DISSERTATION ON
A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING GLOBAL WARMING AND ITS EFFECTS ON HEALTH AMONG HIGHER SECONDARY SCHOOL STUDENTS AT SELECTED
GOVERNMENT SCHOOL IN CHENNAI.
M.SC (NURSING) DEGREE EXAMINATION BRANCH – IV COMMUNITY HEALTH NURSING
COLLEGE OF NURSING
MADRAS MEDICAL COLLEGE, CHENNAI – 600 003
A dissertation submitted to
THE TAMIL NADU DR.M.G.R. MEDICAL UNIVERSITY, CHENNAI- 600 032
In partial fulfillment of the requirement for the award of degree of
MASTER OF SCIENCE IN NURSING
OCTOBER – 2019
DISSERTATION ON
A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING GLOBAL WARMING AND ITS EFFECTS ON HEALTH AMONG HIGHER SECONDARY SCHOOL STUDENTS AT SELECTED
GOVERNMENT SCHOOL IN CHENNAI
Examination : M.Sc (Nursing) Degree Examination Examination month and year : OCTOBER - 2019
Branch & Course : IV – Community Health Nursing
Register No : 301726158
Institution : COLLEGE OF NURSING,
MADRAS MEDICAL COLLEGE, CHENNAI – 600 003
Sd: _________________ Sd: _________________
Internal Examiner External Examiner
Date: _________________ Date: _________________
THE TAMIL NADU DR.M.G.R.MEDICAL UNIVERSITY,
CHENNAI – 600 032
CERTIFICATE
This is to certify that this dissertation titled, “A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING GLOBAL WARMING AND ITS EFFECTS ON HEALTH AMONG HIGHER SECONDARY SCHOOL STUDENTS AT SELECTED GOVERNMENT SCHOOL IN CHENNAI”, is a bonafide work done by M.VIGNESHWARI, M.Sc (Nursing) II year Student, College of Nursing, Madras Medical College, Chennai -03, submitted to the Tamil Nadu Dr.M.G.R. Medical University, Chennai in partial fulfillment of the requirement for the award of the degree of Master of Science in Nursing Branch – IV, Community Health Nursing under our guidance and supervision during academic year 2017 – 2019.
Mrs.A.Thahira Begum, M.Sc(N)., M.B.A., M.Phil., Principal,
College of Nursing, Madras Medical College, Chennai-03.
Dr.R.Jayanthi,M.D.,F.R.C.P(Glasg)., Dean,
Madras Medical College, Chennai-03.
A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING GLOBAL WARMING AND ITS EFFECTS ON HEALTH AMONG HIGHER SECONDARY SCHOOL STUDENTS AT SELECTED
GOVERNMENT SCHOOL IN CHENNAI
Approved by the Dissertation Committee on 24.07.2018
CLINICAL SPECIALITY GUIDE
Selvi.B.Lingeswari, M.Sc(N)., MBA., M.Phil., _____________
Reader in Community Health Nursing, College of Nursing,
Madras Medical College, Chennai -03.
HEAD OF THE DEPARTMENT
Mrs.A.Thahira Begum, M.Sc(N)., MBA., M.Phil., _____________
Principal,
College of Nursing,
Madras Medical College, Chennai-03.
DEAN
Dr.R.Jayanthi, MD., F.R.C.P. (Glasg)., ___________
Dean,
Madras Medical College, Chennai-03.
A Dissertation submitted to
THE TAMILNADU DR.M.G.R MEDICAL UNIVERSITY, CHENNAI
In partial fulfillment of the requirement for award of the degree
MASTER OF SCIENCE IN NURSING
OCTOBER – 2019
ACKNOWLEDGEMENT
“Acknowledge all of your small victories. They will eventually add up to something great”
– Kara Goucher
I thank the Lord almighty for showering his blessings to make my dream of studying in an esteemed college possible in real. He has been bestowed his blessings over me throughout the course of my study period and in completion of this dissertation successfully.
I wish to express my sincere thanks to Dr.R.Jayanthi, MD., F.R.C.P.(Glasg)., Dean, Madras Medical College, Chennai – 03 for permitting me to conduct the study in this prestigious institution.
I am more privileged to thank Institutional Ethics Committee, of Madras Medical College, Chennai – 03 for giving me an approval to conduct this study.
It is my pleasure to express my whole hearted gratitude to Ms.A.Thahira Begum, M.Sc (N)., M.B.A., M.Phil., Principal, College of Nursing, Madras Medical College, Chennai -03 for her constant visionary support and untired efforts which motivated us in completion of the study successfully.
I extend my thanks to Dr.R.Shankar Shanmugam, M.Sc(N)., MBA., Ph.D., for all his motivating efforts in driving us to complete the study in a right way. His motivating words and supportive inputs helped us to take the study in an appropriate direction and complete at the right destiny.
With pleasure and proud I express the credit to Selvi.B.Lingeswari, M.Sc(N)., Reader, Community Health Nursing Department, College of Nursing, Madras Medical College, Chennai – 03
for her constant support, calm approach, supportive guidance which helped me to complete the study peacefully and successfully.
I express my special thanks to Dr.Joy Patricia Pushparani, M.D., Professor, Institute of Community Medicine, Madras Medical College, Chennai – 03 for her valuable guidance and encouragement which enabled me to accomplish this study.
I express my sincere thanks to Ms.N.Sathyanarayani, M.Sc(N)., Reader, former lecturer in Community Health Nursing Department, Mrs.T.Ramanibai, M.Sc(N), Reader, Community Health Nursing Department and Mrs. R.Sumathi, M.Sc(N)., Reader, Nursing Education and Administration Department, College of Nursing, Madras Medical College, Chennai -03 in College of Nursing, Madras Medical College, Chennai -03 for her sincere, untired efforts and facilitation which guided us in making the study successfully.
I would like to express my sincere gratitude to Ms.G.Mala, M.Sc(N)., Ph.D., former Nursing Tutor, Mr.K.Kannan M.Sc (N)., Nursing Tutor, and Mrs.P.Tamilselvi, M.Sc (N)., Nursing Tutor, College of Nursing, Madras Medical College, Chennai -03 for their timely support in selection of the topic for the dissertation and preparing us for the proposals.
It is my privilege to express my gratitude to Mrs.L.Shanthi, M.Sc(N)., former head of the community health nursing department, College of Nursing, Madras Medical College, Chennai -03 for their timely support in selection of the topic for the dissertation and preparing us for the proposals.
I also place on record, my sense of gratitude to all the Faculty Members of College of Nursing, Madras Medical College, Chennai - 03 for their valuable guidance and suggestions in conducting this study.
I would like to express my special thanks to Dr.Shobana Gangadharan, M.Sc(N)., Ph.D, Apollo College of Nursing, Vanagaram, Chennai – 95 for provoking the tool constructed for the study and for the valuable suggestions in bringing the tool in a right way.
I also express my special gratitude to Mrs.Kanchana, M.Sc (N)., Madha College of Nursing, Kundrathur, Chennai – 95 for her valuable suggestions in bringing the tool in a right way for the study.
It’s my pleasure to express my heartfelt gratitude to Mr.Kumaravel Pandian, I.A.S Deputy Commissioner, [Education], Greater Chennai Corporation, Ripon building, Chennai, for permitting me to conduct the study in the selected schools under the ambit of Chennai Corporation.
I express my heartfelt gratitude to Retd.Dr.A.Vengatesan, M.Sc., M.Phil., Ph.D., Deputy Director (Statistics), Directorate of Medical Education, Chennai for his valuable suggestion and guidance in the successful completion of statistical analysis and compiling of this study.
I also place a note on record in expressing my gratitude to Mr.Ravi, M.A., MLIS., Librarian for extending his support in providing all the necessary materials needed to complete the study in an organized manner.
It’s my pleasure to express my heartfelt gratitude to Mr.S.Perumal, M.A., B.Ed., B.T., Assistant, Panchayat union middle school, Padappai for editing the tool and the content in English and Mrs.R.Shanthi, M.A., B.Ed., Head Master, P.U.M.School, Athancheri, for editing the tool and the content in Tamil for this thesis work.
I express my heartfelt gratitude to the Mrs.Vasanthakumari, M.A., M.Ed., Chennai Girls Higher Secondary School, Nungambakkam, Chennai who had extended the kind co-operation during this study.
I express my gratitude to Mr.Jas Ahamed Aslam, Shajee computers Browsing Centre and Mr.Ramesh, B.A., MSM Xerox for their enthusiastic help and sincere effort in typing the manuscript using valuable computer skills and also bringing the study into a printed form.
I am grateful to my colleague sisters D.Madhurima, G.Tamil arasi and S.Pabitha for extending their participation and support with their timely suggestions during the time of data collection. I also extend my sincere gratitude to all my friends.
I will be lost if I am not expressing my gratitude to my family members. I express my heartfelt thanks to my ever loving parents Mr.P.Muthu Gopal and Mrs.M.Thangam, My lovable Sister M.Prasnna DGNM., and my friend Mr. K.John wesly, B.E.,(EEE) the back bone of my life who sacrificed their present for my future. They are the one who brought up me with the good attitude through their constant motivation and encouragement that has led me to work out on this study successfully. Without them I might not be successful today.
Last but not the least; I extend my thanks to all the school students who have participated in this study without their participation I couldn’t complete the study.
ABSTRACT
‘Global warming’ is an annual increase in the temperature of the atmosphere close to the Earth’s surface, which can lead to a change in the global climate patterns. Increases in global temperature have caused many disruptions in human life around the Earth. Global warming has caused the rise in global temperatures, the risk of huge natural disasters, the spread of diseases, and the deaths of about 1,50,000 people annually according to the World Health Organization. The terms climate change and global warming have been used as interchangeable terms, but there is a difference in two meanings. ‘Climate change’ helps show that there are other changes besides rising temperatures. It means that any major change in measures of climate that lasts for decades or longer. Climate change may result from natural factors, natural processes, and human activities.
Global warming is all about adverse climate change caused by trapping of greenhouse gases (CO2) in the earth atmosphere that affects biodiversity and causes a serious health hazards. Counter measures to facilitate living in hotter temperature like air conditioning and refrigeration will unfortunately consume more electricity from power plants that burn coal, releasing CO2. This will further spike global warming and have a seriously damaging influence on human health.
This provoked the investigator to conduct a research to impart knowledge on global warming and its effects on health.
TITLE
A study to assess the effectiveness of structured teaching programme on knowledge regarding global warming and its effects on health among higher secondary school students at selected Government School in Chennai.
OBJECTIVES
The study was carried out i) to assess the pretest knowledge regarding global warming and its effects on health. ii) to evaluate the effectiveness of structured teaching programme on global warming and its effects on health. iii) to compare the pre test and post test knowledge regarding global warming and its effects on health. iv) to find association between the post-test knowledge of higher secondary school students and selected demographic variables.
METHODS AND MATERIALS
The study was carried out using a quantitative, Pre experimental One group pre and post test design. The study was conducted among 60 school children studying 11th standard in Chennai girls higher secondary school, Nungambakkam, Chennai. The study participants were selected by convenient sampling technique. Pre-existing knowledge was assessed by using semi structured questionnaires. After the pre-test, structured teaching program was given on global warming and its effects on health to the students. After one week the post test was conducted by using same tool. The pre and post test knowledge was compared and analyzed.
RESULTS
The findings of the study revealed that in the pre-test 85% of the students had inadequate knowledge, 15% had moderate level of knowledge, and none of them had adequate knowledge, Whereas after the structured teaching, the post-test reveals that 75% of the students gained adequate knowledge, 25% had moderate level of knowledge and none of them had inadequate knowledge. There is a significant difference in the pre test and post test knowledge at P<0.05 level.
CONCLUSION
Today’s children are tomorrow’s consumers and policy makers.
Their current knowledge, attitude and behavior will have profound
impact on how the world’s future stands against global warming. So let us educate and sensitize the children on global warming and its effects on health. The study concluded that the structured teaching programme was effective in improving knowledge on Global warming and its effects on health.
TABLE OF CONTENTS
Chapter Content Page
No
I INTRODUCTION 1
1.1 Need for the study 7
1.2 Statement of the problem 11
1.3 Objectives 11
1.4 Operational definitions 12
1.5 Hypothesis 13
1.6 Assumptions 13
1.7 Delimitations 13
1.8 Conceptual framework 14
II REVIEW OF LITERATURE 17
2.1 Literature review related to the study 17
III RESEARCH METHODOLOGY 35
3.1 Research approach 35
3.2 Research design 35
3.3 Setting of the Study 36
3.4 Duration of the Study 36
3.5 Study population 36
3.6 Sample size 36
3.7 Criteria for sample selection 36
3.8 Sampling technique 37
3.9 Research variables 37
3.10 Development and Description of the tool 37
3.11 Score Interpretation 39
3.12 Content Validity 39
Chapter Content Page No
3.13 Ethical Consideration 40
3.14 Reliability 41
3.15 Pilot Study 41
3.16 Data Collection Procedure 42
3.17 Data analysis 43
IV DATA ANALYSIS AND INTERPRETATION 46 4.1 Description of demographic variables 47 4.2 Description of the pre-test knowledge of the
sample 55
4.3 Description of the post-test knowledge of the
sample 56
4.4 Comparison of pre-test and post-test level of
knowledge 57
4.5 Effectiveness of the structured teaching
programme 58
4.6 Association of post-test level of knowledge with
their selected demographic variables 60
V DISCUSSION 64
VI SUMMARY AND CONCLUSION 71
6.1 Summary 71
6.2 Implications 74
6.3 Recommendations 76
6.4 Limitations 76
6.5 Conclusion 76
REFERENCES ANNEXURES
LIST OF TABLES
Table.
No Title
4.1 Description of demographic variables of the study participants
4.2 Description of pre-test knowledge level of knowledge among higher secondary school students
4.3 Description of post-test knowledge level of knowledge among higher secondary school students
4.4 Comparison of pre-test and post-test level of knowledge 4.5 Effectiveness of structured teaching programme and
generalization of knowledge gain score
4.6 Association of post-test level of knowledge with selected demographic variables of Study participants.
LIST OF FIGURES
Figure.
No Title
1.1 Three pillars of Health Promotion – World Health Organization
1.2 Conceptual framework based on Context Input Process Product (CIPP) model
3.1 Schematic Representation of the Methodology 4.1 Age Distribution
4.2 Type of family
4.3 Education status of father 4.4 Occupation status of father 4.5 Education status of mother 4.6 Occupation status of mother 4.7 Monthly income of family 4.8 Type of fuel used for cooking
4.9 Common mode of transport used in family 4.10 Monthly usage of Electricity
4.11 Pre-test Knowledge Score of the participants 4.12 Post-test Knowledge Score of the participants
4.13 Comparison of pre-test and post-test level of knowledge score
4.14 Effectiveness of structured teaching programme
4.15 Association between post test level of knowledge score and age of the students
4.16 Association between post test level of knowledge score and type of family
4.17 Association between post test level of knowledge score and monthly income of the family
4.18 Association between post test level of knowledge score and their mother education
ANNEXURES
S.no Content
1. Certificate of approval from institutional ethics committee 2. Permission letter from Chief Educational officer
3. Certificate of content validity
4. Informed consent - English and Tamil 5. Certificate of English Editing
6. Certificate of Tamil Editing
7. Tool for Data Collection - English and Tamil 8. Lesson plan - English and Tamil
9. Photograph
10. Booklet regarding Global warming and its effects on health
LIST OF ABBREVIATION
S.
No Abbreviation Expansion
1 CI Confidence Interval
2 DF Degree of freedom
3 Fig Figure
4 H1 and H2 Research hypothesis
5 SD Standard Deviation
6 P Significance
7 X2 Chi square test
8 STP Structured Teaching Programme 9 LED Light Emitting Diode
10 CC Climate change
11 CO2 Carbon-di-oxide
12 CH4 Methane
13 O3 Ozone
14 N2O Nitrous Oxide
15 CO Carbon monoxide
14 CFCs Choloroflurocarbons
15 UNIPCC United Nations Intergovernmental Panal on Climate Change
16 WMO World Metrological Organization
17 UNEP United Nations Environment Programme 18 GHGs Greenhouse gases
19 WHO World Health Organization
CHAPTER – I INTRODUCTION
“Climate change is the most severe problem that we are facing today, more serious even than the threat of terrorism”
– David King
„Global warming‟ is an annual increase in the temperature of the atmosphere close to the Earth‟s surface, which can lead to a change in the global climate patterns. Increases in global temperature have caused many disruptions in human life around the Earth. Global warming has caused the rise in global temperatures, the risk of huge natural disasters, the spread of diseases, and the deaths of about 1,50,000 people annually according to the World Health Organization. The terms climate change and global warming have been used as interchangeable terms, but there is a difference in two meanings. „Climate change‟ helps show that there are other changes besides rising temperatures. It means that any major change in measures of climate that lasts for decades or longer. Climate change may result from natural factors, natural processes, and human activities.
Global warming which is also referred to as climate change is the observed rise in the average temperature of the Earth‟s climate system.
The global surface temperature is likely to rise a future 0.3 to 1.7 degree Celsius in the lowest emissions scenario, and 2.6 to 4.8 degree Celsius in the highest emissions scenario. These readings have been recorded by the: National Science Academies of the major Industrialized nations”.
Future climate change and impacts will differ from region to region.
Expected effects include increase global temperatures, rising sea levels, changing precipitations, and expansion of deserts.
Global warming is a serious environmental issue. It is a global phenomenon that has the potential to adversely affect human lives if
corrective measures are not taken. Global Warming occurs when Greenhouse gases in the atmosphere like, carbon dioxide, methane, and nitrogen oxide are increased. Human activities such as exhaust from automobile and industrial combustion engine, gas flaring during hydrocarbon refinery and deforestation and overgrazing with resulting desertification are some of the main causes for increases in greenhouse gases.
Global warming is all about adverse climate change caused by trapping of greenhouse gases (CO2) in the earth atmosphere that affects biodiversity and causes a serious health hazards. Counter measures to facilitate living in hotter temperature like air conditioning and refrigeration will unfortunately consume more electricity from power plants that burn coal, releasing CO2. This will further spike global warming and have a seriously damaging influence on human health.
External forces refer to processes external to the climate system that influence climate. Climate responds to several types of external forcing, such as radioactive forcing due to changes in atmospheric composition;
change in solar luminosity, volcanic eruption and variation in earth‟s orbit around sun.
The greenhouse effect is the process by which absorption and emission of infrared radiation by gases occurs in atmosphere and surface. It was proposed by Joseph Fourier in 1824 and was first investigated quantitatively by Svante Arrhenius in 1896. Naturally occurring amounts of greenhouse gases have a mean warming effect of about 330C.The major greenhouse gases are water vapor, which causes about 36 to 70% of the greenhouse effect; CO2 which causes 9-26%, methane (CH4) which causes 4-9% and Ozone (O3) which causes 3-7%
of greenhouse effect. Cloud also affects the radiation balance, through cloud forcing similar to greenhouse gases. Human activity since the industrial revolution has increased the amount of greenhouse gases in
atmosphere leading to increased radioactive forces from CO2, Methane, tropospheric ozone, CFCs and Nitrous oxide. The concentration of CO2
and Methane have increased by 36% and 148% respectively since 1750.These values are much higher than at any time during the last 800,000 years, the period of which reliable data have been extracted from ice cores. The fossil fuel burning has produced about thre e quarters of increase in CO2 from human activity over the past 20 years.
There are many greenhouse gases which are mainly emitted by human activity. The first and foremost in the list is carbon dioxide.
Excessive burning of fossil fuels like coal and oil is the major factor for producing this gas. Moreover, deforestation i.e. removal of trees for acquiring lands also causes large amount of carbon dioxide in the atmosphere. Cement manufacture also contributes carbon dioxide to atmosphere when calcium carbonate is heated generating lime and carbon dioxide. The second culprit gas is methane, commonly known as natural gas. It is produced as a result of agricultural activities such as livestock digestion, paddy rice farming and use of manure. Methane is also produced due to improper management of waste. Nitrous oxides are generated mainly by fertilizers. Moreover, fluorinated gases such as chlorofluorocarbons (CFCs) are chiefly a result of various industrial processes and refrigeration. These gases are playing their negative part in increasing the havoc of global warming. They are continuously causing an increase in the earth‟s temperature.
Human beings have increased the CO2 concentration in the atmosphere by about thirty percent, which is an extremely significan t increase, even on inter-glacial timescales. It is believed that human beings are responsible for this because the increase is almost perfectly correlated with increases in fossil fuel combustion, and also due other evidence, such as changes in the ratios of different carbon isotopes in atmospheric CO2 that are consistent with "anthropogenic" (human
caused) emissions. Deforestation is responsible for 25% of all carbon emissions entering the atmosphere, by the burning and cutting of about 34 million acres of trees each year.
Global warming, the phenomenon of increasing average air temperatures near the surface of earth over the past one to two centuries.
Climate scientists have since the mid-20th century gathered detailed observations of various weather phenomena (such as temperatures, precipitations, and storms) and of related influences on climate. These data indicate that Earth‟s climate has changed over almost every conceivable time scale since the beginning of geologic time and that the influence of human activities since at least the beginning of the Industrial Revolution has been deeply woven to the very fabric of climate change.
The Intergovernmental Panal on climate change (IPCC) was formed in 1988 by the World Meteorological Organization (WMO) and the United Nations Environment Program (UNEP). In 2013 the IPCC reported that the interval between 1880 and 2012 saw an increase in global average surface temperature of approximately 0.9 degree Celsius.
The increase is closer to 1.1 degree Celsius when measured relative to the preindustrial (1750 – 1800) mean temperature.
A special report produced by the IPCC in 2018 honed this estimate further, noting that human beings and human activities have been responsible for a worldwide average temperature increase of between 0.8 degree Celsius and 1.2 degree Celsius of global warming since preindustrial times, and most of the warming observed over the second half of the 20th century could be attributed to human activities. It predicted that the global mean surface temperature would increase between 3 and 4 degree Celsius by 2100.
BACKGROUND OF THE STUDY
“Climate change poses a major, and largely unfamiliar, challenge”.
Today, humankind‟s activities are altering the world‟s climate.
We are increasing the atmospheric concentration of energy-trapping gases, thereby amplifying the natural "greenhouse effect" that makes the Earth habitable. These greenhouse gases (GHGs) comprise, principally, carbon dioxide (mostly from fossil fuel combustion and forest burning), plus other heat-trapping gases such as methane (from irrigated agriculture, animal husbandry and oil extraction), nitrous oxide and various human-made halocarbons. In its Third Assessment Report (2001), the UN’s Intergovernmental Panel on Climate Change (IPCC) stated: "There is new and stronger evidence that most of the warming observed over the last 50 years is attributable to human activities.
During the twentieth century, world average surface temperature increased by approximately 0.6ºC, and approximately two-thirds of that warming has occurred since 1975. Climatologists forecast further warming, along with changes in precipitation and climatic variability, during the coming century and beyond. Their forecasts are based on increasingly sophisticated global climate models, applied to plausible future scenarios of global greenhouse gas emissions that take into account alternative trajectories for demographic, economic and technological changes and evolving patterns of governance.
The global scale of climate change differs fundamentally from the many other familiar environmental concerns that refer to localized toxicological or microbiological hazards. Indeed, climate change signifies that, today, we are altering Earth‟s biophysical and ecological systems at the planetary scale – as is also evidenced by stratospheric ozone depletion, accelerating biodiversity losses, stresses on terrestrial
and marine food producing systems, depletion of freshwater supplies, and the global dissemination of persistent organic pollutant s.
Change in world climate would influence the functioning of many ecosystems and their member species. Likewise, there would be impacts on human health. Some of these health impacts would be beneficial. For example, milder winters would reduce the seasonal winter-time peak in deaths that occurs in temperate countries, while in currently hot regions a further increase in temperatures might reduce the viability of disease - transmitting mosquito populations. Overall, however, scientists consider that most of the health impacts of climate change would be adverse.
Climatic changes over recent decades have probably already affected some health outcomes. Indeed, the World Health Organization estimated, in its "World Health Report 2002", that climate change was estimated to be responsible in 2000 for approximately 2.4% of worldwide diarrhoea, and 6% of malaria in some middle-income countries. However, small changes, against a noisy background of ongoing changes in other causal factors, are hard to identify. Once spotted, causal attribution is strengthened if there are similar observations in different population settings.
Climate change is one of several concurrent global environmental changes that simultaneously affect human health – often interactively. A good example is the transmission of vector-borne infectious diseases, which is jointly affected by climatic conditions, population movement, forest clearance and land-use patterns, biodiversity losses (e.g., natural predators of mosquitoes), freshwater surface configurations, and human population density.
Health impacts can result from direct exposures to climate change through changing weather patterns (e.g., heat waves) and extreme weather events, or indirectly through changes in water availability, air
quality and resultant changes in agriculture and the economy (Knowlton et al., 2011).
There are endless examples of the negative health effects of extreme climate events and health. Droughts and floods have disrupted growing seasons resulting in crop failures which can lead to an increase in malnutrition and related disorders, particularly as it relates to child growth and development such as low birth weight (Portier & Tart, 2010).
1.1NEED FOR THE STUDY:
“We are running out of time, we must have a planetary solution to a planetary crisis”
- Al Gore
Global Warming is the observed and projected increase in the average temperature of earth‟s atmosphere and oceans due to greenhouse gas emissions like CFC, CH4, N2O, CO, Hydro carbons on account of human activities. The effects of Greenhouse gas due to increase in Green House Gas warms the planet; decrease in Greenhouse gas cools the planet. Unfortunately there is a steep increase of the temperature in the last three decades. Global warming is not only affecting the nature, but it affects the life and homes of millions of people.
Over the last 50 years, human activities – particularly the burning of fossil fuels – have released sufficient quantities of carbon dioxide and other greenhouse gases to trap additional heat in the lower atmosphere and affect the global climate. In the last 130 years, the world has warmed by approximately 0.85oC. Each of the last 3 decades has been successively warmer than any preceding decade since 1850.Sea levels are rising, glaciers are melting and precipitation patterns are changing.
Extreme weather events are becoming more intense and frequent.
According to the National Climate Assessment, human influences are the number one cause of global warming, especially the carbon pollution we cause by burning fossil fuels and the pollution-capturing we prevent by destroying forests. The carbon dioxide, methane, soot, and other pollutants we release into the atmosphere act like a blanket, trapping the sun's heat and causing the planet to warm. Evidence shows that 2000 to 2009 was hotter than any other decade in at least the past 1,300 years. This warming is altering the earth's climate system, including its land, atmosphere, oceans, and ice, in far-reaching ways.
The U N Intergovernmental panel on climate change [IPCC]
which draws upon the collective wisdom of many hundreds of scientist from around the world. The IPCC projects global temperature increases of 3-10 degree F in the next 100 years and says that human activity is the cause of most of the observed and projected warming. Warmer temperatures lead to greater concentrations of ground level ozone, which forms on hot, sunny days when pollution from cars and sources mix.
Extreme high air temperatures contribute directly to deaths from cardiovascular and respiratory disease, particularly among elderly people. In the heat wave of summer 2003 in Europe for example, more than 70 000 excess deaths were recorded. High temperatures also raise the levels of ozone and other pollutants in the air that exacerbate cardiovascular and respiratory disease. Pollen and other aeroallergen levels are also higher in extreme heat. These can trigger asthma, which affects around 300 million people. On - going temperature increases are expected to increase this burden.
Measuring the health effects from climate change can only be very approximate. Nevertheless, a WHO assessment, taking into account only a subset of the possible health effects, and assuming continued economic growth and health progress, concluded that climate
change is expected to cause approximately 250 000 additional deaths per year between 2030 and 2050; 38 000 due to heat exposure in elderly people, 48 000 due to diarrhea, 60 000 due to malaria, and 95 000 due to childhood under nutrition
Globally, the number of reported weather-related natural disasters has more than tripled since the 1960s. Every year, these disasters result in over 60 000 deaths, mainly in developing countries. Rising sea levels and increasingly extreme weather events will destroy homes, medical facilities and other essential services. More than half of the world's population lives within 60 km of the sea. People may be forced to move, which in turn heightens the risk of a range of health effects, from mental disorders to communicable diseases.
Increasingly variable rainfall patterns are likely to affect the supply of fresh water. A lack of safe water can compromise hygiene and increase the risk of diarrhoeal disease, which kills over 500 000 children aged under 5 years, every year. In extreme cases, water scarcity leads to drought and famine. By the late 21st century, climate change is likely to increase the frequency and intensity of drought at regional and global scale.
Floods are also increasing in frequency and intensity, and the frequency and intensity of extreme precipitation is expected to continue to increase throughout the current century. Floods contaminate freshwater supplies, heighten the risk of water-borne diseases, and create breeding grounds for disease-carrying insects such as mosquitoes.
They also cause drowning‟s and physical injuries, damage homes and disrupt the supply of medical and health services.
Rising temperatures and variable precipitation are likely to decrease the production of staple foods in many of the poorest regions.
This will increase the prevalence of malnutrition and under nutrition, which currently cause 3.1 million deaths every year.
Tanja Wolf et al. (2015) Certain groups are particularly vulnerable to the health effects of climate change, including the elderly, children, people with chronic diseases, people from low income groups, and workers subject to specific exposure (such as extreme temperatures, fires, and flooding). In addition, the increasing burden of climate change on human health will generate new and growing challenges for health systems, due to increases in care demands relating to increased morbidity and mortality, and additional pressure from extreme weather events. This will generate costs for all of society and exacerbate inequality
Many policies and individual choices have the potential to reduce greenhouse gas emissions and produce major health co-benefits. For example, cleaner energy systems, and promoting the safe use of public transportation and active movement – such as cycling or walking as alternatives to using private vehicles – could reduce carbon emissions, and cut the burden of household air pollution, which causes some 4.3 million deaths per year, and ambient air pollution, which causes about 3 million deaths every year.
Fig 1.1 Three Pillars Of Health Promotion – World Health Organization
The components of the framework are utilized to justify the need of the present study as follows:
Good Governance: It provides fair legal framework containing the measures to reduce global warming to make healthy environment.
Healthy Literacy: Increases knowledge by providing information regarding global warming, its causes, health effects and solutions to control global warming. Nurses‟ play an important role in providing health literacy to the community.
Healthy Cities: Healthy cities are possessing an environment with free of disease causing agents which will be provided through the participation of the community in Governance with the various sectors.
The above mentioned model specifies that the nurses play essential roles in public health, clinical care, emergency services, research, and advocacy through their work to reduce and respond to the health effects of global warming.
1.2 STATEMENT OF THE PROBLEM:
A study to assess the effectiveness of structured teaching programme on knowledge regarding global warming and its effects on health among higher secondary school students at selected Government School in Chennai.
1.3 OBJECTIVES
To assess the level of knowledge regarding global warming and its effects on health among higher secondary school students at selected Government school in Chennai.
To evaluate the effectiveness of structured teaching program me (Post-test) on knowledge regarding global warming and its effects
on health among higher secondary school students at selected Government school in Chennai.
To compare the pre-test and post-test knowledge regarding global warming and its effects on health among higher secondary school students at selected Government school in Chennai.
To find out the association between the post-test level of knowledge and selected demographic variables.
1.4 OPERATIONAL DEFINITIONS
AssessIn this study it refers to estimate the knowledge of higher secondary school students regarding global warming and its effects on health.
Effectiveness
In this study it refers to evaluate the outcome of desired changes brought by the structured teaching programme measured by the self - structured knowledge questionnaire.
Structured teaching programme:
In this study it refers to systematically planned instruction module to provide adequate information regarding global warming and its effects on health among higher secondary school students.
Knowledge
It refers to the response and understanding of the students regarding the global warming and its effects on health
Global warming
In this study it refers to an increase in the earth‟s average atmospheric temperature that causes corresponding changes in climate and that may results from the greenhouse effect.
Effects
In this study it refers to an influence or causes someone or something to change over a short time or a long time periods.
Health
In this study tt refers to a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity
Higher secondary school students
In this study it refers to the students those who are studying XI standard at selected Government school in Chennai.
1.5 HYPOTHESES
H1: There will be a significant difference between pre-test and post- test level of knowledge regarding global warming and its effects on health among higher secondary school students at selected Government school, Chennai.
H2: There will be a significant association of post-test level of knowledge regarding global warming and its effects on health with selected demographic variables.
1.6 ASSUMPTIONS
The higher secondary students may have some knowledge regarding global warming and its effects on health.
Administration of Structured teaching programme will enhance adequate knowledge regarding global warming and its effects on health among higher secondary school students.
1.7 DELIMITATIONS
The study is limited to higher secondary school students at selected Government school in Chennai.
The study is limited to 4 weeks 1.8 CONCEPTUAL FRAMEWORK
Context, Input, Process and Product Evaluation (CIPP) Model.
The conceptual framework is a process of ideas which are framed and utilized for the development of a research design .It helps the researcher to know what data needs to be collected and gives direction to an entire research process.
The CIPP Model is a comprehensive framework for guiding formative and summative evaluations of projects, programs, personnel, products, institutions, and systems. The CIPP Model was developed by Daniel Leroy Stufflebeam and colleagues in 1966. Applications have spanned various disciplines and service areas, including education, housing and community development.
The model‟s core concepts are denoted by the acronym CIPP, which stands for evaluations of an entity‟s context, inputs, processes, and products. Context evaluations assess needs, problems, assets and opportunities to define goals and priorities. Input evaluations assess alternative approaches,
Competing action plans and budgets for their feasibility and potential cost effectiveness to meet targeted needs and achieve goals.
Process evaluations assess the implementation of plans. Product evaluations identify and assess outcomes.
In this study, the context process includes the demographic variables like age, education, occupation, family income, family system, type of fuels used for cooking, most common vehicle for transportation and monthly usage of electricity. A pre - intervention assessment was
done on level of knowledge, about Global warming and its effects on health
In the Input the selected sample receives structured Teaching programme on Global warming and its effects on health
The process includes the transformation of knowledge, regarding Global warming and its effects on health.
The product is changing in level of knowledge on Global warming and its effects on health.
FIG 1.2 CONCEPTUAL FRAMEWORK
BASED ON CONTEXT, INPUT, PROCESS, PRODUCT (CIPP) MODEL
Demographic Variables
Age
Education
Occupation
Family income
Family system
Type of fuel used for cooking
Vehicle used for transportati on
Monthly usage of electricity
Pretest level of knowledge
on Global warming and its effects on
health
Administratio n of structured
teaching programme
on Global warming and its effects on
health
Transformat ion of knowledge
on Global warming and its effects on
health
Post test level of knowled
ge on Global warming
and its effects
on healths
CONTEXT INPUT PROCESS PRODUCT
Adequate
Moderate
Inadequate
FEEDBACK
CHAPTER – II
2.1 REVIEW OF LITERATURE RELATED TO THE STUDY
Review of literature is defined as broad, comprehensive in depth systematic and critical review of scholarly publications unpublished scholarly print materials, audiovisual materials and personal communications. Review of literature is a key step in research process.
Review of literature refers to an extensive, exhaustive and systemic examination of publications relevant to research project.
Hence the review of literature done behind the study is organized under the following heading.
2.1.1 Literature related to causes of global warming
2.1.2 Literature related to global warming effects on health
2.1.3 Literature related to preventive and control measures of global warming
2.1.4 Literature related to knowledge and perceptions of global warming
2.1.1 LITERATURE RELATED TO CAUSES OF GLOBAL WARMING
Stephanie Pappas (2017) According to the live science report the main driver of global warming is the combustion of fossil fuels. These hydrocarbon heats up the planet via the greenhouse effect, which is caused by the interaction between Earth‟s atmosphere and incoming radiation from the sun. Solar radiation hits earth surface and then bounces back toward the atmosphere as heat. Gases in the atmosphere trap this heat, preventing it from escaping into the void of space.
Bruno Gervet (2017) conducted a quantitative study on
“Deforestation Contributes to Global Warming”. The study concluded that Deforestation would then contribute for the biggest part of noncommercial heat generation, i.e. about 30% of the missing heat.
Basically, it represents 10.8% of the total net heat generation.
Chigbo A. et al. (2016) conducted a experimental study on Industrialization and its Backlash: Focus on Climate Change and its Consequences. The study examines the links between industrialization and climate change and attempts to address some arguments, which always come up when the effects of human activities on climate change.
The study concluded anthropogenic activities are largely responsible for the problem of climate change.
Chew-Hung chang et al. (2015) conducted a case study on „The Hole in the Sky Causes Global Warming‟ among secondary school students. This study identified secondary school students‟ alternative conceptions (ACs) of climate change and their resistance to instruction.
Using a case-based approach, a diagnostic test was administered to Secondary 3 male students in a pre-test and post-test. The ACs identified in the pre-test were on the causes of climate change, the natural greenhouse effect and its properties, the enhancement of the greenhouse effect, the elements involved in heat-trapping and their characteristics. Whereas there was significant improvement in students‟
understanding in the post-test, the distribution of responses for each of the ACs showed that the reduction in erroneous responses was not sufficient to reject the ACs fully. The authors recommend that instruction should move beyond patchwork pedagogy to a more explicit acknowledgement, incorporation and direct refutation of misconceived knowledge structures.
Umair shahzard, (2015) conducted a descriptive study on “Global warming: causes, effects and solutions”. The paper discussed here has
only dented the surface of what is a very intricate line of scientific and engineering exploration. Global warming is a big hazard and appropriate measures must be taken to tackle this serious problem. This problem is not only causing trouble to the human beings but also to animals and plants. Melting of polar ice caps will lead to floods which can cause mayhem everywhere. Rise of sea levels will devastate agricultural and fishing activities. To embark upon these problems, some remedial steps must be timely taken which include but are not limited to the use of renewable sources of energy and stopping deforestation. Innovative solutions must be brought forward to end this hazard once and forever.
Michael J. Ring et al. (2012) conducted a review on “Causes of the Global Warming Observed since the 19th Century”. The study aims to determine whether this global warming is due to natural causes, as contended by climate contrarians, or by human activities, as argued by the Intergovernmental Panel on Climate Change. Two independent methods are used to analyze the temperature measurements: Singular Spectrum Analysis and Climate Model Simulation. The concurrence of the results of the two methods, each using 13 additional years of temperature measurements from 1998 through 2010, shows that it is humanity, not nature, that has increased the Earth‟s global temperature since the 19th century. Humanity is also responsible for the most recent period of warming from 1976 to 2010.
2.1.2 LITERATURE RELATED GLOBAL WARMING EFFECTS ON HEALTH
Katie Hayes et al. (2018) describes in an article on climate change and mental health: risk, impacts and priority actions. It provides an overview of the current and projected climate change risks and impacts to mental health and provides recommendations for priority actions to address the mental health consequences of climate change.
The article concludes that the climate change affects mental health in a
variety of direct, indirect and overarching pathways disproportionately.
The mental health implications of climate change can result in mental problems and illness as well as affirmative psychosocial outcomes.
Ivan Parise (2018) reported in an article about “A brief review of global climate change and the public consequences”. This paper seeks to examine briefly the association between fossil fuels and global climate change, the consequent environmental changes and the predicted public health effects. The articles describes that in many studies, some summarized by the Intergovernmental Panal on Climate Change, clearly conclude that it is extremely likely that anthropogenic GHG emissions are the dominant reason for global warming since the mid-20th century.
Global climate change was estimated to have caused 1,50,000 deaths and 5.5 million lost disability – adjusted life per year. This paper concludes that a response to global climate change is urgently required, involving strategies to mitigate and adapt to global climate change.
Tanja Wolf et al. (2015) a comprehensive literature search was conducted according to the Preferred Reporting Items for Systema tic Reviews and Meta-Analyses (PRISMA) methodology to study the health effects of climate change in the WHO European region . The search was designed to identify recent research papers relevant to the effects of climate change on health in the WHO European Region. This article summarizes new knowledge on these health risks generated since the IPCC fourth assessment report (AR4) was published in 2007, with a specific focus on the 53 countries comprising the WHO European Region. Many studies on the effects of weather, climate variability, and climate change on health in the European Region have been published since 2007, increasing the level of certainty with regard to already known health threats.
Jonathan De Blois et al. (2015) conducted a correlational study on “The effects of climate change on cardiac health”. The study
concluded the on going climate changes are (at least in part) secondary to anthropogenic activities and are expected to continue, even in the
„best-case scenario‟. Environmental stimuli do have an influence on cardiac health and there is a well-defined U-shape curve relation between temperature and cardiac event outcomes. Increased climate change-related heat exposure is associated with an increase in cardiac events. Elderly people, people with pre-existing cardiac diseases and people who perform heavy physical labour are among the most vulnerable.
Margherita Grasso et al. (2015) conducted a survey of recent quantitative research denotes there has been a large scientific and public debate on climate change and its direct as well as indirect effects on human health. According to Margherita some 2.5 million people die every year from non-infectious diseases directly attributable to environmental factors such as air pollution, extreme weather events, and stressful conditions in the workplace, exposure to chemicals such as lead, and exposure to environmental tobacco smoke.
Massimo Franchini et al. (2015) reported in an article about impact on human health of climate change in which he states that th e on-going increase of greenhouse gas emissions from anthropogenic activities caused dramatic climate changes, the global rise in average temperature is causing a increase of events that have adverse effects on human health, The cardiopulmonary system and the gastrointestinal tract are particularly vulnerable to global warming and there is also a higher risk of infectious and allergic diseases so there is a need to implement at a global level effective strategies for mitigation and adaptation meant to reduce the impact that global warming has on human health.
Leonard E.G. Mboera et al. (2014) conducted a co- relational study on “Impact of climate change on human health and health systems in Tanzania”. The objective of this review was to analyse the potential
risk and vulnerability in the context of climate-sensitive human diseases and health system in Tanzania. The review has shown that a number of climate associated infectious disease epidemics have been reported in various areas of the country; mostly being associated with increase in precipitation and temperature
Louise K. Andersen, MD et al. (2014) conducted a descriptive study on “Global climate change and its dermatological diseases”. The study describes the effects of climate on skin health and disease are an important. Counteracting the effects of change is something all who care for the skin are able to do. Awareness about the potential impacts of climate change on human health seems to be growing. Currently, there is some literature describing how certain skin diseases may be affected by climatic change, but for the future more research and data collection are needed.
Thomas J. Susan Clayton et al. (2014) conducted a qualitative study on “The Psychological Impacts of Global Climate Change”. This article describes three classes of psychological impacts: direct (e.g., acute or traumatic effects of extreme weather events and a changed environment); indirect (e.g., threats to emotional well-being based on observation of impacts and concern or uncertainty about future risks);
and psychosocial (e.g., chronic social and community effects of heat, drought, migrations, and climate- related conflicts, and post disaster adjustment). Responses include providing psychological interventions in the wake of acute impacts and reducing the vulnerabilities contributing to their severity; promoting emotional resiliency and empowerment in the context of indirect impacts; and acting at systems and policy levels to address broad psychosocial impacts.
Jonathan A. Patz et al. (2014) conducted a study on Challenges and opportunities for global health to review recent studies on health risks related to climate change in which he states that the adverse health
aspects related to climate change may include heat related disorders, such as heat stress and economic consequences of reduced work capacity: respiratory disorders, including those exacerbated by air pollution and aeroallergens, such as asthma; infectious diseases, including vector borne diseases and waterborne diseases, such as childhood gastrointestinal diseases; food insecurity, including reduced crop yields and an increase in plant diseases; mental health disorders etc. The article concluded that there is evidence over the past 20 years indicates that climate change can be associated with adverse health outcomes.
2.1.3 LITERATURE RELATED TO PREVENTION AND CONTROL MEASURES OF GLOBAL WARMING
John R. Balmes (2018) reported about Climate change and implications for prevention in California, in which he states that the concept of a climate gap in air quality control captures the decreased effectiveness of regulatory policies to reduce the pollution with a hotter climate. Sources of greenhouse gases and climate forcing aerosols are the sources of air pollutants that harm health. California has adopted robust climate change mitigation policies that are also designed to achieve public health co-benefits by improving air quality. These policies include advanced clean car standards, renewable energy, a sustainable community strategies to limit suburban sprawl, a low carbon fuel standard, and energy efficiency. The study concluded that we need strong policies to move our economy away from reliance on fossil fuels.
Philip Landrigen et al. (2018) states in his article about
“Pollution prevention and climate change mitigation: measuring the health benefits of comprehensive interventions” in which the author states that pollution and climate change have widespread effects on health. Pollution is the largest environmental cause of disease and de ath today. Bold and comprehensive strategies that simultaneously address
both problems are needed to overcome the separation between pollution prevention and climate change mitigation by adoption of wind and solar power, construction of high speed public transport systems, and the design of healthy, walkable, human centered cities. Integration of pollution control with climate change mitigation against a background of rigorous quantification will mark an important advance for planetary health and produce measurable benefits for human wellbeing.
Inyinbor Adejumoke A et al. (2018) states in his article about
“Water pollution: Effects, Prevention and climatic impact” in which the author said, the stress on our water environment as a result of increased industrialization, which aids urbanization, is becoming very high thus reducing the availability of clean water. The availability of clean water is greatly threatened by various human activities and of interest is pollution which in turn affects the ecosystem and causes various climatic changes. Thus effective environmental protection policies compliance drive will be of immense benefit to the environment and by extension to human.
Hui-Jun Wang et al. (2017) reported in an article “On assessing haze attribution and control measures in China”. This paper analyses the air pollution situation in China, particularly the severe intensifying tendency in Central North China. The author states that five major comments on the air pollution issue in China are proposed, emphas izing the scientific understanding on the mechanisms of air pollution formation processes, the inter-annual variability, the relative roles of climate change and pollutant emissions, and the interaction between climate change and atmospheric chemical processes, and the seasonal prediction of air pollution. The development of regional air pollution prevention measures and control plans and enforcement is an important and urgent task, in order to limit the air pollution in China.
Valery Masson et al. (2014) The article about “Solar panals reduce both global warming and urban heat island” in which the author states that the production of solar energy in cities is clearly a way to diminish our dependency to fossil fuels, and is a good way to mitigate global warming by lowering the emissions of greenhouse gases. In future climate conditions, solar panals would also help to decrease the demand of air conditioning. The article summarized that the deployment of solar panals is good both for producing energy and for decreasing urban heat island, especially in summer, when it can be a thread to health.
Mark Z Jacobson et al (2009) states in his paper, reviews and ranks major proposed “Energy related solutions to global warming, air pollution mortality, and energy security” while considering other impacts of the proposed solutions, such as on water supply, land use, wildlife, resource availability, thermal pollution, water chemical pollution, nuclear proliferation and under nutrition. Nine electric power sources and two liquid fuel options are considered. The electricity sources include solar photovolatics, concentrated solar power, wind, geothermal, hydroelectric, wave, tidal, nuclear and coal with carbon capture and storage technology. The combination of these technologi es should be advanced as a solution to global warming, air pollution and energy security.
2.1.4 LITERATURE RELATED TO KNOWLEDGE AND PERCEPTIONS REGARDING GLOBAL WARMING
Janki patel et al. (2018) conducted a quantitative study to assess the knowledge and to assess the effectiveness of structured teaching programme on global warming and its impacts on health among people of unjha city. The data were collected from 50 middle adults were selected by using non probability convenient sampling technique. Pre - experimental one group pre-test post-test design was used. Structured
knowledge questionnaire was used to assess the level of knowledge. The results showed during pre-test, the mean score of level of knowledge was 3.84 and the standard deviation was 1.64. During post-test, the mean score of level of knowledge was 12.16 and the standard deviation was 4.99. „t‟ test value is 9.84. There was no significant association between the knowledge and demographic variables. The study concluded after planned teaching programme middle adults people have improve the knowledge. The planned teaching programme is an effective in inducing the knowledge level of middle adults people regarding Global warming and its impact on health
Kaushal Patidar et al. (2018) conducted a quantitative study to assess the effectiveness of structured teaching programme on knowledge regarding prevention of vector borne disease among adolescents of selected village in Mehsana district. The data were collected from 60 adolescents by non-probability convenient sampling technique. Pre experimental one group pre-test post-test design was used. Structured questionnaire was used to assess the knowledge. The study results shows that overall the highest percentage in the demographic data including the age group (13-14y) 46.67%, Gender 58.33% (Male), Religion 98.33% (Hindu), Type of family 51.67% (Nuclear), Housing facility 91.675 (Pakka house), Education 100% (Secondary), Monthly income 45% (<10,000). The post-test knowledge mean score (17.62+ 4.00) was higher than the mean pre test knowledge score (13.77+2.97). The study concluded that the structured teaching programme found to be effective in improving the knowledge of the adolescents regarding prevention of vector borne diseases.
Sulistyawati Sulistyawati et al. (2018) a cross-sectional study was conducted in Yogyakarta city from June to September 2016. A structured questionnaire was used to collect data among 508 adolescents who were in the second grade of a senior high school. This study
revealed that participants had a low and inconsistent understanding regarding climate change and its impact on health. They reported that they prefer to get climate change information via talking with family. In summary, adolescent knowledge regarding climate change and heal th needs to improve with proper content and appropriate media. The study concluded that Providing proper information regarding climate change and health for young people is a valuable investment in disaster risk reduction. Developing this kind of research is useful for cities in the future since young people are part of the city‟s development.
Julia Hathaway et al. (2018) conducted a review Through a systematic search of English language peer-reviewed studies, to assess how health professionals and the public, worldwide, perceive the health implications of climate change. Recent Findings Among health professionals, perception that climate change is harming health appears to be high, although self-assessed knowledge is low, and perceived need to learn more is high. Among the public, few North Americans can list any health impacts of climate change, or who is at risk, but appear to view climate change as harmful to health. Among vulnerable publics in Asia and Africa, awareness of increasing health harms due to specific changing climatic conditions is high. Americans across the political and climate change opinion spectra appear receptive to information about the health aspects of climate change, although findings are mixed. The review summarized Health professionals feel the need to learn more, and the public appears open to learning more, about the health consequences of climate change.
Lianping Yang et al. (2018) conducted a cross-sectional questionnaire survey on medical, nursing and public health students in china during April and May in 2017. This study aimed to measure the knowledge and perceptions of medical, public health, and nursing students about climate change and its impacts and to identify
