BACKGROUND: The City of Phoenix initiated the HeatReady program in 2018 to prepare for extreme heat, as there was no official tool, framework, or mechanism at the city level to manage extreme heat. The current landscape of heat safety culture in schools, which are critical community hubs, has received less illumination. HeatReady Schools—a critical component of a HeatReady City—are those that are increasingly able to identify, prepare for, mitigate, track, and respond to the negative impacts of schoolgrounds heat. However, minimal attention has been given to formalize heat preparedness in schools to mitigate high temperatures and health concerns in schoolchildren, a heat-vulnerable population. This study set out to understand heat perceptions, (re)actions, and recommendations of key stakeholders and to identify critical themes around heat readiness. METHODS: An exploratory sequential mixed-methods case study approach was used. These methods focused on acquiring new insight on heat perceptions at elementary schools through semi-structured interviews using thematic analysis and the Delphi panel. Participants included public health professionals and school community members at two elementary schools—one public charter, one public—in South Phoenix, Arizona, a region that has been burdened historically with inequitable distribution of heat resources due to environmental racism and injustices. RESULTS: Findings demonstrated that 1) current heat safety resources are available but not fully utilized within the school sites, 2) expert opinions support that extreme heat readiness plans must account for site-specific needs, particularly education as a first step, and 3) students are negatively impacted by the effects of extreme heat, whether direct or indirect, both inside and outside the classroom. CONCLUSIONS: From key informant interviews and a Delphi panel, a list of 30 final recommendations were developed as important actions to be taken to become “HeatReady.” Future work will apply these recommendations in a HeatReady School Growth Tool that schools can tailor be to their individual needs to improve heat safety and protection measures at schools.

The Planned Parenthood Committee of Phoenix was established in 1942 to expand Arizona women's access to family planning resources. The Planned Parenthood Committee of Phoenix was formed through the merging of The Mother's Health Clinic in Phoenix, Arizona, with the national Planned Parenthood Federation of America. The clinic was primarily based within the Phoenix Memorial Hospital campus but expanded to other locations in the late 1960s. Until it became Planned Parenthood of Central and Northern Arizona in 1978, the Planned Parenthood Committee of Phoenix provided Arizona women with contraception, initially in the form of diaphragms and spermicide, and later including the birth control pill. It also provided educational information on relationships, sex, contraception, and infertility.

On 26 May 1994, US President Bill Clinton signed the Freedom of Access to Clinic Entrances Act in to law, which federally criminalized acts of obstruction and violence towards reproductive health clinics. The law was a reaction to the increasing violence toward abortion clinics, providers, and patients during the 1990s. That violence included clinic blockades and protests, assaults on physicians and patients, and murders. The Freedom of Access to Clinic Entrances Act established
criminal and civil penalties against people who obstructed or committed violence towards reproductive health clinics, and has supported women's access to safe reproductive healthcare.

In the late nineteenth century, August Karl Gustav Bier was a surgeon in Germany who studied spinal cord anesthesia, later called spinal block. Bier found that, depending upon the amount of anesthesia introduced into the spinal cord, a large area of the human body could be numbed to various degrees. Bier established a procedure to numb individuals from the lower legs to the upper abdomen, with the individual’s numbness ranging from them feeling pressure on their body to them feeling nothing at all. Bier’s spinal block was one of the first instances of regional anesthesia, or numbing a large area of the body, as opposed to only local anesthesia, or numbing a small area of the body. Bier’s development of spinal anesthesia led to improved pain management during major surgeries, including cesarean sections and amputations.

Butt Out for Baby was a smoking cessation intervention guide, aimed at community health workers, that the Child and Youth Health group published in 2003. The literature was released as the chief publication of the Butt Out for Baby Project, a multiple-resource smoking cessation program directed toward young parents and pregnant smokers, following the revelation of a relatively high rate of smoking among that group. The authors published the pamphlet in Adelaide, South Australia, and did not credit themselves individually. Gill Faulkner, the manager for Butt Out for Baby Project, developed Butt Out for Baby in partnership with young South Australian parents and pregnant women, who contributed significantly to its communicative style and recommended approaches. Targeting behavioral counsellors, Butt Out for Baby represented a model publication in the majorly successful South Australian smoking cessation campaign, which reached thousands of young parents and pregnant women to contribute to a significant decrease in youth smokers over the subsequent decade.

In the mid-1960s, psychologist John Money encouraged the gender reassignment of David Reimer, who was born a biological male but suffered irreparable damage to his penis as an infant. Born in 1965 as Bruce Reimer, his penis was irreparably damaged during infancy due to a failed circumcision. After encouragement from Money, Reimer’s parents decided to raise Reimer as a girl. Reimer underwent surgery as an infant to construct rudimentary female genitals, and was given female hormones during puberty. During childhood, Reimer was never told he was biologically male and regularly visited Money, who tracked the progress of his gender reassignment. Reimer unknowingly acted as an experimental subject in Money’s controversial investigation, which he called the John/Joan case. The case provided results that were used to justify thousands of sex reassignment surgeries for cases of children with reproductive abnormalities. Despite his upbringing, Reimer rejected the female identity as a young teenager and began living as a male. He suffered severe depression throughout his life, which culminated in his suicide at thirty-eight years old. Reimer, and his public statements about the trauma of his transition, brought attention to gender identity and called into question the sex reassignment of infants and children.

Margaret Higgins Sanger advocated for birth control in the United States and Europe during the late nineteenth and early twentieth centuries. Although people used contraceptives prior to the twentieth century, in the US the 1873 Comstock Act made the distribution of information relating to the use of contraceptives illegal, and similar state-level Comstock laws also classified discussion and dissemination of contraceptives as illegal. Sanger helped to repeal the Comstock Act and similar laws so that women could legally use contraceptives to control their fertility and the sizes of their families. In 1916, Sanger opened the first birth control clinic in the US in New York City, New York. Later in life, Sanger formed several advocacy organizations that promoted access to contraception, including the Planned Parenthood Federation of America. Sanger's advocacy increased women's access to contraception and helped change the United States' social and legal perceptions of birth control.

Margaret Goldwater advocated for birth control and reproductive rights in the United States during the twentieth century. Goldwater was a socialite and philanthropist and was married to Barry Goldwater, US Senator from Arizona. She spent much of her life working to further the women's reproductive rights movement, which sought to expand women's legal, social, and physical access to reproductive healthcare, including contraception and abortions. Goldwater, with guidance from birth control activist Margaret Sanger, helped establish the second birth control clinic in Arizona, the Mother's Health Clinic in Phoenix, Arizona. She conducted large fundraising events and authored articles in local newspapers on the need for contraceptives and family planning. Goldwater's advocacy helped launch and sustain The Mother's Health Clinic, which became the largest provider of women's reproductive healthcare in Arizona, and it later became Planned Parenthood of Central and Northern Arizona.

Barry Morris Goldwater was a Republican Arizona Senator and US presidential candidate in the twentieth-century whose policies supported the women's reproductive rights movement. Goldwater, a businessman and Air Force reservist, transitioned into politics in the 1950s. He helped align popular support for a conservative Republican Party in the 1960s. Throughout his life, he worked to maintain personal liberty and to limit governmental intrusion into citizens' private lives. Goldwater, influenced by his wife Margaret (Peggy) Goldwater, supported women's rights to abortions. Goldwater's advocacy and support for reproductive rights assisted in the foundation of the Planned Parenthood chapter in Phoenix, Arizona, and for national policies promoting birth control and abortion rights.

The 1973 case Nelson v. Planned Parenthood Center of Tucson established the legality of abortion in Arizona. The Arizona Court of Appeals ruled that the Arizona Revised Statutes 13-211, 13-212, and 13-213, collectively called the Arizona abortion statutes, were unconstitutional. The statutes had made illegal receiving, providing, or advertising abortions. After the Arizona Appeals Court heard the case, it decided that the Arizona abortion statutes were constitutional. However, two weeks later the US Supreme Court decided in Roe v. Wade (1973) that abortion was constitutional at the federal level. The Arizona court followed the precedent set by the US Supreme Court and amended its decision to rule that the Arizona abortion statutes were unconstitutional. Afterwards, Planned Parenthood, other family planning clinics, and hospitals were legally allowed in Arizona to advertise, discuss, and offer abortions as an option to their patients.