Muslim Communities Learning About Second-hand Smoke in Bangladesh (MCLASS II): An effectiveness-implementation hybrid study

孟加拉国穆斯林社区了解二手烟（MCLASS II）：一项有效性与实施混合研究

• 批准号: MR/P008941/1
• 负责人: Kamran Siddiqi
• 金额: $ 98.36万
• 依托单位: University of York
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2017
• 资助国家: 英国
• 起止时间: 2017 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FP008941%2F1
• 关键词: Muslim; Communities; Learning; About; Second

Breathing in other people's smoke is called passive smoking; also referred to as environmental or second-hand smoking. Second-hand smoke (SHS) contains 4,000 chemicals, and is a serious health hazard to non-smokers. SHS is estimated to cost more than 600,000 lives per year, worldwide. A large proportion of the overall burden of diseases due to SHS is due to lung diseases such as asthma, chest infections and lung cancer. Women and children are worst affected; 47% of deaths from SHS exposure occur in female adults and 28% in children. Recognising SHS as a public health threat, most countries have introduced bans on smoking in enclosed public spaces, which has significantly reduced adults' exposure to SHS. However, for most non-smoking women and children, cars and homes remain the most likely places for them to breathe in SHS. The only possible way to protect them from SHS is to make cars and homes completely smoke free.For the last few years, we have been working with Muslim communities to develop and test a community-based intervention called, 'Smoke Free Homes' (SFH). We train Imams (Muslim faith leaders) based in mosques to encourage their congregations to make a positive change in their smoking behaviours. Imams stimulate discussions during study circles, in-between regular prayers and during Quran classes. Through our pilot work, we found that with proper support mosques are a suitable place for promoting health and Imams are willing to deliver smoke-free messages. In addition, we have also developed technology to measure Indoor Air Quality (IAQ) using a cheap and efficient home installation meter. In a pilot study, we have demonstrated that IAQ feedback can also motivate changes in smoking behaviours in homes.Inspired by our pilot work in the UK, we now propose a large study in Bangladesh where SHS is a major public health problem and a priority for policy making in tobacco control. Through our work in Bangladesh in this area for several years, we have established collaborations with local communities and policy makers. Before carrying out the main study, we will adapt SFH to Bangladesh context. The adaptation will be informed by the findings of the interviews and discussions with community members and Imams in Dhaka. We wish to examine how effective is SFH, with or without IAQ feedback, in reducing exposure to SHS in homes. We are also interested to see if the intervention improves their lung health, general quality of life, and reduce health service use. To provide accurate answers to these important questions, we will recruit a total of 45 Mosques and 1800 households in their catchment area. We will randomly allocate mosques to three arms.Mosques in arm 1, will receive training on SFH and their congregation will receive IAQ feedback on a sample of homes from their community. Those in arm 2, will only receive training on SFH and arm 3 mosques will have usual services. We will also use objective measurements including testing IAQ to assess whether our intervention has reduced SHS exposure in homes. Other measures will include questionnaires to record respiratory symptoms such as cough, wheeze and scales to measure quality of life. We will undertake all the measurements as described above using internationally agreed standards. Over the following six-months, we will repeat these assessments at regular intervals. In parallel, using an economic analysis we will also assess whether SFH with or without IAQ is value for money.Subsequently, we will also assess how best to implement SFH with or without IAQ feedback and bring it to scale. For this part of the study, we will (a) estimate the likely costs and effects of scaling up the intervention, (b) develop a simple implementation monitoring tool, (c) investigate likely obstacles to and opportunities for implementing and scaling up the intervention, and (d) how best to work with communities and policy makers to overcome these obstacles and maximize such opportunities.

吸入别人的烟被称为被动吸烟；也被称为环境吸烟或二手烟。二手烟（SHS）含有4000种化学物质，对不吸烟的人来说是严重的健康危害。据估计，全球每年有60多万人死于急性呼吸道感染。在由急性呼吸道感染引起的总体疾病负担中，很大一部分是由哮喘、胸部感染和肺癌等肺部疾病造成的。妇女和儿童受影响最严重；暴露于SHS造成的死亡中47%发生在女性成人中，28%发生在儿童中。大多数国家认识到二手烟是一种公共卫生威胁，已禁止在封闭的公共场所吸烟，这大大减少了成年人接触二手烟的机会。然而，对于大多数不吸烟的妇女和儿童来说，汽车和家庭仍然是他们最可能吸入二手烟的地方。保护他们免受SHS侵害的唯一可能的方法是使汽车和家庭完全无烟。在过去的几年里，我们一直在与穆斯林社区合作，开发和测试一种以社区为基础的干预措施，称为“无烟家庭”（SFH）。我们培训清真寺的伊玛目（穆斯林信仰领袖），鼓励他们的会众积极改变吸烟行为。伊玛目会在学习圈、常规祈祷间隙和古兰经课上激发讨论。通过试点工作，我们发现，在适当的支持下，清真寺是促进健康的合适场所，伊玛目也愿意传递无烟信息。此外，我们还开发了使用廉价高效的家庭安装仪表测量室内空气质量（IAQ）的技术。在一项初步研究中，我们已经证明，室内空气质量反馈也可以激发家庭吸烟行为的改变。受我们在英国试点工作的启发，我们现在提议在孟加拉国进行一项大型研究，在孟加拉国，二手烟是一个主要的公共卫生问题，也是烟草控制政策制定的优先事项。通过几年来在孟加拉国这一领域的工作，我们与当地社区和决策者建立了合作关系。在进行主要研究之前，我们将使SFH适应孟加拉国的情况。在达卡与社区成员和伊玛目的访谈和讨论结果将为改编提供信息。我们希望研究SFH在有或没有室内空气质量反馈的情况下，在减少家庭暴露于SHS方面的效果如何。我们还想知道干预是否能改善他们的肺部健康、总体生活质量，并减少医疗服务的使用。为了提供这些重要问题的准确答案，我们将在其集水区招募45座清真寺和1800户家庭。我们将把清真寺随机分配给三军。第一组的清真寺将接受关于SFH的培训，他们的会众将收到来自他们社区的家庭样本的室内空气质量反馈。第二组的人将只接受SFH培训，第三组的清真寺将有正常的服务。我们还将使用客观测量方法，包括测试室内空气质量，以评估我们的干预措施是否减少了家庭中的SHS暴露。其他措施将包括记录咳嗽、喘息等呼吸道症状的问卷调查和衡量生活质量的量表。我们将使用国际商定的标准进行上述所有测量。在接下来的六个月里，我们将定期重复这些评估。同时，我们亦会运用经济分析，评估有或没有室内空气质素的家居服务是否物有所值。随后，我们亦会评估如何在有或没有室内空气质素反馈的情况下，以最佳方式推行食物及健康服务，并将其推广。在本研究的这一部分，我们将(a)估计扩大干预的可能成本和效果，(b)开发一个简单的实施监测工具，(c)调查实施和扩大干预的可能障碍和机会，以及(d)如何最好地与社区和政策制定者合作，克服这些障碍并最大限度地利用这些机会。

项目成果

"Everything the hujur tells is very educative but if I cannot apply those in my own life then there is no meaning": a mixed-methods process evaluation of a smoke-free homes intervention in Bangladesh.

• DOI: 10.1186/s12889-022-14283-6
• 发表时间: 2022-10-11
• 期刊: BMC public health
• 影响因子: 4.5

Smoking behaviours and indoor air quality: a comparative analysis of smoking-permitted versus smoke-free homes in Dhaka, Bangladesh

• DOI: 10.1136/tobaccocontrol-2020-055969
• 发表时间: 2022-05-01
• 期刊: TOBACCO CONTROL
• 影响因子: 5.2
• 作者: Ferdous, Tarana;Siddiqi, Kamran;Huque, Rumana
• 通讯作者: Huque, Rumana

Effect of smoke-free policies in military settings on tobacco smoke exposure and smoking behaviour: a systematic review.

军事环境中无烟政策对烟草烟雾暴露和吸烟行为的影响：系统评价。

• DOI: 10.1136/bmjmilitary-2021-001795
• 发表时间: 2021
• 期刊: BMJ military health
• 影响因子: 1.5
• 作者: Falconer Hall T

Involving mosques in health promotion programmes: a qualitative exploration of the MCLASS intervention on smoking in the home.

• DOI: 10.1093/her/cyx051
• 发表时间: 2017-08-01
• 期刊: Health education research
• 影响因子: 2.4
• 作者: King R;Warsi S;Amos A;Shah S;Mir G;Sheikh A;Siddiqi K
• 通讯作者: Siddiqi K

Muslim Communities Learning About Second-hand Smoke in Bangladesh (MCLASS II): a combined evidence and theory-based plus partnership intervention development approach.

• DOI: 10.1186/s40814-022-01100-5
• 发表时间: 2022-07-02
• 期刊: PILOT AND FEASIBILITY STUDIES
• 影响因子: 1.7
• 作者: Kellar, Ian;Al Azdi, Zunayed;Jackson, Cath;Huque, Rumana;Mdege, Noreen Dadirai;Siddiqi, Kamran
• 通讯作者: Siddiqi, Kamran