{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T15:25:01Z","timestamp":1777649101676,"version":"3.51.4"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T00:00:00Z","timestamp":1584057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,26]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Heatwaves can lead to increased mortality. In the Portuguese heat\u2013health warning system (HHWS), \u00cdCARO, a daily report with heat-related mortality prediction is sent to heat\u2013health action plan (HHAP) practitioners. HHAP practitioners assess risk and implement measures to prevent heatwave-related impact, but \u00cdCARO\u2019s use and understanding are unknown. We assessed \u00cdCARO\u2019s use and understanding by key HHAP practitioners.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted semi-structured interviews with national\/regional HHAP practitioners. Interviews were recorded, transcribed and analysed using thematic content analysis. To maximize credibility a validation process was implemented through researcher triangulation; a sample of 30 segments was recorded by independent researchers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We conducted six interviews with nine professionals (mean time 52\u00a0min) from five regions. We identified four categories: report\u2019s content and presentation, report\u2019s reception and communication, \u00cdCARO and risk assessment and other issues. Practitioners use \u00cdCARO and perceived it as relevant; they raised issues on its interpretation and felt these were not fully addressed, given researchers\u2019 use of statistical\/epidemiological terms. We identified the need for improved communication and report\u2019s clarity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our study stresses the need for collaboration between experts within HHWS\/HHAP. Despite \u00cdCARO\u2019s understanding being challenging, practitioners consider it a relevant tool. Researchers should use less statistical language and clarify \u00cdCARO\u2019s interpretation. Practitioners\u2019 needs should be considered when developing\/revising tools.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pubmed\/fdaa029","type":"journal-article","created":{"date-parts":[[2020,2,5]],"date-time":"2020-02-05T12:10:29Z","timestamp":1580904629000},"page":"395-402","source":"Crossref","is-referenced-by-count":7,"title":["Assessing the use and understanding of the Portuguese heat\u2013health warning system (\u00cdCARO)"],"prefix":"10.1093","volume":"42","author":[{"given":"A","family":"Leite","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal"},{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal"}]},{"given":"A J","family":"Santos","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal"},{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal"}]},{"given":"S","family":"Silva","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal"}]},{"given":"B","family":"Nunes","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal"},{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal"}]},{"given":"R","family":"Mexia","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal"}]},{"given":"A P","family":"Rodrigues","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge, 1649-016 Lisbon, Portugal"}]}],"member":"286","published-online":{"date-parts":[[2020,3,13]]},"reference":[{"key":"2020052704201417900_ref1","volume-title":"Heatwaves and Health: Guidance on Warning-System Development","author":"World Meteorological Organization (WMO), World Health Organization (WHO)","year":"2015"},{"key":"2020052704201417900_ref2","volume-title":"Despacho n\u00b0 14\/2015","author":"Deputy State Secretary of the Minister of Health (SEAMS)","year":"2015"},{"key":"2020052704201417900_ref3","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1002\/joc.1546","article-title":"Models for mortality associated with heatwaves: update of the Portuguese heat health warning system","volume":"28","author":"Nogueira","year":"2008","journal-title":"Int J Climatol"},{"key":"2020052704201417900_ref4","volume-title":"Heat-Health Action Plan 2019 [Plano de conting\u00eancia de Sa\u00fade Sazonal - 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