Firstly, could you describe the settings in which you are trying out the different FRESH AIR interventions in Greece?

In Greece, FRESH AIR interventions are being implemented in rural areas in the county of Heraklion, Crete. Selected activities have involved participants from rural areas of the county of Rethymnon, the city of Heraklion and the hard-to-reach population of a Roma camp in the county of Heraklion.

What are the main challenges faced by the communities you are working with?

Greece has one of the highest rates of tobacco consumption in the European Union. There is also evidence that exposure to household air pollution has gone up recently due to an increase in wood-burning, mainly for heating, as a consequence of the ongoing financial crisis. The economic recession has also affected access to healthcare, as well as the quality of healthcare services available. At the same time, rural and remote populations seem to experience greater exposure to known risk factors and higher burden of chronic lung diseases.

Could you give an overview of the different activities you have been carrying out in Crete so far?

Several FRESH AIR activities have been performed in Crete:

    • Literature reviews and surveys have been performed in order to assess the impact of chronic lung diseases in Greece (WP2).
    • Qualitative and quantitative data collections have taken place in order to understand the beliefs, perceptions and behaviours of primary healthcare professionals and the public with regards to chronic lung diseases (WP3).
    • Online training in spirometry and educational activities on delivering the very brief advice on have been offered to selected GPs (WPs 5.1 and 5.2).
    • A community-based pulmonary rehabilitation centre has been established and assessed for the first time in a rural primary health care setting (WP5.3).
    • Information has been gathered through qualitative and quantitative research regarding the terms, concepts and diagnostic practices around childhood cough and asthma/wheeze (WP6).
    • We are at the onset of an awareness-raising intervention regarding the damaging effects of smoke, as well as a quantitative measurement of the levels of household air pollution in selected rural areas (WP4). 

What have been the biggest hurdles for FRESH AIR in Greece?

One of the major problems we have encountered during field work is the distance to the selected settings, as well as the limitations in local resources. This has been minimised by involving local primary healthcare professionals in data collection activities, and through careful planning of the budget. The involvement of local GPs in introducing the objectives of the project and the research team also facilitated the process of data collection.

 

How have you engaged patients in the project?

Since there are no patient organisations for chronic lung diseases in Crete, patients who have participated in the project have been engaged through their general practitioner. Participants tend to be around 65-70 years old and living in a rural area of Crete. They typically have received a low level of education, and are of a lower socioeconomic status, with a small income from an agricultural pension. In addition to their lung condition, they tend to have other chronic health issues, and many are still actively involved in agricultural, farming or household activities. Male patients are usually smokers or ex-smokers, while this is rarer for women.

To what extent will you be engaging with national policy makers about FRESH AIR?

Engaging with national policymakers and stakeholders about FRESH AIR is a priority, as this will ensure that the knowledge, innovative approaches and benefits of the project are sustained. We have already approached several policymakers and stakeholders, and there are plans for more activities, using the five steps for stakeholders’ engagement and participatory learning and action (PLA) methodologies. Incorporating the project’s results to existing educational, scientific and clinical practice frameworks is a major goal, and targeted actions will facilitate this.