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. Issue 9 (29th September 2020)

• Record Type: Journal Article
• Authors: Williams, Kendra N.; Thompson, Lisa M.; Sakas, Zoe; Hengstermann, Mayari; Quinn, Ashlinn; Díaz-Artiga, Anaité; Thangavel, Gurusamy; Puzzolo, Elisa; Rosa, Ghislaine; Balakrishnan, Kalpana; Peel, Jennifer; Checkley, William; Clasen, Thomas F; Miranda, J Jaime; Rosenthal, Joshua P; Harvey, Steven A
• Other Names: author non-byline.; Aravindalochanan Vigneswari author non-byline.; Barr Dana Boyd author non-byline.; Burrowes Vanessa author non-byline.; Bussalleu Alejandra author non-byline.; Campbell Devan author non-byline.; Canuz Eduardo author non-byline.; Castañaza Adly author non-byline.; Chang Howard author non-byline.; Chen Yunyun author non-byline.; Chiang Marilú author non-byline.; Clark Maggie L author non-byline.; Craik Rachel author non-byline.; Crocker Mary author non-byline.; Davila-Roman Victor author non-byline.; Fuentes Lisa de las author non-byline.; León Oscar De author non-byline.; Dusabimana Ephrem author non-byline.; Elon Lisa author non-byline.; Espinoza Juan Gabriel author non-byline.; Fuentes Irma Sayury Pineda author non-byline.; Garg Sarada author non-byline.; Goodman Dina author non-byline.; Gupton Savannah author non-byline.; Hardison Meghan author non-byline.; Hartinger Stella author non-byline.; Herrera Phabiola M author non-byline.; Hossen Shakir author non-byline.; Howards Penelope author non-byline.; Jaacks Lindsay author non-byline.; Jabbarzadeh Shirin author non-byline.; Johnson Michael A author non-byline.; Jones Abigail author non-byline.; Kearns Katherine author non-byline.; Kirby Miles author non-byline.; Kremer Jacob author non-byline.; Laws Margaret A author non-byline.; Lenzen Pattie author non-byline.; Liao Jiawen author non-byline.; Lovvorn Amy E author non-byline.; Majorin Fiona author non-byline.; McCollum Eric author non-byline.; McCracken John author non-byline.; McPeek Julia N author non-byline.; Meyers Rachel author non-byline.; Mollinedo Erick author non-byline.; Moulton Lawrence author non-byline.; Mukhopadhyay Krishnendu author non-byline.; Naeher Luke author non-byline.; Nambajimana Abidan author non-byline.; Natesan Durairaj author non-byline.; Ndagijimana Florien author non-byline.; Nizam Azhar author non-byline.; Ntivuguruzwa Jean de Dieu author non-byline.; Papageorghiou Aris author non-byline.; Piedrahita Ricardo author non-byline.; Pillarisetti Ajay author non-byline.; Puttaswamy Naveen author non-byline.; Rajkumar Sarah author non-byline.; Ramakrishnan Usha author non-byline.; Ramasami Rengaraj author non-byline.; Reardon Davis author non-byline.; Ryan Barry author non-byline.; Saidam Sudhakar author non-byline.; Sambandam Sankar author non-byline.; Sarnat Jeremy A author non-byline.; Simkovich Suzanne author non-byline.; Sinharoy Sheela S author non-byline.; Smith Kirk R author non-byline.; Steenland Kyle author non-byline.; Swearing Damien author non-byline.; Toenjes Ashley author non-byline.; Underhill Lindsay author non-byline.; Uwizeyimana Jean Damascene author non-byline.; Valdes Viviane author non-byline.; Valentine Kayla author non-byline.; Verma Amit author non-byline.; Waller Lance author non-byline.; Warnock Megan author non-byline.; Ye Wenlu author non-byline.; Young Bonnie author non-byline.;
• Is Part Of: BMJ open. Volume 10:Issue 9(2020)
• Publication Date: 2020-09-29
• Subjects: public health -- qualitative research -- community child health; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-037761
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Introduction: Increasing use of cleaner fuels, such as liquefied petroleum gas (LPG), and abandonment of solid fuels is key to reducing household air pollution and realising potential health improvements in low-income countries. However, achieving exclusive LPG use in households unaccustomed to this type of fuel, used in combination with a new stove technology, requires substantial behaviour change. We conducted theory-grounded formative research to identify contextual factors influencing cooking fuel choice to guide the development of behavioural strategies for the Household Air Pollution Intervention Network (HAPIN) trial. The HAPIN trial will assess the impact of exclusive LPG use on air pollution exposure and health of pregnant women, older adult women, and infants under 1 year of age in Guatemala, India, Peru, and Rwanda. Methods: Using the Capability, Opportunity, Motivation–Behaviour (COM–B) framework and Behaviour Change Wheel (BCW) to guide formative research, we conducted in-depth interviews, focus group discussions, observations, key informant interviews and pilot studies to identify key influencers of cooking behaviours in the four countries. We used these findings to develop behavioural strategies likely to achieve exclusive LPG use in the HAPIN trial. Results: We identified nine potential influencers of exclusive LPG use, including perceived disadvantages of solid fuels, family preferences, cookware, traditional foods, non-food-related cooking, heating needs, LPG awareness, safety and cost and availability of fuel. Mapping formative findings onto the theoretical frameworks, behavioural strategies for achieving exclusive LPG use in each research site included free fuel deliveries, locally acceptable stoves and equipment, hands-on training and printed materials and videos emphasising relevant messages. In the HAPIN trial, we will monitor and reinforce exclusive LPG use through temperature data loggers, LPG fuel delivery tracking, in-home observations and behavioural reinforcement visits. Conclusion: Our formative research and behavioural strategies can inform the development, implementation, monitoring and evaluation of theory-informed strategies to promote exclusive LPG use in future stove programmes and research studies. Trial registration number: NCT02944682, Pre-results.