Resilience in healthcare workers: a global scoping review and evidence gap mapping of climate change-related health literacy and attitudes influencing adaptive practice
1
Institute for Sustainable Futures, University of Technology Sydney, Sydney, Australia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Accelerating climate change poses escalating challenges to healthcare systems worldwide, placing healthcare workers at the frontline of acute climate-related events and longer-term systemic stressors 1,2. Understanding how climate-health literacy and attitudes shape healthcare workers’ adaptive practice and resilience is central to building climate-resilient health systems. This review synthesises global evidence on healthcare workers’ climate change-related health literacy and attitudes and examines factors influencing adaptive practice and resilience.
METHODS:
This scoping review followed the Joanna Briggs Institute methodology and is reported in accordance with PRISMA-ScR guidelines. Systematic searches were conducted in PubMed, MEDLINE, Scopus, Web of Science, EMBASE, CINAHL, and PsycINFO for English-language studies published between 2014 and 2025. Quantitative, qualitative, and mixed-methods studies examining HCWs’ climate-health literacy, beliefs and attitudes, adaptive practices, and multi-level barriers and facilitators to adaptive practice and resilience were included. Data were synthesised using descriptive and thematic approaches. Results and conclusion Thirty-one studies from high-, middle-, and low-income settings were included. Climate-health literacy was widely examined, and HCWs generally recognised climate change as an escalating public health threat. Attitudes towards climate-health engagement were largely positive; however, translation of knowledge and concern into routine clinical, organisational, and system-level practice remained limited. Only a small number of studies explicitly examined resilience. Key facilitators of adaptive practice and resilience included competency-based education, leadership engagement, clear operational guidance, supportive workplace cultures, and cross-sector collaboration. Major barriers included fragmented governance, limited resources, workload pressures, and inequitable access to climate-health training. Overall, the findings indicate that climate change constrains healthcare workers’ adaptive capacity and resilience, highlighting the need for coordinated, multi-level interventions that integrate equitable climate-health education, supportive governance, and climate adaptation into routine health system operations to enable sustainable and inclusive public health responses across diverse global health system contexts.
Accelerating climate change poses escalating challenges to healthcare systems worldwide, placing healthcare workers at the frontline of acute climate-related events and longer-term systemic stressors 1,2. Understanding how climate-health literacy and attitudes shape healthcare workers’ adaptive practice and resilience is central to building climate-resilient health systems. This review synthesises global evidence on healthcare workers’ climate change-related health literacy and attitudes and examines factors influencing adaptive practice and resilience.
METHODS:
This scoping review followed the Joanna Briggs Institute methodology and is reported in accordance with PRISMA-ScR guidelines. Systematic searches were conducted in PubMed, MEDLINE, Scopus, Web of Science, EMBASE, CINAHL, and PsycINFO for English-language studies published between 2014 and 2025. Quantitative, qualitative, and mixed-methods studies examining HCWs’ climate-health literacy, beliefs and attitudes, adaptive practices, and multi-level barriers and facilitators to adaptive practice and resilience were included. Data were synthesised using descriptive and thematic approaches. Results and conclusion Thirty-one studies from high-, middle-, and low-income settings were included. Climate-health literacy was widely examined, and HCWs generally recognised climate change as an escalating public health threat. Attitudes towards climate-health engagement were largely positive; however, translation of knowledge and concern into routine clinical, organisational, and system-level practice remained limited. Only a small number of studies explicitly examined resilience. Key facilitators of adaptive practice and resilience included competency-based education, leadership engagement, clear operational guidance, supportive workplace cultures, and cross-sector collaboration. Major barriers included fragmented governance, limited resources, workload pressures, and inequitable access to climate-health training. Overall, the findings indicate that climate change constrains healthcare workers’ adaptive capacity and resilience, highlighting the need for coordinated, multi-level interventions that integrate equitable climate-health education, supportive governance, and climate adaptation into routine health system operations to enable sustainable and inclusive public health responses across diverse global health system contexts.
| eISSN: | 2654-1459 |
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