Exposure to Environmental Pollution, Non-occupational, Fetal Growth Retardation, Infant, Small for Gestational Age, Infections, Respiratory, Premature Birth
Conditions
Brief summary
Greater efforts are needed to bring affordable, clean stoves and adaptive behavioral strategies to the millions of households worldwide that continue to burn solid cooking fuels using inefficient stoves. Two of the leading causes of infant mortality, preterm birth and pneumonia, are associated with high exposures to household air pollution during pregnancy and early infancy. The proposed study will assess the feasibility and acceptability of an introduced liquid petroleum gas stove, complemented by two alternative approaches to delivering tailored behavioral change interventions, among pregnant women and their neonates.
Interventions
OTHERLow-cost gas stove
Women will be provided with a 3-burner liquid propane gas stove and one year's supply of gas
BEHAVIORALPeer education classes
Women will participate in four classes on how to safely use gas stoves and methods to reduce exposure to air pollution
BEHAVIORALResource-intensive behavioral intervention approach
Women will participate in four classes on how to safely use gas stoves and methods to reduce exposure to air pollution. Additionally, peer educators will visit each home after group classes to help the woman, and key decision-makers in her family, identify top priority strategies to reduce air pollution. Using a checklist, peer educators will observe whether household members are adhering to tailored strategies at subsequent home visits, and provide ongoing support to women and their families.
Sponsors
Universidad del Valle, Guatemala
University of California, San Francisco
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* Pregnant woman less than 20 weeks gestation * Does not smoke cigarettes * Uses an open fire or deteriorated woodstove for cooking * Purchases wood * Intends to stay in the study area for at least one year * Uses Ministry of Health clinics for routine prenatal care * Has a mobile phone * Primary person responsible for cooking in the household * Able to give Informed Consent
Exclusion criteria
* Multiple pregnancy (eg twins) * Identified as a high-risk pregnancy by physician * Regularly taking prescription medication * Smokes cigarettes * Routinely carries a child less than 2 years old on their back
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in weekly use of gas stoves (cooking events and total cooking time) using temperature loggers | Every month from recruitment to neonatal one month of life (up to 9 months) |
| Change in 48-hour mean personal carbon monoxide exposure | 1) <20 weeks gestation; 2) 28-32 weeks gestation; 3) Following participation in each behavior change intervention class at 18-24 weeks, 22-28 weeks, and 26-32 weeks gestation; 4) Neonatal after 48 hours, 2 & 4 weeks of life |
| Change in 48-hour mean kitchen particulate matter concentration | 1) <20 weeks gestation; 2) 28-32 weeks gestation; 3) Following participation in each behavior change intervention class at 18-24 weeks, 22-28 weeks, and 26-32 weeks gestation; 4) Neonatal after 48 hours, 2 & 4 weeks of life |
| Change in 48-hour mean personal particulate matter exposure | 1) <20 weeks gestation; 2) 28-32 weeks gestation; 3) Following participation in each behavior change intervention class at 18-24 weeks, 22-28 weeks, and 26-32 weeks gestation; 4) Neonatal after 48 hours, 2 & 4 weeks of life |
| Change in urinary polycyclic aromatic hydrocarbon (PAH) and volatile organic compound (VOC) metabolite concentrations | 1) <20 weeks gestation; 2) 28-32 weeks gestation |
Secondary
| Measure | Time frame |
|---|---|
| Low birth weight | At time of birth (within 48 hours) |
| Respiratory illness | up to one month following birth |
| Preterm birth | At time of birth (within 48 hours) |
Countries
Guatemala
Outcome results
None listed