Fresh Air


About 80 million people suffer from COPD globally and a further 300 million are affected by asthma. Previous research has shown that the greatest burden of non-communicable lung diseases (NCLDs) occurs in low resource settings. Most studies have, however, focused on creating an evidence-base for cost-effective treatments of NCLDs in high resource settings. Consequential, little is known about the application of this evidence-base to low-resource settings, contextual risk-factors and barriers that hamper implementation.


FRESH AIR is a 3-year project that addresses the urgent need to prevent, diagnose and treat lung diseases in four low-resource settings, namely Uganda, Kyrgyzstan, Vietnam and Greece. The overall aim is to improve health outcomes by developing capacity for implementation of evidence-based interventions in these contexts. The project has seven specific objectives:

  1. To identify factors that influence the implementation of evidenced-based interventions in the prevention and treatment of non-communicable lung diseases in these settings.
  2. To explore which awareness-raising approaches are most effective in motivating behaviour change in tobacco consumption and HAP exposure and to evaluate the feasibility, acceptability and effectiveness of HAP reduction interventions.
  3. To provide access to smoking cessation support by adapting very brief advice (VBA).
  4. To test the feasibility and acceptability of methods for diagnosing COPD using innovative spirometry.
  5. To test the feasibility and acceptability of pulmonary rehabilitation (PR) as a low-cost treatment for obstructive lung disease.
  6. To test how to best reduce children’s respiratory symptoms and the risk of lung damage by exploring the feasibility, acceptability and optimal organisation of interventions designed to raise awareness of the damaging effects of exposure to tobacco smoke and HAP during pregnancy and infancy, and to improve diagnosis and treatment of children aged under 5 years presenting to primary care with respiratory symptoms.
  7. To generate new knowledge, innovation and scalable models that ensure equitable access and to support their implementation through proactive dissemination.


The studies will use a range of implementation science methodologies to adapt and test innovative ways to implement the evidence. They will explore implementation science research questions, including what works, for whom and under what contextual circumstances and how to ensure scalability of effective interventions in ways that are accessible and equitable in low-resource settings.


Prof. Dr. N.H. Chavannes, project leider
Dr. R.M.J.J. van der Kleij, project manager
Drs. E.A. Brakema, ph-onderzoeker van onderdeel 'work package 3'


N.H. Chavannes:


The European Commission

the Global Alliance for Communicable Diseases through Horizon 2020.

The International Primary Care Respiratory Group provided funding for the development of the project proposal.