Evidence map›Paper›PMID 34919858›Full record

Observational studyThe Lancet. Global health2022

Mapping low-resource contexts to prepare for lung health interventions in four countries (FRESH AIR): a mixed-method study.

Evelyn A Brakema, Rianne M J J van der Kleij, Charlotte C Poot, Pham Le An, Marilena Anastasaki, Matty R Crone, Le Huynh Thi Cam Hong, Bruce Kirenga, Christos Lionis, Maamed Mademilov and 9 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in The Lancet. Global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Article
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  3. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Evelyn A BrakemaDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands. Electronic address: evelynbrakema@gmail.com.
Rianne M J J van der KleijDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
Charlotte C PootDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
Pham Le AnFamily Medicine Training Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Marilena AnastasakiClinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
Matty R CroneDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
Le Huynh Thi Cam HongFamily Medicine Training Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Bruce KirengaMakerere Lung Institute, Mulago Hospital, Kampala, Uganda.
Christos LionisClinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
Maamed MademilovDepartment of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, Kyrgyzstan.
Mattijs E NumansDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
Lê Thi Tu OanhFamily Medicine Training Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Ioanna TsiligianniClinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
Talant SooronbaevDepartment of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Bishkek, Kyrgyzstan.
Simon WalusimbiMakerere Lung Institute, Mulago Hospital, Kampala, Uganda.
Siân WilliamsInternational Primary Care Respiratory Group, London, UK.
Niels H ChavannesDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
Ria ReisDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands; Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands; The Children's Institute, University of Cape Town, Cape Town, South Africa.
FRESH AIR collaborators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEffectiveness of health programmes can be undermined when the implementation misaligns with local beliefs and behaviours. To design context-driven implementation strategies, we explored beliefs and behaviours regarding chronic respiratory disease (CRD) in diverse low-resource settings.

methodsThis observational mixed-method study was conducted in Africa (Uganda), Asia (Kyrgyzstan and Vietnam) and Europe (rural Greece and a Roma camp). We systematically mapped beliefs and behaviours using the SETTING-tool. Multiple qualitative methods among purposively selected community members, health-care professionals, and key informants were triangulated with a quantitative survey among a representative group of community members and health-care professionals. We used thematic analysis and descriptive statistics.

findingsWe included qualitative data from 340 informants (77 interviews, 45 focus group discussions, 83 observations of community members' households and health-care professionals' consultations) and quantitative data from 1037 community members and 204 health-care professionals. We identified three key themes across the settings; namely, (1) perceived CRD identity (community members in all settings except the rural Greek strongly attributed long-lasting respiratory symptoms to infection, predominantly tuberculosis); (2) beliefs about causes (682 [65·8%] of 1037 community members strongly agreed that tobacco smoking causes symptoms, this number was 198 [19·1%] for household air pollution; typical perceived causes ranged from witchcraft [Uganda] to a hot-cold disbalance [Vietnam]); and (3) norms and social structures (eg, real men smoke [Kyrgyzstan and Vietnam]).

interpretationWhen designing context-driven implementation strategies for CRD-related interventions across these global settings, three consistent themes should be addressed, each with common and context-specific beliefs and behaviours. Context-driven strategies can reduce the risk of implementation failure, thereby optimising resource use to benefit health outcomes.

fundingEuropean Commission Horizon 2020. TRANSLATIONS: For the Greek, Russian and Vietnamese translations of the abstract see Supplementary Materials section.

Indexed as

Developing CountriesHealth Knowledge, Attitudes, PracticeAdultAgedAttitude of Health PersonnelChronic DiseaseFemaleHumansMaleMiddle AgedRespiration Disorders

Identifiers

PMID34919858

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.