Implementing a context-driven awareness programme addressing household air pollution and tobacco: a FRESH AIR study

The FRESH AIR collaborators, Evelyn A. Brakema, Frederik A. van Gemert, Sian Williams, Talant Sooronbaev, Berik Emilov, Maamed Mademilov, Aizhamal Tabyshova, Pham Le An, Nguyen Nhat Quynh, Le Huynh Thi Cam Hong, Tran Ngoc Dang, Rianne M.J.J. van der Kleij, Niels H. Chavannes, Corina de Jong, Pham Duong Uyen Binh, Sally Singh

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
65 Downloads (Pure)


Most patients with chronic respiratory disease live in low-resource settings, where evidence is scarcest. In Kyrgyzstan and Vietnam, we studied the implementation of a Ugandan programme empowering communities to take action against biomass and tobacco smoke. Together with local stakeholders, we co-created a train-the-trainer implementation design and integrated the programme into existing local health infrastructures. Feasibility and acceptability, evaluated by the modified Conceptual Framework for Implementation Fidelity, were high: we reached ~15,000 Kyrgyz and ~10,000 Vietnamese citizens within budget (~€11,000/country). The right engaged stakeholders, high compatibility with local contexts and flexibility facilitated programme success. Scores on lung health awareness questionnaires increased significantly to an excellent level among all target groups. Behaviour change was moderately successful in Vietnam and highly successful in Kyrgyzstan. We conclude that contextualising the awareness programme to diverse low-resource settings can be feasible, acceptable and effective, and increase its sustainability. This paper provides guidance to translate lung health interventions to new contexts globally.

Original languageEnglish
Article number42
Pages (from-to)1-8
Number of pages8
Journalnpj Primary Care Respiratory Medicine
Issue number1
Publication statusPublished - 6 Oct 2020

Bibliographical note

Note - Sally Singh, Faculty of Health & Life Sciences, is a member of the collaborative group 'The FRESH AIR collaborators' - Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing,adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.


This study was funded by the EU Research and Innovation programme Horizon 2020 (Health, Medical research and the challenge of ageing) under grant agreement no. 680997,


  • Disease prevention
  • Patient education
  • Public health
  • Respiratory tract diseases
  • Translational research

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health
  • Family Practice


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