Are ‘evidence-based’ cooling strategies fit-for-purpose?—Investigating the gap between guidance and behaviour

Across two summers self-report surveys were completed by a total of 130 older adults who were trialling a digital heat early warning system in Southeast Queensland. The purpose of the project was to assess participants’ access to (accessibility), and willingness to use (acceptability) commonly promoted cooling strategies, and to further explore the reasons for reluctance to use. Most participants reported access to all strategies (93–100%). Acceptability (mean response [95%CI]) was high for opening/closing windows or blinds (97 [94–100]%), fans, drinking cool water, sitting quietly, removing excess clothing (all 96 [93–99]%), cold showers (92 [87–96]%), and air-conditioning (90 [84–95] %). Conversely, hand/forearm baths (76 [69–84]%), icepacks (68 [60–76]%), dampened clothing (64 [56–72]%), foot baths (63 [54–71]%), and cold baths (49 [39–60]%) were less acceptable. Key reported barriers included messiness (n = 48), physical discomfort (n = 47), and preference for other strategies (n = 47). Among this sample of older adults, several widely promoted water-based cooling strategies were reported as unacceptable despite high accessibility. These findings highlight an implementation gap between public health recommendations and self-reported willingness to use such strategies, underscoring the need for co-designed heat-health interventions.