Objective As extreme heat events (EHEs) increase with climate change, it is important to support cooling access by older adults ≥ 65 years of age to prevent heat-related morbidity and mortality. This study aimed to identify barriers and facilitators to cooling access during EHEs and support equity-focused public health programs. Study Design A qualitative descriptive study design was adopted. Methods We conducted 13 focus groups via purposive sampling of older adults ≥ 65 years of age in the City of Hamilton (Hamilton), Ontario and analyzed the data using thematic analysis. Using the six constructs of the Health Belief Model (HBM) themes were identified inductively to understand the barriers and facilitators to cooling access during EHEs. Results Experiential knowledge, age-related risk and health protection were themes identified for HBM’s first three constructs. The theme of accessibility emerged as a barrier for HBM’s fourth construct. The theme of inclusivity was identified as a facilitator for HBM’s fifth construct. HBM’s final construct of self-efficacy surfaced the theme of limited self-determination. Conclusion Although current public health heat response programs are intended to increase availability of cooling, they may not necessarily increase access to cooling. Considering the barriers and facilitators identified, supports equity-focused public health programs.
Radisic et al. (Mon,) studied this question.