Muslim Communities Learning About Second-hand Smoke in Bangladesh (MCLASS II): study protocol for a cluster randomised controlled trial of a community-based smoke-free homes intervention, with or without Indoor Air Quality feedback
Muslim Communities Learning About Second-hand Smoke in Bangladesh (MCLASS II): study protocol for a cluster randomised controlled trial of a community-based smoke-free homes intervention, with or without Indoor Air Quality feedback
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DOI：
10.1186/s13063-018-3100-y
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发表时间：
2019-01-05
期刊：
影响因子：
2.5
通讯作者：
Siddiqi, Kamran
中科院分区：
文献类型：
--
作者：
Mdege, Noreen;Fairhurst, Caroline;Siddiqi, Kamran
背景二手烟 (SHS) 是一种严重的健康危害，每年导致全球 89 万人丧生。许多经济发展中国家的妇女和儿童受到的影响最严重，因为无烟法仅得到部分实施，家庭仍然是二手烟暴露的主要来源。关于旨在减少家庭（尤其是社区环境）二手烟暴露的干预措施的证据有限。试点成功后，将评估在孟加拉国推广无烟家庭的基于社区的方法，该国坚定致力于无烟环境，但二手烟暴露水平很高。该研究旨在评估基于社区的干预措施“穆斯林促进健康”(M4bH) 在有或没有室内空气质量 (IAQ) 反馈的情况下，在减少非吸烟者在家中接触二手烟的情况方面的有效性和成本效益。方法/设计基于行为改变理论，M4bH 和 IAQ 反馈旨在阻止人们在室内吸烟。 M4bH 由主流伊斯兰话语中表达的一组信息组成，由信仰领袖（伊玛目和哈提卜）在 12 周内每周在清真寺传递（每周一条信息）。这些信息涉及当前吸烟行为的关键决定因素，包括对与二手烟暴露相关的特定危害缺乏了解和误解。 IAQ 反馈包括由家中颗粒物 (PM2.5) 监测仪测量的 IAQ 个性化信息。根据孟加拉国的情况调整 M4bH 和 IAQ 反馈后，将在达卡进行三臂整群随机对照试验。将招募 45 个清真寺和 1800 个家庭，其中至少有一名吸烟者和一名不吸烟者。清真寺将被随机分配到：M4bH 和 IAQ 反馈；单独M4bH；或仅提供常规服务。主要结果是随机分组后 12 个月的 24 小时家庭室内细颗粒物 (PM2.5) 平均浓度。次要结果是随机分组后 3 个月的 24 小时平均家庭 PM2.5、呼吸道症状的频率和严重程度、医疗保健服务的使用和生活质量。还将进行成本效益分析和过程评估。讨论MCLASS II 试验将测试基于社区的干预措施的潜力，以减少家庭二手烟暴露并改善孟加拉国及其他地区非吸烟者的肺部健康。试验注册ISRCTN，ISRCTN49975452。注册日期：2018 年 1 月 11 日。
BackgroundSecond-hand smoke (SHS) is a serious health hazard costing 890,000 lives a year globally. Women and children in many economically developing countries are worst affected as smoke-free laws are only partially implemented and homes remain a major source of SHS exposure. There is limited evidence on interventions designed to reduce SHS exposure in homes, especially in community settings. Following a successful pilot, a community-based approach to promote smoke-free homes in Bangladesh, a country with a strong commitment to smoke-free environments but with high levels of SHS exposure, will be evaluated. The study aims to assess the effectiveness and cost-effectiveness of a community-based intervention, Muslims for better Health (M4bH), with or without Indoor Air Quality (IAQ) feedback, in reducing non-smokers' exposure to SHS in the home.Methods/designBased on behaviour-change theories, M4bH and IAQ feedback are designed to discourage people from smoking indoors. M4bH consists of a set of messages couched within mainstream Islamic discourse, delivered weekly by faith leaders (imams and khatibs) in mosques over 12weeks (one message each week). The messages address key determinants of current smoking behaviours including lack of knowledge and misconceptions on specific harms associated with SHS exposure. IAQ feedback consists of personalised information on IAQ measured by a particulate matter (PM2.5) monitor within the home. Following adaptation of M4bH and IAQ feedback for the Bangladeshi context, a three-arm cluster randomised controlled trial will be conducted in Dhaka. Forty-five mosques and 1800 households, with at least one smoker and one non-smoker, will be recruited. Mosques will be randomised to: M4bH and IAQ feedback; M4bH alone; or usual services only. The primary outcome is 24-h mean household concentration of indoor fine particulate matter (PM2.5) at 12months post randomisation. Secondary outcomes are 24-h mean household PM2.5 at 3 months post randomisation, frequency and severity of respiratory symptoms, health care service use and quality of life. A cost-effectiveness analysis and process evaluation will also be conducted.DiscussionThe MCLASS II trial will test the potential of a community-based intervention to reduce second-hand smoke exposure at home and improve lung health among non-smokers in Bangladesh and beyond.Trial registrationISRCTN, ISRCTN49975452. Registered on 11 January 2018.