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SAGE Publications, Health Education & Behavior, 5(48), p. 651-669, 2021

DOI: 10.1177/1090198121996280

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

Journal article published in 2021 by Anaité Díaz-Artiga, Roberto Otzóy-Sucúc, Ana Laura Maria Ruiz-Aguilar, Lisa M. Thompson, Vigneswari Aravindalochanan, Kalpana Balakrishnan, Dana Boyd Barr, Vanessa Burrowes, Devan Campbell, Julia McPeek Campbell, Eduardo Canuz, Adly Castañaza, Howard Chang, William Checkley, Yunyun Chen and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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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.