1
|
Huang L, Liu Y, Wu Y, Ye Z, Ren F, Liu X, Shen G. Impact of Stove Renovation on PM 2.5 Exposure, Risk Perception, Self-Protective Willingness of Rural Residents. TOXICS 2023; 11:245. [PMID: 36977010 PMCID: PMC10051283 DOI: 10.3390/toxics11030245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
To improve household air quality, the Chinese government has launched a number of pilot stove renovation projects, but few studies have explored the impact of the project on people's perception of and willingness to participate in these renovations; moreover, factors affecting willingness to pay for the project in rural China are not yet clear. We conducted a field measurement and a corresponding door-to-door questionnaire survey using the renovated group and the unrenovated group. The results showed that (1) the stove renovation project could not only reduce PM2.5 exposure and the excess mortality risk of rural residents, but also (2) improve residents' risk perception and self-protective willingness. (3) Specifically, the project had a deeper impact on female and low-income residents. (4) Meanwhile, the higher the income and the larger family size, the higher the risk perception and self-protective willingness. (5) Furthermore, willingness to pay for the project was related with residents' support for the project, benefit from renovation, income, and family size. Our results recommended that stove renovation policies should pay more attention to families with lower income and smaller size.
Collapse
Affiliation(s)
- Lei Huang
- State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
- Nanjing University (Suzhou) High-Tech Institute, Suzhou 215123, China
| | - Yuxin Liu
- State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Yangyang Wu
- State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Ziwen Ye
- State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Futian Ren
- State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Xinlei Liu
- Laboratory for Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Guofeng Shen
- Laboratory for Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| |
Collapse
|
2
|
Neta G, Martin L, Collman G. Advancing environmental health sciences through implementation science. Environ Health 2022; 21:136. [PMID: 36564832 PMCID: PMC9783984 DOI: 10.1186/s12940-022-00933-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/27/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Environmental health sciences have identified and characterized a range of environmental exposures and their associated risk for disease, as well as informed the development of interventions, including recommendations, guidelines, and policies for mitigating exposure. However, these interventions only serve to mitigate exposures and prevent disease if they are effectively disseminated, adopted, implemented, and sustained. MAIN BODY Numerous studies have documented the enormous time lag between research and practice, noting that dissemination and implementation are not passive processes but rely on active and intentional strategies. Implementation science seeks to build the knowledge base for understanding strategies to effectively disseminate and implement evidence and evidence-based interventions, and thus, bridge the research-to-practice gap. CONCLUSION Environmental health researchers are well positioned to advance health promotion and disease prevention by incorporating implementation science into their work. This article describes the rationale for and key components of implementation science and articulates opportunities to build upon existing efforts to advance environmental health supported by the National Institute of Environmental Health Sciences and National Institutes of Health broadly.
Collapse
Affiliation(s)
- Gila Neta
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Lindsey Martin
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709, USA
| | - Gwen Collman
- Office of Scientific Coordination, Planning and Evaluation (SCOPE), National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, NC, 27709, USA
| |
Collapse
|
3
|
Ali J, Khan W. Factors affecting access to clean cooking fuel among rural households in India during COVID-19 pandemic. ENERGY FOR SUSTAINABLE DEVELOPMENT : THE JOURNAL OF THE INTERNATIONAL ENERGY INITIATIVE 2022; 67:102-111. [PMID: 35125780 PMCID: PMC8806018 DOI: 10.1016/j.esd.2022.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/09/2022] [Accepted: 01/22/2022] [Indexed: 05/08/2023]
Abstract
This paper investigates the factors affecting access to clean cooking fuel among rural Indian households during the COVID-19 outbreak, based on World Bank's rural impact survey, covering 2731 rural households. Our analysis shows a significant decline in access to clean fuel among rural households from 35% in 2018 i.e. before COVID-19 to 19.7% during the COVID-19 pandemic. This implies that in order to meet their cooking needs, many rural households have switched from conventional fuels, which have numerous health and environmental concerns. The association between states and socio-demographic profiles of rural households with access to sources of cooking fuel shows a significant difference. The analysis results further indicate that socio-demographic characteristics and asset holdings of the rural households are the key factors that determine access to clean cooking fuel during COVID-19. Among the socio-demographic variables, age, gender, family size, social category, and income level are estimated to be significant factors that affect the access to clean fuel for cooking. Similarly, ownership of assets such as exclusive kitchen room, refrigerator, pressure cooker, television, and furniture are significant factors affecting access to clean cooking fuel among Indian rural households. Additionally, this study provides policy insights on developing mechanisms to ensure that rural households have an access to clean cooking fuel during crisis situations such as COVID-19.
Collapse
Affiliation(s)
- Jabir Ali
- Economics & Business Environment, Indian Institute of Management, Old University Campus, Jammu 180 016, Jammu and Kashmir, India
| | - Waseem Khan
- Institute of Business Management, GLA University, Mathura, Uttar Pradesh, India
| |
Collapse
|
4
|
Sastry J, Agawane S, Rajan M, Black K, Laumbach R, Ramagopal M. The effect of the indoor environment on wheeze- and sleep-related symptoms in young Indian children. Lung India 2021; 38:307-313. [PMID: 34259167 PMCID: PMC8272434 DOI: 10.4103/lungindia.lungindia_120_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Environmental exposures have a significant effect on respiratory and sleep symptoms in young children. Although the effect of air pollution on the respiratory symptoms in young children is well-established, less is known about the effect of household environmental characteristics and practices on wheeze and sleep concerns. Aims The aim of this pilot study is to explore the association between household environmental characteristics and practices with the symptoms of wheezing and sleep concerns in the past year in a convenience sample of young Indian children. Materials and Methods A detailed questionnaire about the child's home environment and respiratory and sleep symptoms was administered to the caregivers of 190 outpatients aged between 6 months and 5 years old at a teaching hospital. Results Indoor environmental characteristics and cleaning techniques were analyzed for the association with wheeze and sleep disorders. Half (50%) of the cohort had the symptoms of wheezing and 21% had occasional or frequent sleep concerns. Sleeping with a stuffed toy was significantly associated with both wheezing and sleep concerns (P = 0.05). Conclusions : Sleeping with a stuffed toy was a risk factor for wheeze and a risk factor for sleep disorders independent of wheeze.
Collapse
Affiliation(s)
- Jayagowri Sastry
- Global and Women's Health Research Unit, Division of Planetary Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shubhangi Agawane
- Department of Community Medicine, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India
| | - Mangala Rajan
- Division of General Internal Medicine, Weill Cornel Medicine, NY, NY, USA
| | - Kathleen Black
- Department of Environmental and Occupational Health, Rutgers University, Piscataway, Piscataway, New Jersey, USA
| | - Robert Laumbach
- Department of Environmental and Occupational Health, Rutgers University, Piscataway; Department of Environmental and Occupational Health, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Maya Ramagopal
- Department of Pediatrics, Division of Pulmonology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| |
Collapse
|
5
|
Rosenthal J, Arku RE, Baumgartner J, Brown J, Clasen T, Eisenberg JN, Hovmand P, Jagger P, Luke DA, Quinn A, Yadama GN. Systems Science Approaches for Global Environmental Health Research: Enhancing Intervention Design and Implementation for Household Air Pollution (HAP) and Water, Sanitation, and Hygiene (WASH) Programs. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:105001. [PMID: 33035121 PMCID: PMC7546437 DOI: 10.1289/ehp7010] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/13/2020] [Accepted: 09/15/2020] [Indexed: 05/23/2023]
Abstract
BACKGROUND Two of the most important causes of global disease fall in the realm of environmental health: household air pollution (HAP) and poor water, sanitation, and hygiene (WASH) conditions. Interventions, such as clean cookstoves, household water treatment, and improved sanitation facilities, have great potential to yield reductions in disease burden. However, in recent trials and implementation efforts, interventions to improve HAP and WASH conditions have shown few of the desired health gains, raising fundamental questions about current approaches. OBJECTIVES We describe how the failure to consider the complex systems that characterize diverse real-world conditions may doom promising new approaches prematurely. We provide examples of the application of systems approaches, including system dynamics, network analysis, and agent-based modeling, to the global environmental health priorities of HAP and WASH research and programs. Finally, we offer suggestions on how to approach systems science. METHODS Systems science applied to environmental health can address major challenges by a) enhancing understanding of existing system structures and behaviors that accelerate or impede aims; b) developing understanding and agreement on a problem among stakeholders; and c) guiding intervention and policy formulation. When employed in participatory processes that engage study populations, policy makers, and implementers, systems science helps ensure that research is responsive to local priorities and reflect real-world conditions. Systems approaches also help interpret unexpected outcomes by revealing emergent properties of the system due to interactions among variables, yielding complex behaviors and sometimes counterintuitive results. DISCUSSION Systems science offers powerful and underused tools to accelerate our ability to identify barriers and facilitators to success in environmental health interventions. This approach is especially useful in the context of implementation research because it explicitly accounts for the interaction of processes occurring at multiple scales, across social and environmental dimensions, with a particular emphasis on linkages and feedback among these processes. https://doi.org/10.1289/EHP7010.
Collapse
Affiliation(s)
- Joshua Rosenthal
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Department of Health and Human Services, Washington, DC, USA
| | - Raphael E. Arku
- Department of Environmental Health Sciences, Department of Environmental Health Sciences, University of Massachusetts, Amherst, Amherst, Massachusetts, USA
| | - Jill Baumgartner
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Joe Brown
- Department of Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Thomas Clasen
- Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | | | - Peter Hovmand
- Center for Community Health Integration, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Pamela Jagger
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, USA
| | - Douglas A. Luke
- Center for Public Health Systems Science, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Ashlinn Quinn
- Division of Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Department of Health and Human Services, Washington, DC, USA
| | - Gautam N. Yadama
- School of Social Work, Boston College, Boston, Massachusetts, USA
| |
Collapse
|
6
|
Affordability, Accessibility, and Awareness in the Adoption of Liquefied Petroleum Gas: A Case-Control Study in Rural India. SUSTAINABILITY 2020. [DOI: 10.3390/su12114790] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Interventions in the clean cooking sector have focused on improved biomass stoves in a bid to address household air pollution (HAP) in low- and middle-income countries. These initiatives have not delivered adequate health and environmental benefits owing to the less than optimal performance of improved biomass stoves. There is an urgency to transition communities to cleaner cooking systems such as liquefied petroleum gas (LPG) to reduce the prevalence of HAP. Adoption of LPG also has challenges. This case-control cross-sectional study with 510 households examines how affordability, accessibility, and awareness (3As) are associated with LPG adoption in rural poor households of Andhra Pradesh, a state of India. Using binomial logistic regression analyses, the study examines the association of 3As with LPG adoption, adjusting for demographic predictors. Results show disparities in LPG adoption owing to affordability, accessibility, and awareness. Household income is positively associated with LPG adoption. Easy availability of biomass deters households from adopting LPG. Concerns for LPG safety reduces likelihood of LPG adoption. On the other hand, attending awareness campaigns on clean cooking benefits is strongly associated with LPG adoption. Awareness drives, primarily targeted marketing campaigns, could help expand LPG coverage among poorer households. This paper offers insights into the determinants of clean fuel adoption with implications for resource-poor settings across the world to advance energy justice and address energy poverty.
Collapse
|
7
|
Dissemination Challenges of Liquefied Petroleum Gas in Rural India: Perspectives from the Field. SUSTAINABILITY 2020. [DOI: 10.3390/su12062327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We look at infrastructure and policies in India around the distribution of liquefied petroleum gas (LPG) to rural communities and incorporate the experiences and perspectives of dissemination personnel. This qualitative study is part of a larger case control study aimed at examining strategies to promote adoption and sustained use of clean cooking technology, particularly among the rural poor in southern India. Our focus on dissemination personnel helps illuminate extant policy implementation and strategies to increase LPG uptake among the poor. Thematic analysis of 13 semi-structured interviews points to gaps in workforce training, infrastructure, and interface of the technology with social norms. Reduction in refill costs and removal of LPG subsidies was widely suggested to increase uptake and use. Themes identified underscore that policies promoting LPG for the poor will have limited success in the absence of commensurate infrastructure for LPG dissemination and awareness. Despite being primary policy beneficiaries, the under-representation of women within energy governance such as LPG distribution systems identified in this study presents a gap that interventions should focus on. Perspectives from those at the frontiers of implementation of a national energy policy provide insights into the high points as well as operational setbacks to help understand dissemination strategies within energy systems.
Collapse
|
8
|
Quinn AK, Neta G, Sturke R, Olopade CO, Pollard SL, Sherr K, Rosenthal JP. Adapting and Operationalizing the RE-AIM Framework for Implementation Science in Environmental Health: Clean Fuel Cooking Programs in Low Resource Countries. Front Public Health 2019; 7:389. [PMID: 31921753 PMCID: PMC6932973 DOI: 10.3389/fpubh.2019.00389] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 12/02/2019] [Indexed: 12/27/2022] Open
Abstract
Introduction: The use of models and frameworks to design and evaluate strategies to improve delivery of evidence-based interventions is a foundational element of implementation science. To date, however, evaluative implementation science frameworks such as Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) have not been widely employed to examine environmental health interventions. We take advantage of a unique opportunity to utilize and iteratively adapt the RE-AIM framework to guide NIH-funded case studies of the implementation of clean cooking fuel programs in eleven low- and middle-income countries. Methods: We used existing literature and expert consultation to translate and iteratively adapt the RE-AIM framework across several stages of the NIH Clean Cooking Implementation Science case study project. Checklists and templates to guide investigators were developed at each stage. Results: The RE-AIM framework facilitated identification of important emerging issues across this set of case studies, in particular highlighting the fact that data associated with certain important outcomes related to health and welfare are chronically lacking in clean fuel programs. Monitoring of these outcomes should be prioritized in future implementation efforts. As RE-AIM was not originally designed to evaluate household energy interventions, employing the framework required adaptation. Specific adaptations include the broadening of Effectiveness to encompass indicators of success toward any stated programmatic goal, and expansion of Adoption to include household-level uptake of technology. Conclusions: The RE-AIM implementation science framework proved to be a useful organizing schema for 11 case studies of clean fuel cooking programs, in particular highlighting areas requiring emphasis in future research and evaluation efforts. The iterative approach used here to adapt an implementation science framework to a specific programmatic goal may be of value to other multi-country program efforts, such as those led by international development agencies. The checklists and templates developed for this project are publicly available for others to use and/or further modify.
Collapse
Affiliation(s)
- Ashlinn K. Quinn
- Fogarty International Center, U.S. National Institutes of Health, Bethesda, MD, United States
| | - Gila Neta
- National Cancer Institute, U.S. National Institutes of Health, Bethesda, MD, United States
| | - Rachel Sturke
- Fogarty International Center, U.S. National Institutes of Health, Bethesda, MD, United States
| | | | - Suzanne L. Pollard
- Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Kenneth Sherr
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Joshua P. Rosenthal
- Fogarty International Center, U.S. National Institutes of Health, Bethesda, MD, United States
| |
Collapse
|
9
|
Pre- and Post-Adoption Beliefs about the Diffusion and Continuation of Biogas-Based Cooking Fuel Technology in Pakistan. ENERGIES 2019. [DOI: 10.3390/en12163184] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A high level of acceptance and adoption is necessary to facilitate the widespread utilization of renewable energy technologies for cooking, as such utilization is essential for displacing the population’s massive dependence on fossil fuels and solid biomass. Economic and demographic aspects have been the focus of recent literature in exploring the adoption phenomenon of biogas technology. However, literature to date has given little attention to the behavioral factors and the perceptions of the end-users. Our study does not only include behavioral factors, but it employs a hybrid model to explore the continued attentions of users based on their post-adoption beliefs and performance expectations. Using a survey conducted in Pakistan in 2017, the study conducts a multivariate analysis through structural equation modeling to measure the effect of pre- and post-adoption beliefs and expectation on adoption and the continuing intention of households towards biogas technology. Results show that the acceptance of the households towards biogas technology is highly influenced by their perceptions on the benefits, as well as their trust in the technology. The perceived cost and risk attached to the technology are found to be negatively correlated with the acceptance. Households’ intentions to continue the use of biogas technology is highly influenced by the satisfaction level of the users of biogas technology. With the integrated model of adoption and continuation, the study illustrates the dynamic process in obtaining a deeper understanding of a user’s behavior to better formulate the policies for increasing the rate of technology adoption.
Collapse
|
10
|
Shupler M, Hystad P, Gustafson P, Rangarajan S, Mushtaha M, Jayachtria KG, Mony PK, Mohan D, Kumar P, Lakshmi PVM, Sagar V, Gupta R, Mohan I, Nair S, Varma RP, Li W, Hu B, You K, Ncube T, Ncube B, Chifamba J, West N, Yeates K, Iqbal R, Khawaja R, Yusuf R, Khan A, Seron P, Lanas F, Lopez-Jaramillo P, Camacho PA, Puoane T, Yusuf S, Brauer M. Household, Community, Sub-National and Country-level Predictors of Primary Cooking Fuel Switching in Nine Countries from the PURE Study. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2019; 14:085006. [PMID: 33777170 PMCID: PMC7995525 DOI: 10.1088/1748-9326/ab2d46] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Switching from polluting (e.g. wood, crop waste, coal) to clean cooking fuels (e.g. gas, electricity) can reduce household air pollution (HAP) exposures and climate-forcing emissions. While studies have evaluated specific interventions and assessed fuel-switching in repeated cross-sectional surveys, the role of different multilevel factors in household fuel switching, outside of interventions and across diverse community settings, is not well understood. METHODS We examined longitudinal survey data from 24,172 households in 177 rural communities across nine countries within the Prospective Urban and Rural Epidemiology (PURE) study. We assessed household-level primary cooking fuel switching during a median of 10 years of follow up (~2005-2015). We used hierarchical logistic regression models to examine the relative importance of household, community, sub-national and national-level factors contributing to primary fuel switching. RESULTS One-half of study households (12,369) reported changing their primary cooking fuels between baseline and follow up surveys. Of these, 61% (7,582) switched from polluting (wood, dung, agricultural waste, charcoal, coal, kerosene) to clean (gas, electricity) fuels, 26% (3,109) switched between different polluting fuels, 10% (1,164) switched from clean to polluting fuels and 3% (522) switched between different clean fuels. Among the 17,830 households using polluting cooking fuels at baseline, household-level factors (e.g. larger household size, higher wealth, higher education level) were most strongly associated with switching from polluting to clean fuels in India; in all other countries, community-level factors (e.g. larger population density in 2010, larger increase in population density between 2005-2015) were the strongest predictors of polluting-to-clean fuel switching. CONCLUSIONS The importance of community and sub-national factors relative to household characteristics in determining polluting-to-clean fuel switching varied dramatically across the nine countries examined. This highlights the potential importance of national and other contextual factors in shaping large-scale clean cooking transitions among rural communities in low- and middle-income countries.
Collapse
Affiliation(s)
- Matthew Shupler
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States
| | - Paul Gustafson
- Department of Statistics, University of British Columbia, Vancouver, British Columbia
| | - Sumathy Rangarajan
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Maha Mushtaha
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - KG Jayachtria
- St. John’s Medical College & Research Institute, Bangalore, India
| | - Prem K. Mony
- St. John’s Medical College & Research Institute, Bangalore, India
| | - Deepa Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | | | - PVM Lakshmi
- School of Public Health, PGIMER, Chandigarh, India
| | - Vivek Sagar
- School of Public Health, PGIMER, Chandigarh, India
- Department of Community Medicine, PGIMER, Chandigarh, India
| | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute, Jaipur, India
| | - Indu Mohan
- Eternal Heart Care Centre and Research Institute, Jaipur, India
| | - Sanjeev Nair
- Health Action By People, Thiruvananthapuram and Medical College, Trivandrum, India
| | - Ravi Prasad Varma
- Health Action By People, Thiruvananthapuram and Medical College, Trivandrum, India
- Achutha Menon Centre for Health Science Studies, Trivandrum India
| | - Wei Li
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Beijing, China
| | - Bo Hu
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Beijing, China
| | - Kai You
- Shunyi District Center for Disease Prevention and Control, Beijing, China
| | - Tatenda Ncube
- Department of Physiology, University of Zimbabwe, Harare, Zimbabwe
| | - Brian Ncube
- Department of Physiology, University of Zimbabwe, Harare, Zimbabwe
| | - Jephat Chifamba
- Department of Physiology, University of Zimbabwe, Harare, Zimbabwe
| | - Nicola West
- Pamoja Tunaweza Research Centre, Moshi, Tanzania
| | - Karen Yeates
- Pamoja Tunaweza Research Centre, Moshi, Tanzania
- Department of Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Romaina Iqbal
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Rehman Khawaja
- Department of Community Health Science, Aga Khan University Hospital, Karachi, Pakistan
| | - Rita Yusuf
- School of Life Sciences, Independent University, Dhaka, Bangladesh
| | - Afreen Khan
- School of Life Sciences, Independent University, Dhaka, Bangladesh
| | | | | | - Patricio Lopez-Jaramillo
- Research Department, FOSCAL and Medical School, Universidad de Santander (UDES), Bucaramanga, Colombia
| | - Paul A. Camacho
- Research Department, FOSCAL and Medical School, Universidad Autonoma de Bucaramanga (UNAB), Colombia
| | - Thandi Puoane
- School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
11
|
Thompson LM, Hengstermann M, Weinstein JR, Diaz-Artiga A. Adoption of Liquefied Petroleum Gas Stoves in Guatemala: A Mixed-Methods Study. ECOHEALTH 2018; 15:745-756. [PMID: 30229372 PMCID: PMC6265077 DOI: 10.1007/s10393-018-1368-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 07/31/2018] [Accepted: 08/22/2018] [Indexed: 05/20/2023]
Abstract
Household air pollution is the sixth leading risk factor for premature mortality in Guatemala. Households in Guatemala are gradually adopting liquefied petroleum gas (LPG) stoves, but a strong tradition of woodstove use persists. We conducted a mixed-methods study of LPG stove use in peri-urban Guatemala. We used knowledge, attitudes and practices surveys with 187 LPG stove owners who also used woodstoves to identify perceptions of stove and cooking practices. Barriers to sustained use of LPG stoves were evaluated through focus groups, participant observations with stove users, and key informant interviews with community leaders. Seven themes emerged that explain household decisions to use LPG stoves: (1) The "new technology" should be framed in terms of what the "old technology" lacks, (2) income is not a predictor of gas stove acquisition but may predict sustained use, (3) men are key decision-makers but messages about LPG do not target them, (4) when stoves are viewed as "prize possessions" they may not be used, (5) collective fear about gas stoves is not based on personal experience, but on "stories we hear," (6) sustained LPG use is hampered by two major factors, seasonally available wood and LPG retailers who are perceived as dishonest, and (7) wood fuel collection is a time to enjoy the company of friends and family and is not "drudgery." National policies should promote the use of clean cookstove technologies in peri-urban and rapidly urbanizing areas in Guatemala where LPG stoves are in use, but used intermittently, instead of the current plan to install 100,000 "improved" woodstoves by 2032. This could be done by improving dependable cylinder distribution services, targeting gas safety and promoting positive health messages that appeal to men, as well as women.
Collapse
Affiliation(s)
- Lisa M Thompson
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Suite 226, Atlanta, GA, 30322, USA.
| | | | | | - Anaite Diaz-Artiga
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| |
Collapse
|