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The FRESH AIR project in Greece is being implemented by a multidisciplinary research team from the Clinic of Social and Family Medicine within the University of Crete. The project is focused on primary health care (PHC) settings, and targets rural and deprived populations. At present, several research tasks are ongoing and significant progress has already been achieved.

A pulmonary rehabilitation programme was established for the first time in a rural PHC Centre in Crete. Three groups of patients with chronic respiratory diseases (CRD) participated in the programme, supervised by one general practitioner (GP), two physiotherapists and a nurse. The programme was warmly embraced by both patients and stakeholders, and may be a feasible and effective approach against CRDs in Cretan PHC settings.

Qualitative research on beliefs, perceptions and behaviours towards CRDs was performed in several rural settings, as well as in a Roma community. Preliminary data from healthcare professionals, community members and key informants has shed light into aspects of awareness, health needs and barriers to healthcare. To supplement these data, quantitative surveys are currently being conducted in randomly-selected villages and with GPs.

A ‘teach-the-teacher’ module will also be implemented in certain rural settings. GPs will be trained to teach other healthcare professionals who will teach community members on the harmful effects of smoking and household air pollution (HAP), likely to be caused by wood burning for heating. Educational materials are currently being adapted to this context.

Initial observations from rural settings emphasise the impact of the financial crisis on HAP. Although awareness may be relatively high and households may already be equipped with modern heating devices, they may not be able to afford to use them. The FRESH AIR team is also conducting observations of clinical consultations in selected PHC centres and one hospital setting, with the aim of exploring diagnostic approaches and treatment of acute respiratory illness in children under 5 years old with cough and/or difficulty breathing. Qualitative interviews with healthcare professionals, caregivers and local experts are being performed to investigate terms and concepts of childhood cough and asthma. More than half of both the quantitative and the qualitative work has been completed.

In order to explore the health economic impact of CRDs in Greece, an extensive set of secondary data has been identified. Additionally, 100 ‘Work Productivity and Impairment’ questionnaires of consecutive patients visiting selected GPs have been collected. The health economics workshop will be held in April 2017.

Several GPs have completed online training in spirometry. Participating GPs will now be able to use a modern diagnostic spirometer, which will allow them to receive feedback on each spirometry performed. GPs will also be able to attend a session on ‘Very Brief Advice on Smoking Cessation’ in May 2017.

The FRESH AIR Team in Greece has presented the project to several stakeholders nationally and in international conferences and meetings. Detailed information and results of FRESH AIR actions in Greece will be featured in future scientific papers.

Fresh air newsletter May 2017