Addressing ClimaTe Change FOR IMPROVED CLEAN COOKSTOVE Uptake, Household Air Pollution Reduction, and Hypertension Prevention (ACT4ICC)

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Abstract The Community Mobilization for Improved Clean Cookstove Uptake, Household Air Pollution Reduction, and Hypertension Prevention (R01HL157091) (CF-CS) parent study is an ongoing type-2 hybrid design implementation trial that examines the role of community mobilization in household air pollution (HAP) reduction and blood pressure (BP) control in 32 peri-urban communities of Lagos, Nigeria. In response to NOT-HD-23- 006, we propose this administrative supplement, Addressing ClimaTe Change FOR IMPROVED CLEAN COOKSTOVE Uptake, Household Air Pollution Reduction, and Hypertension Prevention (ACT4ICC). ACT4ICC will leverage Local Government Area (LGA) teams (particularly the environmental health officers that work closely with the communities) to collect and monitor black carbon (BC) concentrations across all participating households (experimental and control arms) and include its effects in the parent study analysis of HAP on BP control. Additionally, ACT4ICC will build the epidemiological capacity of local authorities, to facilitate the reduction in HAP in households and improve BP outcomes. Expansion into this area of monitoring and assessing the effects of BC concentrations in the study population on BP, and epidemiological capacity building will allow us to comprehensively understand and contextualize the effect of BC, which is known to be major components of HAP with associations with high BP, and the role of local key players in environmental health management of Lagos. CF-CS parent study is currently in the implementation phase and has begun recruitment. In addition to engaging in the proposed climate and health research, ACT4ICC will build epidemiological capacity among local environmental partners through training in data collection and monitoring of BC concentrations, engaging stakeholders, interpreting findings, and integrating this new knowledge into practical strategies to potentially scale climate change and health initiatives in LMICs. Per instructions in to NOT-HD-23-006, this supplement is specific to climate change and health.