P3 Ghana Cookstove Study

Study Overview
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Brief Summary
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Background: Despite their potential health and social benefits, adoption and use of improved cookstoves has been low throughout much of the world. Explanations for low adoption rates of these technologies include prices that are not affordable for the target populations, limited opportunities for households to learn about cookstoves through peers, and perceptions that these technologies are not appropriate for local cooking needs. The P3 project employs a novel experimental design to explore each of these factors and their interactive effects on cookstove demand, adoption, use and exposure outcomes. Methods: The P3 study is being conducted in the Kassena-Nankana Districts of Northern Ghana. Leveraging an earlier improved cookstove study that was conducted in this area, the central design of the P3 biomass stove experiment involves offering stoves at randomly varying prices to peers and non-peers of households that had previously received stoves for free. Using household surveys, electronic stove use monitors, and low-cost, portable monitoring equipment, we measure how prices and peers' experience affect perceptions of stove quality, the decision to purchase a stove, use of improved and traditional stoves over time, and personal exposure to air pollutants from the stoves. Discussion: The challenges that public health and development communities have faced in spreading adoption of potentially welfare-enhancing technologies, like improved cookstoves, have highlighted the need for interdisciplinary, multisectoral approaches. The design of the P3 project draws on economic theory, public health practice, engineering, and environmental sciences, to more fully grasp the drivers and barriers to expanding access to and uptake of cleaner stoves. Our partnership between academic institutions, in the US and Ghana, and a local environmental non-governmental organization creates unique opportunities to disseminate and scale up lessons learned.

Official Title
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Prices, Peers, and Perceptions: Field Experiments on Technology Adoption in the Context of Improved Cookstoves

Conditions
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Household Air Pollution, Behavior, Social

Intervention / Treatment
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* Behavioral: P3 Bio Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Classified as rural Uses biofuel as main cooking fuel source Has women in household aged 18-55 and at least one child under five Exclusion Criteria: Clusters that are close to the S1 clusters, creating a set of clusters far enough from the original R group that will create the S2 cluster.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: S1 (Peer) group<br>S1 group households located in 25 clusters that were included in a prior cookstove study: selected households are nearest neighbors (peers) of households who received free stoves in that prior study. This group is used to represent a potentially high peer influence on the adoption of improved cookstoves. The P3 Bio Intervention is implemented in this group. | Behavioral: P3 Bio Intervention<br>* Two types of improved biomass burning cookstoves (ACE1 and Greenway Jumbo) are offered to participants in both arms at varying prices.<br>|
| Experimental: S2 (Non-Peer) Group<br>S2 group households are located in 25 clusters randomly selected from the area of the K-N Districts more than 1 km from the S1 clusters. This group will have minimal prior knowledge of the cookstoves through peers. The P3 Bio Intervention is implemented in this group. | Behavioral: P3 Bio Intervention<br>* Two types of improved biomass burning cookstoves (ACE1 and Greenway Jumbo) are offered to participants in both arms at varying prices.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stove Purchases | Number of households that order stoves and complete payments | Number of households in each arm that place orders for and subsequently complete all payments on the two types of stoves. | up to 13 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cooking Behaviors | Household use of both traditional and improved cookstoves over time | Use of traditional and improved stoves over time across intervention arms. | up to 13 months | 
| Perceptions of Stove Quality | Smoke production, efficiency, ease of use, quality of food, etc. | Likert-scale and subjective expectation questions measuring perceptions of stove quality / performance for both stove types along multiple dimensions. Example scale question: How much smoke do you think the ACE1 stove would produce? Response options: 1 = A lot less smoke than a 3 stone fire, 2 = A little less smoke than a 3 stone fire; 3 = About the same amount of smoke as a 3 stone fire; 4 = A little more smoke than a 3 stone fire; 5 = A lot more smoke than a 3 stone fire; 99 = Don't know / not sure. | up to 13 months | 
| Exposure to CO and PM 2.5 | Kitchen concentrations of and personal exposure to carbon monoxide (CO) and particular matter (PM2.5) among study participants | up to 13 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cookstoves, Household Air Pollution, Behavior Change, Global Health