Clinical trial NCT03352830: Encouraging LPG Adoption in Ghana: A Factorial Randomized Clinical Trial to Enhance LPG Adoption & Sustained Use
Official title: Understanding Adoption of Clean Cookstoves
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Behavior, Consumer
Health Knowledge, Attitudes, Practice
Health Attitude
Keywords: household air pollution
health promotion
clean cookstove adoption
clean cookstove sustained use
Lead sponsor: Columbia University
Sponsor class: OTHER
Collaborators: name: Kintampo Health Research Centre, Ghana
name: National Institute of Environmental Health Sciences (NIEHS)
First posted: 2017-11-24
Enrollment: 781
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Primary purpose: PREVENTION

Brief summary: Household air pollution (HAP) is a top-priority public health problem in developing countries. According to the most recent comparative risk assessment, 3.5 million people die prematurely each year as a result of HAP exposures. While uncertainties remain regarding causal links between HAP exposures and health, the time is ripe for focused research into effective interventions. Limited past research has shown that the demand for clean cookstoves is low, and that households continue to use traditional hearths even when they have clean stoves. The investigators propose to harness an existing cohort in Ghana to study factors that increase the adoption of clean cookstoves, and to test strategies to promote adoption and continued use.

Detailed description: Health conditions resulting from household air pollution (HAP) are responsible for approximately 3.9 million premature deaths each year. Exposure to HAP is the third largest preventable contributor to illness worldwide. Even so, HAP exposures persist since 3 billion individuals worldwide continue to rely on biomass fuel for cooking and heating, especially in the developing world. Though the transition away from traditional biomass stoves is projected curb the health effects of HAP by mitigating exposure, the benefits of newer clean cookstove technologies can only be fully realized if use of these stoves is exclusive and sustained. Most studies indicate that the provision of clean cookstoves to these individuals is, on its own, insufficient to encourage and foster adoption. In order to better understand how to promote clean cookstove adoption, the proposed study aims to (1) develop an educational intervention to promote clean cookstove adoption and sustained use and (2) determine the influence of liquid petroleum gasoline (LPG) accessibility on product demand.

Households enrolled into the control and the BioLite arms of GRAPHS (the parent study) will receive clean LPG cookstoves for their participation in the study (clinicaltrials.gov registration: NCT01335490). The objective of this study is to test the relative impact of two approaches to encourage stove use: providing a behavior change intervention and offering convenient access to LPG refueling. The investigators hypothesize that these interventions will increase overall use of LPG cook stoves.

Prior evidence on the role of health information in promoting the adoption of health-promoting technology is limited, and the results are mixed. Although little work has been done to investigate the importance of accessibility to sustained use of cookstoves, accessibility remains one of the basic market drivers of product demand.

A total of 27 communities will be cluster randomized, with 979 study households nested throughout the sites. The study arms will be arranged as a 2x2 factorial design, with approximately equal numbers of households in each arm.

Eligibility criteria: Inclusion criteria -- an individual is eligible to participate in the study if she:

* Previously participated in the Ghana Randomized Air Pollution and Health Study (GRAPHS; NCT01335490)
* Was originally randomized to the Biolite or Control arms of GRAPHS
* Currently resides in the Kintampo Health Research Centre study area

Primary outcomes:
measure: Minutes of LPG Use (via SUMS)
timeFrame: 10 months
Secondary outcomes:
measure: Amount of LPG refueled (via weight)
timeFrame: 10 months
Other outcomes:
Locations:
city: New York
country: United States
facility: Columbia University Medical Center
state: New York
city: Kintampo
country: Ghana
facility: Kintampo Medical Research Center
Study officials:
affiliation: Columbia University
name: Darby Jack, PhD
role: PRINCIPAL_INVESTIGATOR
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