Exploring the behaviours and responses of older adults to hot weather in Queensland, Australia: a mixed-methods study

Abstract Background Heat-response behaviours in older adults are shaped by physiological, social, environmental and psychological factors. However, interactions among these determinants remain insufficiently understood in Queensland’s subtropical and tropical settings. This study examined heat-response behaviours among older adults across Queensland using a survey conducted in 2022 and explored the contextual factors influencing these behaviours in greater depth. Methods A mixed-methods design combined a statewide survey of 547 adults aged 65 years or older with two focus-group discussions involving 12 older adults in Southeast Queensland. Survey analyses described cooling behaviours and used chi-square tests as screening analyses followed by binary or multinomial logistic regression, as appropriate. Focus-group data were analysed using hybrid deductive-inductive thematic analysis and integrated with the quantitative findings. Results Common cooling strategies included fan use (93%), air-conditioning use (79%) and increased fluid intake (52%). Compared with respondents living alone, those not living alone had higher odds of frequently rather than never using air conditioning (odds ratio [OR] 3.92, 95% confidence interval [CI] 1.78–8.62). Compared with respondents who described themselves as not sensitive to heat at all, heat-sensitive respondents had 5.46 times the odds of frequently rather than sometimes increasing fluid intake (95% CI 1.34–22.29; p = 0.018). Focus-group findings highlighted cooling costs and heat-related social confinement as contextual barriers to adaptation. Conclusion Addressing financial constraints to cooling and improving social connectedness is critical for improving heat resilience in this at-risk population.