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; 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 Mc Peek Campbell; Eduardo Canuz; Adly Castañaza; Howard Chang; William Checkley; Yunyun Chen; Marilú Chiang; Maggie L. Clark; Thomas Clasen; Rachel Craik; Mary Crocker; Victor Davila-Roman; Lisa de las Fuentes; Oscar De Léon; Anaité Diaz-Artiga; Ephrem Dusabimana; Lisa Elon; Juan Gabriel Espinoza; Irma Sayury Pineda Fuentes; Sarada Garg; Dina Goodman; Savannah Gupton; Meghan Hardison; Stella Hartinger; Steven A. Harvey; Mayari Hengstermann; Phabiola Herrera; Shakir Hossen; Penelope Howards; Lindsay Jaacks; Shirin Jabbarzadeh; Michael A. Johnson; Abigail Jones; Katherine Kearns; Miles Kirby; Jacob Kremer; Margaret Laws; Jiawen Liao; Amy Lovvorn; Fiona Majorin; Eric McCollum; John McCracken; Rachel Meyers; J. Jaime Miranda; Erick Mollinedo; Lawrence Moulton; Krishnendu Mukhopadhyay; Luke Naeher; Abidan Nambajimana; Florien Ndagijimana; Azhar Nizam; Jean de Dieu Ntivuguruzwa; Aris Papageorghiou; Jennifer Peel; Ricardo Piedrahita; Ajay Pillarisetti; Naveen Puttaswamy; Elisa Puzzolo; Ashlinn Quinn; Sarah Rajkumar; Usha Ramakrishnan; Davis Reardon; Ghislaine Rosa; Joshua Rosenthal; P. Barry Ryan; Zoe Sakas; Sankar Sambandam; Jeremy Sarnat; Suzanne Simkovich; Sheela Sinharoy; Kirk R. Smith; Kyle Steenland; Damien Swearing; Gurusamy Thangavel; Lisa M. Thompson; Ashley Toenjes; Lindsay Underhill; Jean Damascene Uwizeyimana; Viviane Valdes; Amit Verma; Lance Waller; Megan Warnock; Kendra Williams; Wenlu Ye; Bonnie Young

doi:10.1177/1090198121996280

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, 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 Mc Peek Campbell, Eduardo Canuz, Adly Castañaza, Howard Chang, William Checkley, Yunyun Chen, Marilú Chiang, Maggie L. Clark, Thomas Clasen, Rachel CraikMary Crocker, Victor Davila-Roman, Lisa de las Fuentes, Oscar De Léon, Anaité Diaz-Artiga, Ephrem Dusabimana, Lisa Elon, Juan Gabriel Espinoza, Irma Sayury Pineda Fuentes, Sarada Garg, Dina Goodman, Savannah Gupton, Meghan Hardison, Stella Hartinger, Steven A. Harvey, Mayari Hengstermann, Phabiola Herrera, Shakir Hossen, Penelope Howards, Lindsay Jaacks, Shirin Jabbarzadeh, Michael A. Johnson, Abigail Jones, Katherine Kearns, Miles Kirby, Jacob Kremer, Margaret Laws, Jiawen Liao, Amy Lovvorn, Fiona Majorin, Eric McCollum, John McCracken, Rachel Meyers, J. Jaime Miranda, Erick Mollinedo, Lawrence Moulton, Krishnendu Mukhopadhyay, Luke Naeher, Abidan Nambajimana, Florien Ndagijimana, Azhar Nizam, Jean de Dieu Ntivuguruzwa, Aris Papageorghiou, Jennifer Peel, Ricardo Piedrahita, Ajay Pillarisetti, Naveen Puttaswamy, Elisa Puzzolo, Ashlinn Quinn, Sarah Rajkumar, Usha Ramakrishnan, Davis Reardon, Ghislaine Rosa, Joshua Rosenthal, P. Barry Ryan, Zoe Sakas, Sankar Sambandam, Jeremy Sarnat, Suzanne Simkovich, Sheela Sinharoy, Kirk R. Smith, Kyle Steenland, Damien Swearing, Gurusamy Thangavel, Lisa M. Thompson, Ashley Toenjes, Lindsay Underhill, Jean Damascene Uwizeyimana, Viviane Valdes, Amit Verma, Lance Waller, Megan Warnock, Kendra Williams, Wenlu Ye, Bonnie Young

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

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.

Original language	English
Pages (from-to)	651-669
Number of pages	19
Journal	Health Education and Behavior
Volume	48
Issue number	5
DOIs	https://doi.org/10.1177/1090198121996280
State	Published - Oct 2021

Keywords

audiovisual aids
behavioral change communication
health literacy
household air pollution

Access to Document

10.1177/1090198121996280

Cite this

Hengstermann, M., Díaz-Artiga, A., Otzóy-Sucúc, R., Laura Maria Ruiz-Aguilar, A., Thompson, L. M., Aravindalochanan, V., Balakrishnan, K., Barr, D. B., Burrowes, V., Campbell, D., Campbell, J. M. P., Canuz, E., Castañaza, A., Chang, H., Checkley, W., Chen, Y., Chiang, M., Clark, M. L., Clasen, T., ... Young, B. (2021). Developing Visual Messages to Support Liquefied Petroleum Gas Use in Intervention Homes in the Household Air Pollution Intervention Network (HAPIN) Trial in Rural Guatemala. Health Education and Behavior, 48(5), 651-669. https://doi.org/10.1177/1090198121996280

@article{eb98c37d7dde4d8f813d8014bcc8c25a,

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

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{\textquoteright} 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.",

keywords = "audiovisual aids, behavioral change communication, health literacy, household air pollution",

author = "Mayar{\'i} Hengstermann and Anait{\'e} D{\'i}az-Artiga and Roberto Otz{\'o}y-Suc{\'u}c and {Laura Maria Ruiz-Aguilar}, Ana and Thompson, {Lisa M.} and Vigneswari Aravindalochanan and Kalpana Balakrishnan and Barr, {Dana Boyd} and Vanessa Burrowes and Devan Campbell and Campbell, {Julia Mc Peek} and Eduardo Canuz and Adly Casta{\~n}aza and Howard Chang and William Checkley and Yunyun Chen and Maril{\'u} Chiang and Clark, {Maggie L.} and Thomas Clasen and Rachel Craik and Mary Crocker and Victor Davila-Roman and {de las Fuentes}, Lisa and {De L{\'e}on}, Oscar and Anait{\'e} Diaz-Artiga and Ephrem Dusabimana and Lisa Elon and Espinoza, {Juan Gabriel} and Fuentes, {Irma Sayury Pineda} and Sarada Garg and Dina Goodman and Savannah Gupton and Meghan Hardison and Stella Hartinger and Harvey, {Steven A.} and Mayari Hengstermann and Phabiola Herrera and Shakir Hossen and Penelope Howards and Lindsay Jaacks and Shirin Jabbarzadeh and Johnson, {Michael A.} and Abigail Jones and Katherine Kearns and Miles Kirby and Jacob Kremer and Margaret Laws and Jiawen Liao and Amy Lovvorn and Fiona Majorin and Eric McCollum and John McCracken and Rachel Meyers and Miranda, {J. Jaime} and Erick Mollinedo and Lawrence Moulton and Krishnendu Mukhopadhyay and Luke Naeher and Abidan Nambajimana and Florien Ndagijimana and Azhar Nizam and {de Dieu Ntivuguruzwa}, Jean and Aris Papageorghiou and Jennifer Peel and Ricardo Piedrahita and Ajay Pillarisetti and Naveen Puttaswamy and Elisa Puzzolo and Ashlinn Quinn and Sarah Rajkumar and Usha Ramakrishnan and Davis Reardon and Ghislaine Rosa and Joshua Rosenthal and Ryan, {P. Barry} and Zoe Sakas and Sankar Sambandam and Jeremy Sarnat and Suzanne Simkovich and Sheela Sinharoy and Smith, {Kirk R.} and Kyle Steenland and Damien Swearing and Gurusamy Thangavel and Thompson, {Lisa M.} and Ashley Toenjes and Lindsay Underhill and Uwizeyimana, {Jean Damascene} and Viviane Valdes and Amit Verma and Lance Waller and Megan Warnock and Kendra Williams and Wenlu Ye and Bonnie Young",

note = "Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study is funded by the U.S. National Institutes of Health (NIH; cooperative agreement 1UM1HL134590) in collaboration with the Bill & Melinda Gates Foundation (OPP1131279). Participating NIH organizations include the National Heart, Lung and Blood Institute, National Institute of Environmental Health Sciences, National Cancer Institute, National Institute of Child Health and Human Development, Fogarty International Center, and the NIH Common Fund. Publisher Copyright: {\textcopyright} The Author(s) 2021.",

year = "2021",

month = oct,

doi = "10.1177/1090198121996280",

language = "English",

volume = "48",

pages = "651--669",

journal = "Health Education and Behavior",

issn = "1090-1981",

number = "5",

}

Hengstermann, M, Díaz-Artiga, A, Otzóy-Sucúc, R, Laura Maria Ruiz-Aguilar, A, Thompson, LM, Aravindalochanan, V, Balakrishnan, K, Barr, DB, Burrowes, V, Campbell, D, Campbell, JMP, Canuz, E, Castañaza, A, Chang, H, Checkley, W, Chen, Y, Chiang, M, Clark, ML, Clasen, T, Craik, R, Crocker, M, Davila-Roman, V , de las Fuentes, L, De Léon, O, Diaz-Artiga, A, Dusabimana, E, Elon, L, Espinoza, JG, Fuentes, ISP, Garg, S, Goodman, D, Gupton, S, Hardison, M, Hartinger, S, Harvey, SA, Hengstermann, M, Herrera, P, Hossen, S, Howards, P, Jaacks, L, Jabbarzadeh, S, Johnson, MA, Jones, A, Kearns, K, Kirby, M, Kremer, J, Laws, M, Liao, J, Lovvorn, A, Majorin, F, McCollum, E, McCracken, J, Meyers, R, Miranda, JJ, Mollinedo, E, Moulton, L, Mukhopadhyay, K, Naeher, L, Nambajimana, A, Ndagijimana, F, Nizam, A, de Dieu Ntivuguruzwa, J, Papageorghiou, A, Peel, J, Piedrahita, R, Pillarisetti, A, Puttaswamy, N, Puzzolo, E, Quinn, A, Rajkumar, S, Ramakrishnan, U, Reardon, D, Rosa, G, Rosenthal, J, Ryan, PB, Sakas, Z, Sambandam, S, Sarnat, J, Simkovich, S, Sinharoy, S, Smith, KR, Steenland, K, Swearing, D, Thangavel, G, Thompson, LM, Toenjes, A, Underhill, L, Uwizeyimana, JD, Valdes, V, Verma, A, Waller, L, Warnock, M, Williams, K, Ye, W & Young, B 2021, 'Developing Visual Messages to Support Liquefied Petroleum Gas Use in Intervention Homes in the Household Air Pollution Intervention Network (HAPIN) Trial in Rural Guatemala', Health Education and Behavior, vol. 48, no. 5, pp. 651-669. https://doi.org/10.1177/1090198121996280

Developing Visual Messages to Support Liquefied Petroleum Gas Use in Intervention Homes in the Household Air Pollution Intervention Network (HAPIN) Trial in Rural Guatemala. / Hengstermann, Mayarí; Díaz-Artiga, Anaité; Otzóy-Sucúc, Roberto et al.

In: Health Education and Behavior, Vol. 48, No. 5, 10.2021, p. 651-669.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Developing Visual Messages to Support Liquefied Petroleum Gas Use in Intervention Homes in the Household Air Pollution Intervention Network (HAPIN) Trial in Rural Guatemala

AU - Hengstermann, Mayarí

AU - Díaz-Artiga, Anaité

AU - Otzóy-Sucúc, Roberto

AU - Laura Maria Ruiz-Aguilar, Ana

AU - Thompson, Lisa M.

AU - Aravindalochanan, Vigneswari

AU - Balakrishnan, Kalpana

AU - Barr, Dana Boyd

AU - Burrowes, Vanessa

AU - Campbell, Devan

AU - Campbell, Julia Mc Peek

AU - Canuz, Eduardo

AU - Castañaza, Adly

AU - Chang, Howard

AU - Checkley, William

AU - Chen, Yunyun

AU - Chiang, Marilú

AU - Clark, Maggie L.

AU - Clasen, Thomas

AU - Craik, Rachel

AU - Crocker, Mary

AU - Davila-Roman, Victor

AU - de las Fuentes, Lisa

AU - De Léon, Oscar

AU - Diaz-Artiga, Anaité

AU - Dusabimana, Ephrem

AU - Elon, Lisa

AU - Espinoza, Juan Gabriel

AU - Fuentes, Irma Sayury Pineda

AU - Garg, Sarada

AU - Goodman, Dina

AU - Gupton, Savannah

AU - Hardison, Meghan

AU - Hartinger, Stella

AU - Harvey, Steven A.

AU - Hengstermann, Mayari

AU - Herrera, Phabiola

AU - Hossen, Shakir

AU - Howards, Penelope

AU - Jaacks, Lindsay

AU - Jabbarzadeh, Shirin

AU - Johnson, Michael A.

AU - Jones, Abigail

AU - Kearns, Katherine

AU - Kirby, Miles

AU - Kremer, Jacob

AU - Laws, Margaret

AU - Liao, Jiawen

AU - Lovvorn, Amy

AU - Majorin, Fiona

AU - McCollum, Eric

AU - McCracken, John

AU - Meyers, Rachel

AU - Miranda, J. Jaime

AU - Mollinedo, Erick

AU - Moulton, Lawrence

AU - Mukhopadhyay, Krishnendu

AU - Naeher, Luke

AU - Nambajimana, Abidan

AU - Ndagijimana, Florien

AU - Nizam, Azhar

AU - de Dieu Ntivuguruzwa, Jean

AU - Papageorghiou, Aris

AU - Peel, Jennifer

AU - Piedrahita, Ricardo

AU - Pillarisetti, Ajay

AU - Puttaswamy, Naveen

AU - Puzzolo, Elisa

AU - Quinn, Ashlinn

AU - Rajkumar, Sarah

AU - Ramakrishnan, Usha

AU - Reardon, Davis

AU - Rosa, Ghislaine

AU - Rosenthal, Joshua

AU - Ryan, P. Barry

AU - Sakas, Zoe

AU - Sambandam, Sankar

AU - Sarnat, Jeremy

AU - Simkovich, Suzanne

AU - Sinharoy, Sheela

AU - Smith, Kirk R.

AU - Steenland, Kyle

AU - Swearing, Damien

AU - Thangavel, Gurusamy

AU - Thompson, Lisa M.

AU - Toenjes, Ashley

AU - Underhill, Lindsay

AU - Uwizeyimana, Jean Damascene

AU - Valdes, Viviane

AU - Verma, Amit

AU - Waller, Lance

AU - Warnock, Megan

AU - Williams, Kendra

AU - Ye, Wenlu

AU - Young, Bonnie

N1 - Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study is funded by the U.S. National Institutes of Health (NIH; cooperative agreement 1UM1HL134590) in collaboration with the Bill & Melinda Gates Foundation (OPP1131279). Participating NIH organizations include the National Heart, Lung and Blood Institute, National Institute of Environmental Health Sciences, National Cancer Institute, National Institute of Child Health and Human Development, Fogarty International Center, and the NIH Common Fund. Publisher Copyright: © The Author(s) 2021.

PY - 2021/10

Y1 - 2021/10

N2 - 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.

AB - 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.

KW - audiovisual aids

KW - behavioral change communication

KW - health literacy

KW - household air pollution

UR - http://www.scopus.com/inward/record.url?scp=85102773058&partnerID=8YFLogxK

U2 - 10.1177/1090198121996280

DO - 10.1177/1090198121996280

M3 - Article

C2 - 33733893

AN - SCOPUS:85102773058

SN - 1090-1981

VL - 48

SP - 651

EP - 669

JO - Health Education and Behavior

JF - Health Education and Behavior

IS - 5

ER -

Hengstermann M, Díaz-Artiga A, Otzóy-Sucúc R, Laura Maria Ruiz-Aguilar A, Thompson LM, Aravindalochanan V et al. Developing Visual Messages to Support Liquefied Petroleum Gas Use in Intervention Homes in the Household Air Pollution Intervention Network (HAPIN) Trial in Rural Guatemala. Health Education and Behavior. 2021 Oct;48(5):651-669. doi: 10.1177/1090198121996280

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

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