'Pneumonia has gone': exploring perceptions of health in a cookstove intervention trial in rural Malawi.
'Pneumonia has gone': exploring perceptions of health in a cookstove intervention trial in rural Malawi.
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DOI：
10.1136/bmjgh-2020-004596
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发表时间：
2021-10
影响因子：
8.1
通讯作者：
Tolhurst R
中科院分区：
文献类型：
--
作者：
Ardrey J;Jehan K;Kumbuyo C;Ndamala C;Mortimer K;Tolhurst R
明火烹饪或使用生物质燃料的低效炉灶造成的空气污染与肺部健康受损和每年400多万人过早死亡有关。然而，使用更清洁的炉灶往往是零星的，有迹象表明，使用者没有优先考虑长期健康效益。关于炉灶使用者如何认识清洁烹饪干预措施对健康的益处的信息也很有限。因此，我们在烹饪与肺炎研究（CAPS）的同时进行了一项定性研究。定性方法和参与性方法Photovoice被用于深入检查CAPS试验参与者的健康观念和理解。五个CAPS干预村的50名参与者收集了有关烹饪的图像。这些问题在村一级的焦点小组和与12名有代表性的与会者的访谈中得到讨论。还采访了村社区代表。四名女性和八名男性CAPS实地工作者参加了针对性别的焦点小组，两名女性和两名男性实地工作者接受了采访。数据分析采用了主题内容方法。我们发现当地对健康的看法与以生物医学为重点的试验模式之间存在脱节。这包括形成可能有害的认识，例如肺炎不再是一种威胁，以及可能混淆肺炎和疟疾的症状。研究参与者认为健康和福祉的好处包括：炉灶节省了身体能量；快速烹饪有助于保持家庭和谐。对共同行动计划中关于健康的叙述有了更深入的了解，这表明人们是如何根据具体情况对炉灶的健康益处产生看法的。这突出了炉灶干预研究人员和参与者之间相互冲突的优先事项，以及无意和潜在有害的健康理解。该研究还强调了在类似的复杂干预措施中进行定性探索的重要性，在这些干预措施中，产生有益（和有害）影响的潜在途径不能仅通过生物医学模型完全阐明。
Air pollution through cooking on open fires or inefficient cookstoves using biomass fuels has been linked with impaired lung health and with over 4 million premature deaths per annum. However, use of cleaner cookstoves is often sporadic and there are indications that longer-term health benefits are not prioritised by users. There is also limited information about how recipients of cookstoves perceive the health benefits of clean cooking interventions. We therefore conducted a qualitative study alongside the Cooking and Pneumonia Study (CAPS). Qualitative methods and the participatory methodology Photovoice were used in an in-depth examination of health perceptions and understandings of CAPS trial participants. Fifty participants in five CAPS intervention villages collected images about cooking. These were discussed in village-level focus groups and in interviews with 12 representative participants. Village community representatives were also interviewed. Four female and eight male CAPS fieldworkers took part in gender-specific focus groups and two female and two male fieldworkers were interviewed. A thematic content approach was used for data analysis. We found a disconnect between locally situated perceptions of health and the biomedically focused trial model. This included the development of potentially harmful understandings such as that pneumonia was no longer a threat and potential confusion between the symptoms of pneumonia and malaria. Study participants perceived health and well-being benefits including: cookstoves saved bodily energy; quick cooking helped maintain family harmony. A deeper understanding of narratives of health within CAPS showed how context-specific perceptions of the health benefits of cookstoves were developed. This highlighted the conflicting priorities of cookstove intervention researchers and participants, and unintended and potentially harmful health understandings. The study also emphasises the importance of including qualitative explorations in similar complex interventions where potential pathways to beneficial (and harmful) effects, cannot be completely explicated through biomedical models alone.
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影响因子：
3.7
作者：
Ardrey J;Desmond N;Tolhurst R;Mortimer K
通讯作者：
Mortimer K
影响因子：
5.4
作者：
Castleden, Heather;Garvin, Theresa;Nation, Huu-Ay-Aht First
通讯作者：
Nation, Huu-Ay-Aht First
影响因子：
3.7
作者：
Ewing, Victoria L.;Tolhurst, Rachel;Lalloo, David G.
通讯作者：
Lalloo, David G.
影响因子：
5.4
作者：
Avotri, JY;Walters, V
通讯作者：
Walters, V
影响因子：
6.7
作者：
Fingleton-Smith, Edwina
通讯作者：
Fingleton-Smith, Edwina