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      The Shamba Chef Educational Entertainment Program to Promote Modern Cookstoves in Kenya: Outcomes and Dose–Response Analysis

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          Abstract

          Background: Globally, an estimated 3.6 billion people rely on solid fuels for cooking over open fires or in simple cookstoves. Universal access to clean cooking fuels and technology by 2030 is a United Nations’ Sustainable Development Goal. Methods: The Mediae Company created a home makeover television and radio show, Shamba Chef, designed to promote modern, cleaner, safer cooking methods and improved nutrition in Kenya, which reached 5 million homes in late 2017. This was accompanied by a mobile phone platform called iChef. Researchers evaluated the effects of Shamba Chef on cookstove purchase, use, and attitudes, beliefs, and intentions. Results: The study revealed dose–response effects of Shamba Chef exposure on several key outcomes. Exposure to the program was associated with an awareness of improved biomass stoves (OR 4.4; 95% CI 2.8 to 6.9), and aspirations to own an improved biomass stove (OR 2.0; 95% CI 1.4 to 2.9). Receiving information about modern stoves from two or more sources generated greater awareness of liquefied petroleum gas (LPG) stoves (OR 2.0; 95% CI 1.3 to 3.1). The qualitative study revealed that Shamba Chef explained how the stoves worked, communicated their benefits, and encouraged participants to trust and purchase those cookstoves. Conclusion: Shamba Chef was successful in influencing determinants of cookstove purchase and use, and there is evidence from the qualitative study that it influenced the purchase and use of improved biomass stoves.

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          Evidence of a dose-response relationship between "truth" antismoking ads and youth smoking prevalence.

          In early 2000, the American Legacy Foundation launched the national "truth" campaign, the first national antismoking campaign to discourage tobacco use among youths. We studied the impact of the campaign on national smoking rates among US youths (students in grades 8, 10, and 12). We used data from the Monitoring the Future survey in a pre/post quasi-experimental design to relate trends in youth smoking prevalence to varied doses of the "truth" campaign in a national sample of approximately 50000 students in grades 8, 10, and 12, surveyed each spring from 1997 through 2002. Findings indicate that the campaign accounted for a significant portion of the recent decline in youth smoking prevalence. We found that smoking prevalence among all students declined from 25.3% to 18.0% between 1999 and 2002 and that the campaign accounted for approximately 22% of this decline. This study showed that the campaign was associated with substantial declines in youth smoking and has accelerated recent declines in youth smoking prevalence.
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            Effect of the first federally funded US antismoking national media campaign.

            Every year, smoking kills more than 5 million people globally, including 440,000 people in the USA, where the long-term decline in smoking prevalence has slowed. The US Centers for Disease Control and Prevention (CDC) delivered a national, 3-month antismoking campaign called Tips From Former Smokers (Tips) that started in March, 2012, in which hard-hitting, emotionally evocative television advertising was featured, depicting smoking-related suffering in real people. We aimed to assess the effects of the Tips campaign. We undertook baseline and follow-up surveys of nationally representative cohorts of adult smokers and non-smokers. The national effect of the Tips campaign was estimated by applying rates of change in the cohort before and after the campaign to US census data. 3051 smokers and 2220 non-smokers completed baseline and follow-up assessments. 2395 (78%) smokers and 1632 (74%) non-smokers recalled seeing at least one Tips advertisement on television during the 3-month campaign. Quit attempts among smokers rose from 31.1% (95% CI 30.3-31.9) at baseline to 34.8% (34.0-35.7) at follow-up, a 12% relative increase. The prevalence of abstinence at follow-up among smokers who made a quit attempt was 13.4% (95% CI 9.7-17.2). Nationally, an estimated 1.64 million additional smokers made a quit attempt, and 220,000 (95% CI 159,000-282,000) remained abstinent at follow-up. Recommendations by non-smokers to quit grew from 2.6% at baseline to 5.1% at follow-up, and the prevalence of people talking with friends and family about the dangers of smoking rose from 31.9% (95% CI 31.3-32.5) to 35.2% (34.6-35.9), resulting in an estimated 4.7 million additional non-smokers recommending cessation services and more than 6 million talking about the dangers of smoking. The high-exposure Tips media campaign was effective at increasing population-level quit attempts. The growth in smokers who quit and became sustained quitters could have added from a third to almost half a million quality-adjusted life-years to the US population. Expanded implementation of similar campaigns globally could accelerate progress on the WHO Framework Convention on Tobacco Control and reduce smoking prevalence globally. CDC, US Department of Health and Human Services. Copyright © 2013 Elsevier Ltd. All rights reserved.
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              Adoption and sustained use of improved cookstoves

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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                25 December 2019
                January 2020
                : 17
                : 1
                : 162
                Affiliations
                [1 ]Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
                [2 ]Colorado State University, Fort Collins, CO 80523, USA; Bonnie.Young@ 123456colostate.edu
                [3 ]Berkeley Air Monitoring Group, Berkeley University, Berkeley, CA 94704, USA; mjohnson@ 123456berkeleyair.com (M.A.J.); kajagoe@ 123456gmail.com (K.A.J.); dcharron@ 123456berkeleyair.com (D.C.); mrossanese@ 123456berekleyair.com (M.R.)
                [4 ]Mediae Company, Nairobi 00100, Kenya; kate@ 123456mediae.org (K.L.M.); patricia@ 123456mediae.org (P.G.)
                [5 ]Clean Cooking Alliance, Washington, DC 20052, USA; jipe@ 123456cleancookstoves.org
                Author notes
                [* ]Correspondence: wdevans@ 123456gwu.edu
                Author information
                https://orcid.org/0000-0002-7559-1592
                https://orcid.org/0000-0002-6524-2348
                https://orcid.org/0000-0002-4886-1534
                Article
                ijerph-17-00162
                10.3390/ijerph17010162
                6981508
                31881652
                d75bd831-49f5-4d8c-893f-7b25990ef244
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 22 November 2019
                : 20 December 2019
                Categories
                Article

                Public health
                cookstoves,public health,environment,social marketing,behavior change communication,demand creation

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