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. 2020 Oct 6;30(1):42.
doi: 10.1038/s41533-020-00201-z.

Implementing a context-driven awareness programme addressing household air pollution and tobacco: a FRESH AIR study

Evelyn A Brakema #  1 , Frederik A van Gemert #  2   3 , Sian Williams  4 , Talant Sooronbaev  5 , Berik Emilov  5 , Maamed Mademilov  5 , Aizhamal Tabyshova  5 , Pham Le An  6 , Nguyen Nhat Quynh  6 , Le Huynh Thi Cam Hong  6 , Tran Ngoc Dang  6 , Rianne M J J van der Kleij  7 , Niels H Chavannes  7 , Corina de Jong  8 ; FRESH AIR collaborators
Collaborators, Affiliations

Implementing a context-driven awareness programme addressing household air pollution and tobacco: a FRESH AIR study

Evelyn A Brakema et al. NPJ Prim Care Respir Med. .

Erratum in

Abstract

Most patients with chronic respiratory disease live in low-resource settings, where evidence is scarcest. In Kyrgyzstan and Vietnam, we studied the implementation of a Ugandan programme empowering communities to take action against biomass and tobacco smoke. Together with local stakeholders, we co-created a train-the-trainer implementation design and integrated the programme into existing local health infrastructures. Feasibility and acceptability, evaluated by the modified Conceptual Framework for Implementation Fidelity, were high: we reached ~15,000 Kyrgyz and ~10,000 Vietnamese citizens within budget (~€11,000/country). The right engaged stakeholders, high compatibility with local contexts and flexibility facilitated programme success. Scores on lung health awareness questionnaires increased significantly to an excellent level among all target groups. Behaviour change was moderately successful in Vietnam and highly successful in Kyrgyzstan. We conclude that contextualising the awareness programme to diverse low-resource settings can be feasible, acceptable and effective, and increase its sustainability. This paper provides guidance to translate lung health interventions to new contexts globally.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Design of the awareness programme.
HCW healthcare worker, CHW community health workers. §Workstream 2 is optional.
Fig. 2
Fig. 2. Development of the illustrations, from the first draft (left) to the final version used in Uganda, Kyrgyzstan and Vietnam.
The illustrations show solutions to smoke exposure (use of improved stoves, improve ventilation by opening a window or installing a chimney, quit smoking, etc.). Illustrations were made by the art department of local universities.
Fig. 3
Fig. 3. Knowledge questionnaire scores.
HW health worker (CHW and social worker), HCW healthcare worker, CHW community health worker. All differences between pre- and post-training scores were significant (P < 0.05; Wilcoxon signed-rank tests). In Kyrgyzstan, the ten HCWs were not included, as some members were part of the FRESH AIR team.
See this image and copyright information in PMC

References

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