Developing Visual Messages to Support Liquefied Petroleum Gas Use in Intervention Homes in the Household Air Pollution Intervention Network (HAPIN) Trial in Rural Guatemala

Overview

Journal Health Educ Behav

Publisher Sage Publications

Specialties Medical Education
Public Health
Social Sciences

Date 2021 Mar 18

PMID 33733893

Citations 2

Authors

Mayari Hengstermann

Anaite Diaz-Artiga

Roberto Otzoy-Sucuc

Ana Laura Maria Ruiz-Aguilar

Lisa M Thompson

Affiliations

Soon will be listed here.

Abstract

Background: Household air pollution adversely affects human health and the environment, yet more than 40% of the world still depends on solid cooking fuels. The House Air Pollution Intervention Network (HAPIN) randomized controlled trial is assessing the health effects of a liquefied petroleum gas (LPG) stove and 18-month supply of free fuel in 3,200 households in rural Guatemala, India, Peru, and Rwanda.

Aims: We conducted formative research in Guatemala to create visual messages that support the sustained, exclusive use of LPG in HAPIN intervention households.

Method: We conducted ethnographic research, including direct observation ( = 36), in-depth ( = 18), and semistructured ( = 6) interviews, and 24 focus group discussions ( = 96) to understand participants' experience with LPG. Sixty participants were selected from a pilot study of LPG stove and 2-months of free fuel to assess the acceptability and use of LPG. Emergent themes were used to create visual messages based on observations and interviews in 40 households; messages were tested and revised in focus group discussions with 20 households.

Results: We identified 50 codes related to household air pollution and stoves; these were reduced into 24 themes relevant to LPG stoves, prioritizing 12 for calendars. Messages addressed fear and reluctance to use LPG; preference of wood stoves for cooking traditional foods; sustainability and accessibility of fuel; association between health outcomes and household air pollution; and the need for inspirational and aspirational messages.

Discussion: We created a flip chart and calendar illustrating themes to promote exclusive LPG use in HAPIN intervention households.

Citing Articles

Advancing environmental health sciences through implementation science.

Neta G, Martin L, Collman G Environ Health. 2022; 21(1):136.

PMID: 36564832 PMC: 9783984. DOI: 10.1186/s12940-022-00933-0.

Fidelity and Adherence to a Liquefied Petroleum Gas Stove and Fuel Intervention during Gestation: The Multi-Country Household Air Pollution Intervention Network (HAPIN) Randomized Controlled Trial.

Quinn A, Williams K, Thompson L, Harvey S, Piedrahita R, Wang J Int J Environ Res Public Health. 2021; 18(23).

PMID: 34886324 PMC: 8656791. DOI: 10.3390/ijerph182312592.

References

Stanistreet D, Hyseni L, Puzzolo E, Higgerson J, Ronzi S, de Cuevas R . Barriers and Facilitators to the Adoption and Sustained Use of Cleaner Fuels in Southwest Cameroon: Situating 'Lay' Knowledge within Evidence-Based Policy and Practice. Int J Environ Res Public Health. 2019; 16(23). PMC: 6926764. DOI: 10.3390/ijerph16234702. View

Puzzolo E, Pope D, Stanistreet D, Rehfuess E, Bruce N . Clean fuels for resource-poor settings: A systematic review of barriers and enablers to adoption and sustained use. Environ Res. 2016; 146:218-34. DOI: 10.1016/j.envres.2016.01.002. View

Fedak K, Good N, Walker E, Clark M, LOrange C, Volckens J . An Expert Survey on the Material Types used to Start Cookstoves. Energy Sustain Dev. 2019; 48:59-66. PMC: 6784844. DOI: 10.1016/j.esd.2018.11.001. View

Hooper L, Dieye Y, Ndiaye A, Diallo A, Sack C, Fan V . Traditional cooking practices and preferences for stove features among women in rural Senegal: Informing improved cookstove design and interventions. PLoS One. 2018; 13(11):e0206822. PMC: 6245512. DOI: 10.1371/journal.pone.0206822. View

Hollada J, Williams K, Miele C, Danz D, Harvey S, Checkley W . Perceptions of Improved Biomass and Liquefied Petroleum Gas Stoves in Puno, Peru: Implications for Promoting Sustained and Exclusive Adoption of Clean Cooking Technologies. Int J Environ Res Public Health. 2017; 14(2). PMC: 5334736. DOI: 10.3390/ijerph14020182. View

Tamire M, Addissie A, Skovbjerg S, Andersson R, Larstad M . Socio-Cultural Reasons and Community Perceptions Regarding Indoor Cooking Using Biomass Fuel and Traditional Stoves in Rural Ethiopia: A Qualitative Study. Int J Environ Res Public Health. 2018; 15(9). PMC: 6164706. DOI: 10.3390/ijerph15092035. View

Lipkus I . Numeric, verbal, and visual formats of conveying health risks: suggested best practices and future recommendations. Med Decis Making. 2007; 27(5):696-713. DOI: 10.1177/0272989X07307271. View

Clasen T, Checkley W, Peel J, Balakrishnan K, McCracken J, Rosa G . Design and Rationale of the HAPIN Study: A Multicountry Randomized Controlled Trial to Assess the Effect of Liquefied Petroleum Gas Stove and Continuous Fuel Distribution. Environ Health Perspect. 2020; 128(4):47008. PMC: 7228119. DOI: 10.1289/EHP6407. View

Pollard S, Williams K, OBrien C, Winiker A, Puzzolo E, Kephart J . An evaluation of the Fondo de Inclusión Social Energético program to promote access to liquefied petroleum gas in Peru. Energy Sustain Dev. 2018; 46:82-93. PMC: 6197055. DOI: 10.1016/j.esd.2018.06.001. View

10.

Smith K, Bruce N, Balakrishnan K, Adair-Rohani H, Balmes J, Chafe Z . Millions dead: how do we know and what does it mean? Methods used in the comparative risk assessment of household air pollution. Annu Rev Public Health. 2014; 35:185-206. DOI: 10.1146/annurev-publhealth-032013-182356. View

11.

Barr D, Puttaswamy N, Jaacks L, Steenland K, Rajkumar S, Gupton S . Design and Rationale of the Biomarker Center of the Household Air Pollution Intervention Network (HAPIN) Trial. Environ Health Perspect. 2020; 128(4):47010. PMC: 7228115. DOI: 10.1289/EHP5751. View

12.

Sharma M, Dasappa S . Emission reduction potentials of improved cookstoves and their issues in adoption: An Indian outlook. J Environ Manage. 2017; 204(Pt 1):442-453. DOI: 10.1016/j.jenvman.2017.09.018. View

13.

Thurber M, Warner C, Platt L, Slaski A, Gupta R, Miller G . To promote adoption of household health technologies, think beyond health. Am J Public Health. 2013; 103(10):1736-40. PMC: 3780735. DOI: 10.2105/AJPH.2013.301367. View

14.

Evans W, Johnson M, Jagoe K, Charron D, Young B, Rahman A . Evaluation of Behavior Change Communication Campaigns to Promote Modern Cookstove Purchase and Use in Lower Middle Income Countries. Int J Environ Res Public Health. 2017; 15(1). PMC: 5800111. DOI: 10.3390/ijerph15010011. View

15.

Woodward E, Marrfurra McTaggart P . Co-developing Indigenous seasonal calendars to support 'healthy Country, healthy people' outcomes. Glob Health Promot. 2019; 26(3_suppl):26-34. DOI: 10.1177/1757975919832241. View

16.

Ronzi S, Puzzolo E, Hyseni L, Higgerson J, Stanistreet D, Hugo M . Using photovoice methods as a community-based participatory research tool to advance uptake of clean cooking and improve health: The LPG adoption in Cameroon evaluation studies. Soc Sci Med. 2019; 228:30-40. PMC: 7081729. DOI: 10.1016/j.socscimed.2019.02.044. View

17.

Williams K, Thompson L, Sakas Z, Hengstermann M, Quinn A, Diaz-Artiga A . Designing a comprehensive behaviour change intervention to promote and monitor exclusive use of liquefied petroleum gas stoves for the Household Air Pollution Intervention Network (HAPIN) trial. BMJ Open. 2020; 10(9):e037761. PMC: 7526279. DOI: 10.1136/bmjopen-2020-037761. View

18.

Shupler M, Hystad P, Birch A, Miller-Lionberg D, Jeronimo M, Arku R . Household and personal air pollution exposure measurements from 120 communities in eight countries: results from the PURE-AIR study. Lancet Planet Health. 2020; 4(10):e451-e462. PMC: 7591267. DOI: 10.1016/S2542-5196(20)30197-2. View

19.

Ruiz-Mercado I, Canuz E, Walker J, Smith K . Quantitative metrics of stove adoption using Stove Use Monitors (SUMs). Biomass Bioenergy. 2014; 57:136-148. PMC: 4170739. DOI: 10.1016/j.biombioe.2013.07.002. View

20.

Pillarisetti A, Ghorpade M, Madhav S, Dhongade A, Roy S, Balakrishnan K . Promoting LPG usage during pregnancy: A pilot study in rural Maharashtra, India. Environ Int. 2019; 127:540-549. PMC: 7213905. DOI: 10.1016/j.envint.2019.04.017. View