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Volume 23
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Article

Improving Health Outcomes in Women Who Use Traditional Open Fire Cookstoves by Addressing Cooking Behaviors: A Longitudinal Cohort Study

by
Amy C. Buckenmeyer
1,2,*,
Kevin L. Jantzi
3,
Deanna Marriott
2,
Jeri M. Antilla
2,
Vanesa Abad
1,
Emily Barnes
1,
Katelyn Blackmon
1,
Claire E. Burman
1,
Carly Crave
1,
Christina E. Roembke
1,
Tricia Stathakis
1,
Paige A. Takalamingan
1,
Madison M. Wood
1,
Eve Goddard
4 and
Beatrice Hunt
4
1
College of Nursing and Health Professions, Valparaiso University, Valparaiso, IN 46383, USA
2
School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA
3
College of Arts and Sciences, Valparaiso University, Valparaiso, IN 46383, USA
4
College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI 48109, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2026, 23(5), 647; https://doi.org/10.3390/ijerph23050647
Submission received: 20 March 2026 / Revised: 7 May 2026 / Accepted: 11 May 2026 / Published: 13 May 2026
Review Reports Versions Notes

Abstract

Approximately one-third of the global population cooks over open fires in the home, which are responsible for millions of deaths per year globally. The aim of this longitudinal cohort study was to develop, implement, and evaluate an intervention to improve the cooking behaviors of women in a rural Nicaraguan community. The study employed the Community Health Action Model for Participatory Behavior Change (CHAMP-BC) framework to develop a novel approach to improving cooking behaviors and reducing symptoms associated with household air pollution. The study was conducted from October 2007 to March 2018. Community health needs assessments and community forums were conducted. Readiness to change surveys were administered. Pre- and post-test cookstove implementation surveys were conducted. One hundred sixty-seven primary cooks, primarily women (99%), consented to participate in the improved cookstove program and were followed from baseline for up to seven years post-intervention. There were significant improvements in cough (p < 0.0001), chest illness (p < 0.0001), shortness of breath (p < 0.0001), headaches (p < 0.0001), and eye irritation (p < 0.0001). The novel CHAMP-BC framework enhanced the research approach by empowering women to change their cooking behaviors while providing them with the autonomy and agency necessary for decision-making regarding evidence-based methods to improve their health.
Keywords: air pollution; indoor; community-based participatory research; community health action model for participatory behavior change; global health; health behavior; rural health; transtheoretical model air pollution; indoor; community-based participatory research; community health action model for participatory behavior change; global health; health behavior; rural health; transtheoretical model

Share and Cite

MDPI and ACS Style

Buckenmeyer, A.C.; Jantzi, K.L.; Marriott, D.; Antilla, J.M.; Abad, V.; Barnes, E.; Blackmon, K.; Burman, C.E.; Crave, C.; Roembke, C.E.; et al. Improving Health Outcomes in Women Who Use Traditional Open Fire Cookstoves by Addressing Cooking Behaviors: A Longitudinal Cohort Study. Int. J. Environ. Res. Public Health 2026, 23, 647. https://doi.org/10.3390/ijerph23050647

AMA Style

Buckenmeyer AC, Jantzi KL, Marriott D, Antilla JM, Abad V, Barnes E, Blackmon K, Burman CE, Crave C, Roembke CE, et al. Improving Health Outcomes in Women Who Use Traditional Open Fire Cookstoves by Addressing Cooking Behaviors: A Longitudinal Cohort Study. International Journal of Environmental Research and Public Health. 2026; 23(5):647. https://doi.org/10.3390/ijerph23050647

Chicago/Turabian Style

Buckenmeyer, Amy C., Kevin L. Jantzi, Deanna Marriott, Jeri M. Antilla, Vanesa Abad, Emily Barnes, Katelyn Blackmon, Claire E. Burman, Carly Crave, Christina E. Roembke, and et al. 2026. "Improving Health Outcomes in Women Who Use Traditional Open Fire Cookstoves by Addressing Cooking Behaviors: A Longitudinal Cohort Study" International Journal of Environmental Research and Public Health 23, no. 5: 647. https://doi.org/10.3390/ijerph23050647

APA Style

Buckenmeyer, A. C., Jantzi, K. L., Marriott, D., Antilla, J. M., Abad, V., Barnes, E., Blackmon, K., Burman, C. E., Crave, C., Roembke, C. E., Stathakis, T., Takalamingan, P. A., Wood, M. M., Goddard, E., & Hunt, B. (2026). Improving Health Outcomes in Women Who Use Traditional Open Fire Cookstoves by Addressing Cooking Behaviors: A Longitudinal Cohort Study. International Journal of Environmental Research and Public Health, 23(5), 647. https://doi.org/10.3390/ijerph23050647

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