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Randomized Controlled Trial
. 2021 Oct;48(5):651-669.
doi: 10.1177/1090198121996280. Epub 2021 Mar 18.

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

Mayarí Hengstermann  1 , Anaité Díaz-Artiga  1 , Roberto Otzóy-Sucúc  1 , Ana Laura Maria Ruiz-Aguilar  2 , Lisa M Thompson  3 ; HAPIN Investigators
Collaborators, Affiliations
Randomized Controlled Trial

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

Mayarí Hengstermann et al. Health Educ Behav. 2021 Oct.

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 (n = 36), in-depth (n = 18), and semistructured (n = 6) interviews, and 24 focus group discussions (n = 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.

Trial registration: ClinicalTrials.gov NCT02944682.

Keywords: audiovisual aids; behavioral change communication; health literacy; household air pollution.

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Conflict of interest statement

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(a) Draft sketch shared with focus group. (b) Line drawing shared with investigators. (c) Final color image included in calendar.
See this image and copyright information in PMC

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