Combustion of plastic waste and human health effects in Guatemala

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ABSTRACT Household waste burning, especially of plastics, is a major, but unaddressed environmental and health hazard in low resource countries that lack a waste management infrastructure to properly dispose of waste. In rural Guatemala, 95% of households use solid fuels for cooking and 71% burn waste as the primary means of disposal. Plastic waste is burned in solid fuel (e.g., wood) cookstoves and in outdoor fires as a means of disposal. ECOLECTIVOS is a cluster randomized trial using implementation research to develop and evaluate community-level working groups that aim to reduce household burning of plastic waste. With this administrative supplement we will select up to three environmental health community workers (promotoras) per village from among the women who participate in the 12-week community working group sessions in 8 intervention villages. We will use the Behavior Change Wheel and RE-AIM, two implementation science frameworks to assess opportunities, capabilities and motivations that determine behaviors, as well as the reach, effectiveness, adoption, implementation fidelity, maintenance, and sustainability of community-driven interventions. In Aim 1, the promotoras will be trained to administer short checklist surveys to the 25 women in their village who participate in the working groups and who continue to implement the intervention selected by the village (e.g., community recycling) to assess domains of COM-B and RE-AIM. The promotoras will communicate with ECOLECTIVOS research staff about implementation bottlenecks (e.g., recycling truck didn’t arrive) and successes (e.g., number of villagers engaged successfully in recycling). In Aim 2, the promotoras will help project staff design and implement “intervention fairs” to be rolled out in 8 control villages. These fairs will be structured to promote the uptake and adoption of intervention activities in nearby control villages. The project is relevant to the NIEHS mission because it fosters collaboration between research and community groups in the conduct of community-engaged research that aims to improve household and ambient air quality. Our findings will be incorporated into community-driven public health actions with policymakers to develop programs in other local contexts.