Evaluating and communicating CCH-focused IR

Health outcomes

One key metric for evaluating success is the reduction in climate-sensitive disease morbidity or mortality. Secondary data sources are more commonly used than primary data because they are easier and less expensive to collect.

System resilience

Assessing health care system resilience involves measuring preparedness and response effectiveness following extreme weather events (e.g. heatwaves). Metrics may include the efficiency of hospital response times, the ability of medical facilities to maintain operations during climate disruptions and the post-disaster recovery timeline. Monitoring the implementation of climate-adaptive strategies is also critical in determining system resilience.

Emission reductions

A crucial component of evaluation is the quantifiable reduction in greenhouse gas emissions resulting from implemented interventions. This could include lower emissions from health care facilities through energy-efficient upgrades, reductions in transportation-related emissions due to increased telehealth use or overall decreased carbon footprints of health care supply chains. Reliable data collection methods, such as carbon tracking systems, can provide measurable insights into these improvements.

Behavioural changes

Sustainable behaviour adoption is another important evaluation factor. This includes monitoring increased use of public transportation or active commuting, such as walking and cycling. Additionally, greater community engagement in energy-efficient practices – such as the use of renewable energy sources and waste reduction – can demonstrate the long-term cultural shift toward sustainability. Survey data associated with objective measurements can help assess the effectiveness of these behavioural changes.

Key performance indicators (KPIs) are essential for tracking progress, improving effectiveness and ensuring sustainability in CCH interventions. They help policy-makers, health systems and implementing organizations by:

• providing measurable benchmarks for assessing interventions;
• enabling data-driven decisions for policies and resource allocation;
• allowing for adjustments and optimization of interventions.

KPIs for CCH interventions can be categorized as follows:

• Process indicators help track implementation progress. For example, number of personnel trained on CCH adaptation.
• Outcome indicators help measure effectiveness and impact of implementation activities. For example, reduction in heat-related hospital admissions.
• Sustainability indicators measure long-term impact of interventions.

It is easy to fall into the trap of measuring the wrong thing and inadvertently misrepresenting an intervention’s effectiveness. While process indicators – measuring what was done – are a useful and relatively simple means of monitoring implementation efforts, they can create a false sense of success if they are not paired with strong outcome indicators – measuring what changed as a result.

For example, a CCH programme may report that 500 health care workers attended a workshop on heatwave response. However, if the programme does not measure whether those workers implemented heatwave protocols in their hospitals when needed, the intervention’s real effectiveness remains unknown.

Developing KPIs is a complex and technical undertaking, as is developing the methods and tools to collect these. Methods that are geared to climate–health KPIs must go beyond tracking activities and focus on measuring real-world improvements in health outcomes, resilience and long-term sustainability.

• Make KPIs outcome-driven: measure what changes, not simply what was done.
• Ensure KPIs track real-world impact: use community engagement data, health outcomes, and long-term resilience measures.
• Be flexible: KPIs may need to evolve as new risks emerge and interventions are scaled up.

Research findings only matter if they reach the right stakeholders (e.g. policy-makers, health care professionals, researchers and communities) in clear, actionable and engaging formats.

Providing timely and engaging stakeholder feedback helps to:

• Ensure IR findings are practical and useful for decision-makers and implementers.
• Build trust and transparency, developing long-term collaboration between researchers and communities.
• Improve intervention effectiveness, as stakeholders refine solutions based on real-world challenges.
• Encourage policy integration, helping create actionable CCH strategies.

Bowen et al (2023) note that “despite the acknowledged importance of research translation, there is a lack of research funding and collaborative processes to support this”.⁷⁷ When designing IR studies, researchers should consider how best to share the findings for maximum impact.

When communicating about climate change, one of the most effective strategies is to connect it to something people already care about: their health. Many climate solutions don’t just reduce emissions – they also deliver direct health benefits. Framing climate messaging around health co-benefits, helps shift the conversation from distant, abstract environmental concerns to immediate, tangible improvements in people’s well-being. This makes climate messaging more relatable, persuasive and inclusive.

For example:

• Air pollution – highlight how cleaner air leads to fewer cases of asthma, heart disease and stroke.
• Active transport – walking and cycling does not just lower carbon footprints, it improves fitness, mental health and reduces risk of chronic diseases.
• Diet changes – eating more plant-based foods is not only good for the environment, it reduces risk of heart disease and certain cancers.

Despite the importance of clear communication, researchers often face barriers to effectively disseminating CCH findings. These challenges can hinder public understanding, policy adoption and intervention effectiveness. Table 10 outlines common barriers to CCH communication and how to overcome them.