particularly those living in densely populated urban environments with poor housing conditions and limited access to cooling resources. Community-based heat-health interventions have been proposed as an important climate adaptation strategy to reduce heat-related vulnerability among older adults, yet little is known about how such interventions are implemented in real-world settings. Methods This qualitative case study examined how two nongovernmental organizations (NGOs) implemented a community-based heat-health intervention for vulnerable older adults in Hong Kong. Data were drawn from observations of 51 home visits and 7 community activities, case conference notes, and four semi-structured focus groups with frontline and management staff ( n = 18). Inductive thematic analysis was used to explore how organizational approaches, local contexts, and service-delivery models shaped implementation. Results Although both NGOs implemented the same core intervention components, they adopted different service-delivery models. NGO 1 employed a relationship-centered approach emphasizing continuity of care, individualized assessment, and trust-building. This approach facilitated rapport-building, individualized support, and identification of misconceptions and environmental risks, but required substantial staff time and resources to maintain continuity of care and individualized engagement. NGO 2 adopted a standardized, outreach-oriented model designed to maximize community outreach, visibility, and awareness. This approach increased visibility and facilitated broad distribution of cooling resources but was sometimes constrained by the diverse housing conditions and complex needs of older adults. Housing characteristics, social isolation, and environmental constraints influenced how both approaches were implemented in practice. Collaboration with an academic team supported ongoing adaptation and capacity building throughout implementation. Conclusions Community-based heat-health interventions can play an important role in protecting older adults from heat-related health risks and supporting climate adaptation in ageing populations, but different delivery models involve distinct implementation strengths and challenges. Relationship-centered approaches may be particularly valuable when ongoing assessment, trust-building, and individualized support are required, whereas outreach-oriented approaches may promote awareness of heat-health risks and community engagement. The findings highlight the importance of aligning intervention strategies with the needs and living environments of older adults and suggest that community-based adaptation efforts should be accompanied by broader policies addressing housing-related heat vulnerability. Clinical trial number not applicable.
Source: BMC Geriatrics
Institution: Chinese University of Hong Kong
Language: English
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W7225743759
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