Assessing acceptability, feasibility, and appropriateness of heat-mitigation infrastructure interventions in the BRAC primary schools of two selected climate-vulnerable districts of Bangladesh: A mixed-method implementation study

Abstract

Background: In recent years, Bangladesh has seen a rise in heat waves, impacting the health, well-being and livelihood of people. Children are one of the population groups experiencing the worst impact. To reduce the impact of heat wave on primary school going children, BRAC James P Grant School of Public Health (JPGSPH), BRAC University, in close collaboration with the Architecture department of BRAC University and BRAC Education Programme (BEP) is currently implementing two locally led heat-mitigation interventions - Solar Reflective Paint (SRP) and Bamboo Ceiling with Polyethylene Foam (BCPF) in 92 BRAC primary schools located in two climate-vulnerable districts of Bangladesh- Gaibandha and Kurigram. This study assesses the acceptability, feasibility and appropriateness of these interventions.

Objectives: The objective of this study is to assess key implementation outcomes of two heatmitigation infrastructure interventions, the SRP and BCPF, focusing on their acceptability, feasibility, and appropriateness among key stakeholders in selected BRAC primary schools, which are tin-sheds located in climate-vulnerable districts of Bangladesh.

Methods: A cross-sectional design using a convergent mixed-methods approach nested within the parent Cluster Randomized Controlled Design (cRCT) was used.. To assess the acceptability, feasibility and appropriateness, the TFA (Theoretical Framework of Acceptability), FIM (Feasibility of Intervention) and IAM (Intervention Appropriateness Measurement) were used, respectively. A 5-point Likert scale questionnaire was used to collect data from different stakeholder groups such as BRAC School house owners, teachers and implementers. Both EFA (Exploratory Factor Analysis) and CFA (Confirmatory Factor Analysis) were performed for the TFA scale validation. Additionally, Cronbach’s Alpha values were assessed to measure the internal consistency of the contextualized scale.

Results: The EFA revealed a three-factor solution to identify the TFA for both interventions, SRP and BCPE with Cronbach's Alpha value (>0.7). Items from the EFA factors showed high median scores for both of the interventions, which indicated high acceptability of the interventions. Similarly, for both interventions the median score for feasibility and appropriateness were high. Therefore, the results displayed that both interventions were feasible and appropriate for the community and the implementers.

Conclusions: Both interventions, SRP and BCPF, were perceived as acceptable, feasible and appropriate by the study population in the context of tin-surfaced one room classrooms run by BEP in two climate vulnerable districts where extreme heat is a major problem impacting the health and education of children.