Climate change has been described as the greatest health threat of the 21st century. Adaptation involves adjusting to the current and predicted effects of climate change, to reduce vulnerability to harmful effects. Strategies for adaptation can have both direct and indirect health benefits. However, research to date includes limited recognition of health impacts and limited study incorporating a health perspective. Attributing health outcomes to adaptation interventions can be challenging for many reasons. Evidence synthesis collating data on the effectiveness of adaptation interventions is therefore of strong interest to the health community and the public at large. Effective search strategies are a cornerstone of high-quality syntheses so appropriate methods are crucial.
The objective of this presentation is to present the challenges in creating a search strategy for a scoping review to evaluate the effectiveness of climate change adaptation measures in creating health impacts.
The primary research question is, ‘Globally, what adaptation measures have been effective in reducing the negative impacts of climate change on human health?’ We designed search strategies for OVID Medline, OVID Embase, and Web of Science, as well as for numerous grey literature sources, EBSCO Open Dissertations and Google Scholar.
Numerous iterations of the search strategy were required for this scoping review. Challenges included:
– developing a working definition and list of search terms to adequately cover the broad concept of ‘health impacts’;
– incorporating search terms for a wide range of study designs (not just clinical studies) that are measuring effectiveness of adaptation initiatives;
– encompassing the wide range of activities that can be considered as adaptation initiatives with direct or indirect health co-benefits;
– capturing studies that are relevant but that are not explicitly described as being related to climate change;
– teasing out health benefits from other social, economic and/or environmental benefits.
The impacts of climate change will be more deeply felt around the world in the coming decades, so it is essential to establish what is effective for protecting human health. Relevant interventions are planned, delivered and implemented in a highly complex space, given that the long-term impacts of climate change are still unknown and the huge variability of the social and economic systems in which the interventions are unfolding.
Developing high-quality evidence syntheses about the health impacts of climate change will be an important contribution to global adaptation planning. Well-designed search strategies are a fundamental component of this work, and the complexities of designing them must be thoroughly explored.