Currently submitted to: JMIR Research Protocols
Date Submitted: Nov 11, 2026
Open Peer Review Period: Nov 12, 2026 - Jan 7, 2027
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Evaluating Community and Household Assistance for Reducing Plastic Waste Burning with Enhanced Waste Management (CARE) in Malang, Indonesia: Research Protocol
ABSTRACT
Background:
Open burning of plastic waste has been established a major contributor of non-communicable disease (NCD) burden and environmental degradation. In Malang and Banyuwangi, Indonesia, the issue has led the PM2.5 levels exceed safety guidelines and in one tofu factory in Malang where plastic waste burned as fuel, dioxin levels in eggs were recorded as the second-highest in Asia.
Objective:
This study aims to evaluate the effectiveness of Community and household Assistance for reducing plastic waste burning with Enhanced waste management (CARE) intervention in Malang, Indonesia.
Methods:
A controlled quasi-experimental study with mixed-methods approach will be conducted in six intervention villages in Malang and six control villages in Banyuwangi to evaluate the effectiveness of the CARE intervention. A minimum of 1374 households will be recuited and involved in the three components of the intervention: regulatory, infrastructural and behavioural measures. Difference-in-differenc (DiD) methods will be used to analyse the quantitave outcomes, while cost-consequence analysis (CCA will be used to evaluate economic aspects and thematic analysis will be used to assess qualitative outcomes.
Results:
A pilot assessment of air quality has been conducted in two intervention villages and the result indicated the sensor’s sensitivity in capturing relevant exposure variations in the village area. A total of 60 kader lingkungan have been recruited and will proceed to the training phase.
Conclusions:
The CARE study is expected to generate critical evidence on the effectiveness, feasibility and sustainability of community-led initiative to reduce open plastic waste burning and related NCD risks in Indonesia and broader LMIC contexts. Clinical Trial: ISRCTN14580292 (https://doi.org/10.1186/ISRCTN14580292)
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