Capability, opportunity and motivation are associated with heat protective behaviour among urban residents

Abstract Extreme heat poses increasing public health risks due to climate change, yet adoption of protective behaviours remains suboptimal. This study applied the Capability, Opportunity, Motivation, and Behaviour (COM-B) framework to identify correlates of heat-protective behaviour during extreme heat episodes in three Spanish cities. A cross-sectional survey of 1508 urban residents was conducted in July 2025 following several heat wave episodes. Participants reported frequency of seven protective behaviours and completed measures of capability (knowledge, confidence, resource availability, perceived effectiveness), opportunity (housing characteristics, social support, institutional resources), and motivation (worry, perceived severity, intention, attitudes, self-efficacy). Hierarchical multiple regression examined incremental contributions of COM-B components. The full model explained 28% of behavioural variance, with motivation and capability contributing roughly equally and opportunity showing smaller effects. The strongest predictors were intention, worry, perceived severity, positive attitudes toward self-protection, and social support. Women and younger adults reported higher protective behaviour. These findings suggest that effective interventions must address both emotional engagement and positive attitudes toward protection while highlighting the need for universal access to cooling resources and leveraging community networks. The relative importance of COM-B components may vary by behaviour type and context, requiring tailored approaches.