Seguimiento del proceso de obtención del consentimiento informado en los participantes de protocolos de investigación

Objetivo. Hacer el seguimiento del proceso de obtención del Consentimiento Informado en los participantes en los estudios de investigación. Material y Métodos. Se entrevistó a 87 personas participantes en cuatro ensayos clínicos y tres estudios epidemiológicos en 10 sedes. Resultados. Al 100% se le solicitó el Consentimiento Informado. La lectura progresiva y laabsolución de las preguntas fue la modalidad más empleada. El 69% entendió más de la mitad del Consentimiento Informado, 53% dijo no habérsele explicado los riesgos. Mejoría con la droga y confianza con su médico fueron las principales razones de participación. Sólo el 37,9% entendió adecuadamente el estudio en que participaba. Conclusiones. El Consentimiento Informado fue solicitado a todos los participantes. Un alto porcentaje no entendió el estudio. La mitad ignoraba que podría no tener beneficios y más de la mitad ignoraba que podría retirarse del estudio

Nitrogen dioxide exposures from biomass cookstoves in the Peruvian Andes

Household air pollution from biomass cookstoves is a major contributor to global morbidity and mortality, yet little is known about exposures to nitrogen dioxide (NO ). To characterize NO kitchen area concentrations and personal exposures among women with biomass cookstoves in the Peruvian Andes. We measured kitchen area NO concentrations at high-temporal resolution in 100 homes in the Peruvian Andes. We assessed personal exposure to NO in a subsample of 22 women using passive samplers. Among 97 participants, the geometric mean (GM) highest hourly average NO concentration was 723 ppb (geometric standard deviation (GSD) 2.6) and the GM 24-hour average concentration was 96 ppb (GSD 2.6), 4.4 and 2.9 times greater than WHO indoor hourly (163 ppb) and annual (33 ppb) guidelines, respectively. Compared to the direct-reading instruments, we found similar kitchen area concentrations with 48-hour passive sampler measurements (GM 108 ppb, GSD 3.8). Twenty-seven percent of women had 48-hour mean personal exposures above WHO annual guidelines (GM 18 ppb, GSD 2.3). In univariate analyses, we found that roof, wall, and floor type, as well as higher SES, was associated with lower 24-hour kitchen area NO concentrations. Kitchen area concentrations and personal exposures to NO from biomass cookstoves in the Peruvian Andes far exceed WHO guidelines. More research is warranted to understand the role of this understudied household air pollutant on morbidity and mortality and to inform cleaner-cooking interventions for public health

Designing a comprehensive behaviour change intervention to promote and monitor exclusive use of liquefied petroleum gas stoves for the Household Air Pollution Intervention Network (HAPIN) trial

Introduction Increasing use of cleaner fuels, such as liquefied petroleum gas (LPG), and abandonment of solid fuels is key to reducing household air pollution and realising potential health improvements in low-income countries. However, achieving exclusive LPG use in households unaccustomed to this type of fuel, used in combination with a new stove technology, requires substantial behaviour change. We conducted theory-grounded formative research to identify contextual factors influencing cooking fuel choice to guide the development of behavioural strategies for the Household Air Pollution Intervention Network (HAPIN) trial. The HAPIN trial will assess the impact of exclusive LPG use on air pollution exposure and health of pregnant women, older adult women, and infants under 1 year of age in Guatemala, India, Peru, and Rwanda.Methods Using the Capability, Opportunity, Motivation–Behaviour (COM–B) framework and Behaviour Change Wheel (BCW) to guide formative research, we conducted in-depth interviews, focus group discussions, observations, key informant interviews and pilot studies to identify key influencers of cooking behaviours in the four countries. We used these findings to develop behavioural strategies likely to achieve exclusive LPG use in the HAPIN trial.Results We identified nine potential influencers of exclusive LPG use, including perceived disadvantages of solid fuels, family preferences, cookware, traditional foods, non-food-related cooking, heating needs, LPG awareness, safety and cost and availability of fuel. Mapping formative findings onto the theoretical frameworks, behavioural strategies for achieving exclusive LPG use in each research site included free fuel deliveries, locally acceptable stoves and equipment, hands-on training and printed materials and videos emphasising relevant messages. In the HAPIN trial, we will monitor and reinforce exclusive LPG use through temperature data loggers, LPG fuel delivery tracking, in-home observations and behavioural reinforcement visits.Conclusion Our formative research and behavioural strategies can inform the development, implementation, monitoring and evaluation of theory-informed strategies to promote exclusive LPG use in future stove programmes and research studies.Trial registration number NCT02944682, Pre-results