Applied Implementation Research for Clean Cooking in Cambodia (AIR-C3)

Emory University

Status: Enrolling

Conditions: Exposure to Household Air Pollution; Exposure to Environmental Pollution

Treatments: Other: Electric Induction Cookstoves

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT06942715

STUDY00007929

1R01ES035395-01A1 (U.S. NIH Grant/Contract)

2025P013174 (Other Identifier)

Details and patient eligibility

About

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

Full description

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.

Enrollment: 6,150 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

- A household must:

• Provide consent to participate in our study, with at least one adult household member who identifies as the primary cook consenting to serve as the study participant
• Resides in village selected for implementation
• Household has electricity access
• Household does not already use electricity-based induction cooking technology

Exclusion criteria

-Plans to move permanently outside the study area in the next 12 months

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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6,150 participants in 5 patient groups

Community-based demand generation only

Experimental group

Description:

The implementation strategy consists of community-based demand generation and behavior change communication activities, including village meetings, cooking and stove demonstrations, and locally appropriate communication materials designed to build awareness, trust, and confidence in induction cooking

Treatment:

Other: Electric Induction Cookstoves

Community-based demand generation + direct sales

Experimental group

Description:

The implementation strategy encompasses community-based demand generation and behavior change communication, complemented by personalized direct sales engagement. Trained sales agents conduct door-to-door and small-group visits, provide tailored sales pitches and demonstrations, respond to questions, and facilitate stove purchases.

Treatment:

Other: Electric Induction Cookstoves

Community-based demand generation + subsidies

Experimental group

Description:

The implementation strategy includes community-based demand generation and behavior change communication, paired with financial support through stove subsidies. Subsidies include a lower-value subsidy available to early non-poor purchasers and a higher-value subsidy targeted to households classified as poor or at-risk.

Treatment:

Other: Electric Induction Cookstoves

Community-based demand generation + direct sales + subsidies

Experimental group

Description:

The implementation strategy includes community-based demand generation and behavior change communication, personalized direct sales engagement, and financial support through stove subsidies. Sales agents provide household-level engagement and facilitate purchases, while subsidies improve affordability through both lower-value and targeted higher-value support.

Treatment:

Other: Electric Induction Cookstoves

Control villages

No Intervention group

Description:

Control Villages assigned to the control arm will receive no study intervention during the trial period.