1. Method identification

• Identify possibly useful risk management tools (considering standard risk-management tools and health impact assessment tools), guidelines, and models.

• Collect information helpful in assessing how well these risk-management tools, guidelines, and models fit the needs of the local context.

• Establish a stakeholder reference group of multidisciplinary experts, from service providers to climate change scientists, to ensure regional knowledge translation and implementation.

2. Method modification

• Modify risk-management tool to include scope for collecting data on regional-level health risks and possible service developments under the 5 service development domains.

• Use both quantitative and qualitative data-collection methods, supplementing quantitative data with observational case studies and interviews with local experts.

• Use community consultation methods to ensure a focus on the needs of climate-vulnerable groups, such as children and older citizens as well as the socioeconomically disadvantaged.

• Include scope to collect data on the wider pragmatic determinants of policy, such as strategic and economic considerations relevant to service development options.

• Work with stakeholder groups to collect trial data and refine data-collection methods.

3. Data collection

• Implement tool through stakeholder reference group.

• Involve a wide range of health and allied health services in data collection.

• Include policymakers and others who can offer accounts of sociopolitical and economic barriers to implementation of any service adaptation options, as well as strategies for overcoming these barriers.

• Collect a wide range of supplementary comparative information, such as known benefits and costs of different adaptation (and mitigation) responses in other systems (in other countries and in the same region).

4. Development of data analyses

• Analyze data to identify priority areas of risk and adaptation (as well as mitigation) under each of the 5 service development areas.

• Use epidemiological and narrative analyses to obtain information-rich findings about the local context.

• Invite the stakeholder reference group to review data analyses and provide information on likely lag times of any effects as well as bias introduced by participant populations.

• Audit regional findings obtained in this way against local health plans and developments to determine which priorities need to be added to existing public health policies.

• Analyze best-practice implications of regional findings in the light of existing guidelines and models for achieving adaptation and mitigation, to help decide what is best practice for this region.

5. Development of service priorities

• Develop a user-friendly, written regional impact statement with policy priorities, working with the stakeholder reference group to include: risks for identified groups; likelihood of specific negative (and positive) health outcomes; key health service adaptation and mitigation options for managing each risk, given under the 5 service development domains; cost-benefit analyses of each adaptation and mitigation option, including the costs of inaction; and strategic and political considerations important to the implementation success of the priority adaptation options.