To determine the risk perception, health-related adaptive behaviours and associated factors related to climate change among high school students in Thiruvananthapuram district, Kerala, India.

A cross-sectional study with multistage cluster sampling was conducted among high school students from Neyyatinkara Taluk in the Thiruvananthapuram district of Kerala, India. After identifying the taluk, 10 schools were chosen using probability proportionate to size to ensure adequate representation.

The study was conducted among 600 high school students (mean age 14 years, SD 0.75) from Neyyatinkara Taluk in the Thiruvananthapuram district of Kerala.

Neyyattinkara taluk was randomly selected from the six taluks in Thiruvananthapuram district. From each of the 10 selected schools, students from classes 8 to 10, section A, formed the study clusters, with cluster sizes ranging from 45 to 60 students. All students from classes 8 to 10 (section A) who were present on the day of the survey and had obtained informed consent from their parents or guardian were considered eligible to participate in the study. Risk perception and health-related adaptive behaviour scores for children were calculated using a pretested structured questionnaire with 8 and 17 questions, respectively. All questions were designed on a 5-point scale. For positively worded questions, scores ranged from 5 to 1 (strongly agree to strongly disagree), and for negatively worded questions, the scoring was reversed. Binary logistic regression analysis was used to determine the independent factors associated with risk perception and health-related adaptive behaviour.

Nearly three in four study participants (72.1%) were aware of the term climate change. The median risk perception score and health-related adaptive behaviour scores were 28 (IQR 26–30) and 52 (IQR 47–57), respectively. Study participants from urban areas had significantly better risk perception compared with rural counterparts (AOR 2.42; 95% CI 1.54 to 3.78). Similarly, children from above poverty line (APL) households demonstrated markedly higher risk perception than those from below poverty line households (AOR 28.77; 95% CI 16.84 to 45). Participation in a climate change awareness programme was also associated with higher risk perception (AOR 1.98; 95% CI 1.23 to 3.19). Positive health-related adaptive behaviour was more likely among children aged 14–16 years compared with those younger than 14 (AOR 1.92; 95% CI 1.3 to 2.84). Urban residence (AOR 20.72; 95% CI 5.04 to 85.17), higher paternal education (AOR 1.91; 95% CI 1.15 to 3.13) and APL household status (AOR 2.50; 95% CI 1.57 to 3.93) were also significantly associated with better adaptive behaviour.

Climate change interventions and awareness programmes should prioritise rural, lower socioeconomic and younger populations and equip them with practical life skills for adaptive behaviour.