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Feasibility intervention trial of two types of improved cookstoves in three resource-limited settings: study protocol for a randomized controlled trial.

Klasen E, Miranda JJ, Khatry S, Menya D, Gilman RH, Tielsch JM, Kennedy C, Dreibelbis R, Naithani N, Kimaiyo S, Chiang M, Carter EJ, Sherman CB, Breysse PN, Checkley W, COCINAS Trial Working Gro - Trials (2013)

Bottom Line: All participants will then be randomized to receive one of two types of improved, ventilated cookstoves with a chimney: a commercially-constructed cookstove (Envirofit G3300/G3355) or a locally-constructed cookstove.We will also measure pulmonary function testing in the women participants and 24-hour kitchen particulate matter and carbon monoxide levels at least once per period.Findings from this study will help us better understand the behavioral, biological, and environmental changes that occur with a cookstove intervention.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1800 Orleans Ave, Suite 9121, Baltimore, MD 21205, USA. wcheckl1@jhmi.edu.

ABSTRACT

Background: Exposure to biomass fuel smoke is one of the leading risk factors for disease burden worldwide. International campaigns are currently promoting the widespread adoption of improved cookstoves in resource-limited settings, yet little is known about the cultural and social barriers to successful improved cookstove adoption and how these barriers affect environmental exposures and health outcomes.

Design: We plan to conduct a one-year crossover, feasibility intervention trial in three resource-limited settings (Kenya, Nepal and Peru). We will enroll 40 to 46 female primary cooks aged 20 to 49 years in each site (total 120 to 138).

Methods: At baseline, we will collect information on sociodemographic characteristics and cooking practices, and measure respiratory health and blood pressure for all participating women. An initial observational period of four months while households use their traditional, open-fire design cookstoves will take place prior to randomization. All participants will then be randomized to receive one of two types of improved, ventilated cookstoves with a chimney: a commercially-constructed cookstove (Envirofit G3300/G3355) or a locally-constructed cookstove. After four months of observation, participants will crossover and receive the other improved cookstove design and be followed for another four months. During each of the three four-month study periods, we will collect monthly information on self-reported respiratory symptoms, cooking practices, compliance with cookstove use (intervention periods only), and measure peak expiratory flow, forced expiratory volume at 1 second, exhaled carbon monoxide and blood pressure. We will also measure pulmonary function testing in the women participants and 24-hour kitchen particulate matter and carbon monoxide levels at least once per period.

Discussion: Findings from this study will help us better understand the behavioral, biological, and environmental changes that occur with a cookstove intervention. If this trial indicates that reducing indoor air pollution is feasible and effective in resource-limited settings like Peru, Kenya and Nepal, trials and programs to modify the open burning of biomass fuels by installation of low-cost ventilated cookstoves could significantly reduce the burden of illness and death worldwide.

Trial registration: ClinicalTrials.gov NCT01686867.

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Envirofit G-3300/3355 installed in Peru.
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Figure 2: Envirofit G-3300/3355 installed in Peru.

Mentions: Our study design will be a randomized crossover intervention trial in which all participants will first have a run-in observational period of four months with their traditional cookstove prior to randomization into two intervention arms (Figure 1). At baseline, we will obtain sociodemographic information for each household, respiratory outcomes and other health data for the participating women. Qualitative methods, such as interviews and direct observations, and quantitative questionnaires will be used during the observational period to collect data on fuel use, the cooking process, and the participant’s current perception of their traditional cookstove. One of the intervention arms will first have the commercially constructed, ventilated cookstove installed in their kitchen (Figure 2). They will then be followed for four months. At crossover, we will install a locally constructed, ventilated cookstove and follow the participants for another four months. The other intervention arm will first receive the locally constructed cookstove at the beginning of the first four-month intervention period followed by installation of the commercially constructed improved, ventilated cookstove for the second four-month intervention period. The materials and method of construction of the locally constructed cookstove will vary by site (Figures 3, 4, 5).


Feasibility intervention trial of two types of improved cookstoves in three resource-limited settings: study protocol for a randomized controlled trial.

Klasen E, Miranda JJ, Khatry S, Menya D, Gilman RH, Tielsch JM, Kennedy C, Dreibelbis R, Naithani N, Kimaiyo S, Chiang M, Carter EJ, Sherman CB, Breysse PN, Checkley W, COCINAS Trial Working Gro - Trials (2013)

Envirofit G-3300/3355 installed in Peru.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3852602&req=5

Figure 2: Envirofit G-3300/3355 installed in Peru.
Mentions: Our study design will be a randomized crossover intervention trial in which all participants will first have a run-in observational period of four months with their traditional cookstove prior to randomization into two intervention arms (Figure 1). At baseline, we will obtain sociodemographic information for each household, respiratory outcomes and other health data for the participating women. Qualitative methods, such as interviews and direct observations, and quantitative questionnaires will be used during the observational period to collect data on fuel use, the cooking process, and the participant’s current perception of their traditional cookstove. One of the intervention arms will first have the commercially constructed, ventilated cookstove installed in their kitchen (Figure 2). They will then be followed for four months. At crossover, we will install a locally constructed, ventilated cookstove and follow the participants for another four months. The other intervention arm will first receive the locally constructed cookstove at the beginning of the first four-month intervention period followed by installation of the commercially constructed improved, ventilated cookstove for the second four-month intervention period. The materials and method of construction of the locally constructed cookstove will vary by site (Figures 3, 4, 5).

Bottom Line: All participants will then be randomized to receive one of two types of improved, ventilated cookstoves with a chimney: a commercially-constructed cookstove (Envirofit G3300/G3355) or a locally-constructed cookstove.We will also measure pulmonary function testing in the women participants and 24-hour kitchen particulate matter and carbon monoxide levels at least once per period.Findings from this study will help us better understand the behavioral, biological, and environmental changes that occur with a cookstove intervention.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, 1800 Orleans Ave, Suite 9121, Baltimore, MD 21205, USA. wcheckl1@jhmi.edu.

ABSTRACT

Background: Exposure to biomass fuel smoke is one of the leading risk factors for disease burden worldwide. International campaigns are currently promoting the widespread adoption of improved cookstoves in resource-limited settings, yet little is known about the cultural and social barriers to successful improved cookstove adoption and how these barriers affect environmental exposures and health outcomes.

Design: We plan to conduct a one-year crossover, feasibility intervention trial in three resource-limited settings (Kenya, Nepal and Peru). We will enroll 40 to 46 female primary cooks aged 20 to 49 years in each site (total 120 to 138).

Methods: At baseline, we will collect information on sociodemographic characteristics and cooking practices, and measure respiratory health and blood pressure for all participating women. An initial observational period of four months while households use their traditional, open-fire design cookstoves will take place prior to randomization. All participants will then be randomized to receive one of two types of improved, ventilated cookstoves with a chimney: a commercially-constructed cookstove (Envirofit G3300/G3355) or a locally-constructed cookstove. After four months of observation, participants will crossover and receive the other improved cookstove design and be followed for another four months. During each of the three four-month study periods, we will collect monthly information on self-reported respiratory symptoms, cooking practices, compliance with cookstove use (intervention periods only), and measure peak expiratory flow, forced expiratory volume at 1 second, exhaled carbon monoxide and blood pressure. We will also measure pulmonary function testing in the women participants and 24-hour kitchen particulate matter and carbon monoxide levels at least once per period.

Discussion: Findings from this study will help us better understand the behavioral, biological, and environmental changes that occur with a cookstove intervention. If this trial indicates that reducing indoor air pollution is feasible and effective in resource-limited settings like Peru, Kenya and Nepal, trials and programs to modify the open burning of biomass fuels by installation of low-cost ventilated cookstoves could significantly reduce the burden of illness and death worldwide.

Trial registration: ClinicalTrials.gov NCT01686867.

Show MeSH
Related in: MedlinePlus