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![Impact of a Cookstove Intervention on Exposure and Blood Pressure in Rural Honduran Women için kapak resmi Impact of a Cookstove Intervention on Exposure and Blood Pressure in Rural Honduran Women için kapak resmi](/client/assets/cf6e192b74af2810/ctx/images/no_image.png)
Impact of a Cookstove Intervention on Exposure and Blood Pressure in Rural Honduran Women
Başlık:
Impact of a Cookstove Intervention on Exposure and Blood Pressure in Rural Honduran Women
Yazar:
Heiderscheidt, Judy Marie, author.
ISBN:
9780438042759
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (270 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 79-10(E), Section: B.
Advisors: Jennifer L. Peel; Thomas J. Keefe Committee members: Maggie Clark; Ann Magennis; Lorann Stallones.
Özet:
Nearly three billion people use solid fuels for cooking; the resulting high levels of household air pollution accounted for an estimated 2.6 million premature deaths worldwide in 2016. Furthermore, high systolic blood pressure accounted for over 10 million premature deaths globally in 2016. In Honduras, blood pressure is the leading risk factor for the burden of disease, with household air pollution ranking fourth. Stoves have been designed that have the potential to reduce air pollutants such as fine particulate matter (PM2.5) and carbon monoxide (CO), yet low adoption rates prevent intended users from realizing their benefits. Several previous intervention efforts have observed small but meaningful decreases in systolic and/or diastolic blood pressure within a year of a cleaner-burning stove intervention; however, evidence in this realm is still limited. We conducted a cookstove intervention study among participating women (n = 121) in three rural communities near Copan Ruinas, Honduras to evaluate the impact of introducing the Ecocina wood-fuel cookstove (thought to be cleaner burning) on pollutant concentrations and blood pressure in women who previously cooked over traditional wood fires. In early 2013 (baseline) we initiated a non-randomized cookstove intervention study and collected 24-hour kitchen PM2.5, kitchen CO, and personal CO measurements along with obtaining blood pressure measurements and administering a questionnaire on personal and household characteristics. In March 2013, we delivered the Ecocina stove to 91 of these women, with the remaining 30 women serving as a control population. In January 2014 (post-intervention), we performed the same exposure and blood pressure measurements and again asked about personal and household demographics.
First, we used key informant interviews to quantify the communities' willingness to address the issue of cooking with traditional biomass stoves (open fires or poorly constructed stoves) both pre-intervention and ten months post-intervention. Next, we measured and described use of the Ecocina stove over time in the intervention arm (n = 84) of the study and also compared use over time between intervention recipients who received additional stove use training (n = 58) and those who did not (n = 26) to determine if more focused training increased sustained use of the Ecocina. We also defined four indicators of Ecocina use and evaluated the association between each of these four definitions of stove use with household, sociodemographic, and stove preference characteristics. We then assessed changes in exposure by intervention status (including whether or not participants received additional training). We evaluated changes between baseline and post-intervention exposures and then calculated standardized ratios to compare the intervention group to the control group (change in geometric means of the pollutant concentrations in the intervention population relative to the change in geometric means of pollutant concentrations observed in the control population). We compared blood pressure levels at post-intervention (January 2014) between the intervention and control populations and examined potential effect modification on this relationship by age (those 40 years and older and those younger than 40 years). We also evaluated the effect of receiving additional stove use training on blood pressure levels. Blood pressure and pollutant measures obtained at baseline and post-intervention visits were used in a mixed-model repeated measures regression analysis to estimate the exposure-response relationship for the three pollutant measurements and systolic and diastolic blood pressures separately. And finally, we used regression analysis to estimate the impact of exclusive use or stove stacking on post-intervention blood pressure levels.
The overall stage of readiness (nine point scale) for all three communities combined increased from denial/resistance (stage 2) prior to introducing the intervention cookstove to pre-planning (stage 4) post-intervention; the communities remained at a low stage of readiness to address the issue of cooking over open fires. During the seven months of stove use monitoring, mean percent time using the Ecocina decreased from 43% for those not receiving additional training and 35% for those who did receive additional training in the first month of monitoring to 27% mean use for both groups in the final month of monitoring. Ten months after delivery of the Ecocinas, only 25% of participants reported exclusive use of their Ecocina. Self-reported exclusive Ecocina users on average had higher and more consistent use of the Ecocina across time compared to those using their traditional stove plus the Ecocina where use decreases over time. However, mean percent Ecocina use overlapped for both exclusive and non-exclusive users for each of the seven stove use monitoring periods. Women who were exclusive Ecocina users tended to be younger, more educated, have fewer family members, and have homes with attached kitchens than women who were not exclusively using the Ecocina. (Abstract shortened by ProQuest.).
Notlar:
School code: 0053
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(679046.1) | 679046-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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