Table 1. FRESH AIR studies.

Study area of each objective	Research questions	Methods
Objective 1: prevalence, exposure and burden	• What is the expected and observed burden of chronic respiratory diseases and exposure to risk factors, including HAP and tobacco consumption in each of the four countries?	• Quantitative analysis of existing data
Objective 1: beliefs and perceptions of respiratory symptoms and their causes	• What beliefs, perceptions and behaviours are observed about respiratory symptoms and their causes?	• Participative workshops • Interviews
Objective 1: critical factors for implementation	• What are the critical factors for the successful implementation of evidence-based interventions to reduce HAP and tobacco smoke exposure?	• Systematic review of literature
Objective 2: action research on awareness raising	• What are the factors that influence awareness of, and attitude to, risks of HAP and tobacco among healthcare workers and the public? • How can communities be motivated to change their behaviour to reduce their exposure to smoke from HAP and tobacco?	• Development and testing of resources using Plan Do Study Act (PDSA) cycles25 • Training for healthcare workers • Household questionnaires • Patient questionnaires
Objective 2: reducing exposure to household air pollution	• What are the local barriers to accessing clean fuel? • What opportunities exist to improve access to clean fuels and how can these be maximised?	• Training for healthcare workers • Before and after awareness questionnaires • Monitoring 30 households on indoor pollution before and after intervention
Objective 3: very brief advice training for healthcare workers	• Who are the best placed healthcare workers to provide very brief advice in contexts where access to health care is limited? • What are the obstacles and facilitators for these healthcare workers in these contexts to provide very brief advice?	• Data collection through questionnaires • Mapping of service provision • Interviews with healthcare professionals • Interviews with patients
Objective 4: improving diagnostics for COPD	• What is the acceptability and feasibility of using the SpiroSmart smart phone spirometer in low-resource settings? • How can healthcare workers be supported to administer and interpret spirometry for improved diagnosis?	• Feasibility study • Data collection through questionnaires and/or focus groups about user experience • Pilot training with follow-up • Interviews with healthcare professionals
Objective 5: pulmonary rehabilitation feasibility study	• How can pulmonary rehabilitation (PR) programmes be set up in low-resource settings? • What are the community’s attitudes to exercise programmes and what socially acceptable and equitable opportunities are there to increase the exercise capacity of people at risk of chronic lung disease? • Are IT-based home PR methods applicable in remote settings?	• Feasibility study • Semi-structured interviews • Focus groups with practitioners, patients and other key stakeholders
Objective 6: midwife-led smoke reduction study	• Is a HAP and tobacco smoke reduction education programme delivered by midwives and village HC teams feasible and acceptable? • Does it reduce exposure to particulate matter and carbon monoxide? • Does it improve a range of health outcomes in pregnancy and infancy including respiratory outcomes at the age of 6 months?	• Pilot cluster randomised controlled trial
Objective 6: research on terms, concepts and treatment practices for childhood asthma	• What are the concepts and terms used by carers, healthcare providers and local experts (e.g., traditional healers) for long-term coughing, asthma/wheeze and ARI? • What are the treatment practices for management of long-term cough and ARI in children aged under 5 years in health centres and by local experts?	• Qualitative research, including interviews with parents, healthcare professionals and traditional healers
Objective 6: asthma and acute respiratory infection study	• What is the feasibility, acceptability and optimal organisation for the roll-out of the findings of a hospital-based intervention using asthma treatment for children presenting with ARI in primary care in rural settings to reduce infant mortality?	• PDSA cycles • Observation • Cost and logistics analysis of supply of medicines • Qualitative research with healthcare workers and carers
Objective 7: cost-effectiveness reviews	• Which interventions are most cost-effective in low-resource settings? • How many people in the population to be studied have COPD/asthma/the relevant condition? • How many people could benefit from the intervention? • What is the cost of providing this intervention for these people?	• Data analysis using STAR (socio-technical allocation of resources) approach26 • Facilitated workshops for stakeholders using STAR approach
Objective 7: capacity building in implementation science to key stakeholders	• What are the local obstacles and facilitators to translating evidence into practice including context, organisation, professional issues and availability of interventions?	• Participative workshops • Interviews with stakeholders