The goal of this study is to learn how to help families in Cambodia switch to using electric induction stoves instead of traditional stoves that burn wood or charcoal. The study will also look at whether this switch is safe, affordable, and sustainable over time. The main questions researchers want to answer are: * What strategies work best to encourage families to use induction stoves regularly and stop using traditional cooking methods? * Does switching to induction cooking reduce household air pollution for primary cooks? * What are the costs and benefits of these strategies? To answer these questions, researchers will compare different strategies across 65 peri-urban villages in Cambodia. They will use data loggers to track when families use induction stoves or traditional stoves, and measure air pollution levels in the home before and after families receive induction stoves. Participants will: * Receive an electric induction stove and support based on their group's strategy * Have their stove use tracked through special devices * Take part in air pollution measurements in their homes * Share information about their cooking habits and experiences
Around 3 billion people worldwide cook using biomass fuels like wood, charcoal, and animal dung, which creates household air pollution responsible for about 2.3 million premature deaths each year from diseases such as heart disease, respiratory illnesses, diabetes, and cancer. Previous efforts to clean up biomass fuel burning have not sufficiently reduced air pollution or replaced traditional stoves, leading researchers to explore even cleaner alternatives like electric induction cooking. This study evaluates whether electric induction stoves can effectively lower household air pollution in Cambodia. Using a rigorous, multi-year, cluster-randomized trial in 65 peri-urban villages, the study will: * Develop and test different strategies (such as direct sales, subsidies, and community promotion) to encourage the purchase and regular use of induction stoves. * Measure stove usage with cloud-connected data loggers that record cooking times and energy consumption. * Collect household air pollution data and conduct surveys and interviews with approximately 3,100 households, with a focus on primary cooks. The study also includes a comprehensive cost-effectiveness analysis to understand the benefits in terms of health, environmental impact, time savings, including impacts on individuals responsible for household cooking or fuel collection. By using established frameworks to plan, evaluate, and improve implementation (RE-AIM: Reach, Effectiveness, Adoption, Implementation, and Maintenance; CFIR: Consolidated Framework for Implementation Research), the research aims to build a strong evidence base to support the scale-up of clean cooking interventions in Cambodia and other low- and middle-income settings.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
6,150
The intervention consists of high-quality, locally available electric induction cookstoves with two burners, each equipped with cloud-connected data loggers, and includes compatible cookware.
International Development Enterprises: iDE
Kampong Speu, Kampong Speu Province, Cambodia
RECRUITINGInduction cookstove purchase: Proportion of households that purchase an induction stove
Purchase will be defined as the acquisition of an induction stove during the trial period, as reported in household surveys and verified through study-linked sales records matched to household study IDs. The outcome will be calculated as the number of participating households with a confirmed induction stove acquired divided by the total number of households in each village. Results will be reported overall and stratified by household poverty status, verified by the Cambodian Government (IDPoor status).
Time frame: Endline, 18-30 months post-intervention
Disuse of biomass fuels: Proportion of meals cooked without biomass fuels
Disuse will be defined as the reduction in biomass fuel use for cooking, measured as the proportion of meals cooked without biomass fuels (e.g., firewood and charcoal) during a defined recent reference period, as reported in household surveys. Results will be reported overall and stratified by household poverty status.
Time frame: Endline, 18-30 months post-intervention
Induction stove use: Daily electricity consumption of cooking events
Daily electricity consumption (kWh) associated with induction cookstove use, measured using built-in, cloud-connected data loggers that record energy use during cooking events among households that purchase an induction cookstove and consent to monitoring. Results will be summarized at the household and village level and stratified by household poverty status.
Time frame: Up to 30 months following stove purchase
Induction cookstove use: Number of daily cooking events
Number of daily cooking events measured using built-in, cloud-connected data loggers installed on induction cookstoves. Cooking events will be derived from time-stamped stove activity among households that purchase an induction cookstove and consent to monitoring. Results will be summarized at the household and village level and stratified by household poverty status.
Time frame: Up to 30 months following stove purchase
Induction cookstove use: Duration of daily cooking
Total duration of induction cookstove use per day, measured using built-in, cloud-connected data loggers based on time-stamped stove activity among households that purchase an induction cookstove and consent to monitoring. Results will be summarized at the household and village level and stratified by household poverty status.
Time frame: Up to 30 months following stove purchase
Clean stove stacking patterns: Proportion of monitored days with no biomass stove use
Stove stacking will be defined as the concurrent use of multiple cooking technologies within a household, including biomass (e.g., firewood and charcoal), liquefied petroleum gas (LPG), and induction stoves. Stove use will be measured using thermocouple-based temperature loggers (Geocene Dots) installed on non-induction stoves. These devices record stove temperatures continuously and transmit data via Bluetooth to mobile devices, which sync to a central server. The outcome will be calculated as the proportion of monitored days with no biomass stove use and summarized at the household and village level, with results stratified by household poverty status.
Time frame: Daily over a 1-week period, 6-8 weeks following stove purchase
Household air pollution: Personal exposure to fine particulate matter (PM2.5) and black carbon among primary cooks
Personal exposure to PM2.5 and black carbon will be measured among primary cooks using wearable personal exposure monitors (Ultrasonic Personal Aerosol Sampler) placed in the breathing zone of the primary cook for a continuous 24-hour period. Measurements will be collected among households that purchase an induction cookstove and a time-series matched subset of households that do not purchase. The outcome will be defined as 24-hour average PM2.5 (µg/m³) and black carbon concentrations and summarized at the household and village level, with results stratified by household poverty status.
Time frame: 24-hour measurement, 6-8 weeks following stove purchase
Maintenance (behavioral): Induction cookstove use trajectories
Induction cookstove use trajectories will be assessed as longitudinal patterns of use among households that purchase an induction cookstove (e.g., sustained, increasing, declining, or discontinued use), measured using built-in, cloud-connected stove data loggers, including frequency of use, duration of use, and electricity consumption. Results will be summarized across households and villages and stratified by household poverty status.
Time frame: Up to 30 months following stove purchase
Maintenance (behavioral): Determinants of sustained use and clean cooking behaviors
Determinants of sustained use, declining use, or discontinuation of induction stove use, as well as adoption and continued use of clean cooking technologies (e.g., LPG) and reliance on biomass fuels (e.g., firewood and charcoal), will be assessed using after-sales service and warranty records and structured household surveys. Measures will include household- and system-level factors such as stove functionality, repairs, service interactions, user-reported experiences, and contextual factors influencing adoption and use among both purchasing and non-purchasing households.
Time frame: Throughout implementation and summarized at endline, 18-30 months post-intervention
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