Feasibility study of a community-based intervention to reduce air pollution exposure.
| dc.contributor.author | Sepeede, DR Salah | |
| dc.date.accessioned | 2021-12-22T11:11:59Z | |
| dc.date.available | 2021-12-22T11:11:59Z | |
| dc.date.issued | 2020-11-11 | |
| dc.description.abstract | Study Type A before-after study to test the feasibility of a community-wide cooking intervention Problem to be studied Air pollution is a leading environmental health risk globally, particularly in low- and middle-income countries, contributing to pathology in the major organ systems and poor pregnancy outcomes (Schraufnagel et al., 2019a, 2019b; World Health Organization, 2018). Whilst evidence exists for health improvement from air pollution reduction interventions, the interventional research in low income settings has to date largely relied on the introduction of single devices (improved cookstoves) in attempts to tackle the problem, and these have not reached their theoretical potential, in terms of achieving particulate exposure reductions seen in laboratory conditions, due at least in part to insufficient uptake (also incorporating exclusive use), and continued use (Hanna, Duflo, & Greenstone, 2016). The overall PAMODZI study (“P.02/19/2600 - Participatory Approaches in Mpemba for Developing Clean Air interventions (PAMODZI) version 2.0”) has sought to understand the cultural and social context in which smoke exists, describe the patterns of smoke exposure within a village in rural Malawi, and top co-develop a context-appropriate, feasible cleaner air intervention together with the community on the village. Following the initial ethnographic and participatory phase, we now seek to implement this intervention, in an engaged and receptive way, within the same village. Such an evaluation with community at the centre throughout, will optimise the chances of success in achieving its goals and reap meaningful conclusions in terms of how we do Global Health research. Overall aim 1 To assess feasibility of a community-based intervention in Makanjira village to reduce smoke exposure and to determine the effects of the intervention on particulate exposures in this setting Objectives 1 To assess how the study population (in the village) engage with the research intervention, in terms of uptake and continuing use of the intervention (qualitative and quantitative outcomes) 2 To assess whether the proposed approach for air quality monitoring is informative and acceptable (see protocol section vi] Data collection) 3 To quantify any changes in ambient and personal PM2.5 and carbon monoxide (CO) exposures from baseline to selected follow-up timepoints (as described in methodology section) Methodology The study will involve two phases: 1 ‘Before’ (baseline phase) - Baseline ambient particulate monitoring using stationary PM2.5 and CO monitors at three public points within the village; additional baseline monitoring of individual exposures as required given previously collected data (2x24 hour periods per participant); community preparation for intervention introduction. 2 ‘After’ (post-intervention phase) – Initial month of in-depth observation (realist process evalution) postintervention introduction; similar qualitative evaluation approximately 3 selected timepoints post-evaluation. Ambient air quality monitoring (3 points) at one month post-intervention and at the final follow-up timepoint; personal air quality monitoring (2x24 hour periods per participant) at the same two timepoints. Intervention will incorporate two elements: 1 Local wood burning cookstove for each household 2 Request to cook outdoors or on a well-ventilated khonde where possible Data Management and analysis Qualitative and quantitative data will be collected and analysed separately as appropriate. Qualitative data will be entered into NVIVO for management and analysis, which will be thematic, done iteratively throughout and beyond the period of fieldwork, in discussion with the research assistant and fieldworker. Quantitative data will be input into excel and the programme ‘R’ will assist in statistical analysis. Comparisons will be made between baseline CO and PM2.5 levels at baseline and post-intervention. Decisions on appropriate analyses and specific statistical tests will be informed by discussions with staff from the statistical support unit at MLW. Expected findings and dissemination An in-depth account of uptake and continued use of the cooking intervention and complex implementation factors. In addition, a qualitative indication of any changes to personal and ambient particulate exposures in the village throughout the time of the trial. These will be disseminated through a number of pathways, both locally within the community itself, regionally and nationally in Malawi, including to COMREC, and through wider scientific networks through publication and presentation. This will be supported by the MLW Science Communications team. | en_US |
| dc.description.sponsorship | Self Sponsor | en_US |
| dc.identifier.uri | http://rscarchive.kuhes.ac.mw/handle/20.500.12988/812 | |
| dc.language.iso | en | en_US |
| dc.publisher | Kamuzu university of Health Sciences | en_US |
| dc.relation.ispartofseries | ;P.06/20/3069 | |
| dc.title | Feasibility study of a community-based intervention to reduce air pollution exposure. | en_US |