scholarly journals Effect of complementary feeding behavior change communication delivered through community-level actors on the time of initiation of complementary foods in rural communities of West Gojjam zone, Northwest Ethiopia: a cluster-randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chalachew Abiyu ◽  
Tefera Belachew
Keyword(s):  
Behavior Change ◽  
Feeding Behavior ◽  
Complementary Feeding ◽  
Intervention Group ◽  
Complementary Food ◽  
Control Group ◽  
Complementary Foods ◽  
Behavior Change Communication ◽  
Link Type ◽  
Change Communication

Abstract Background Attaining the recommended level of complementary feeding practices remains a serious challenge in many developing countries. Complementary foods are usually untimely initiated, which has adverse consequences on the growth, development, and survival of infants. The focus of most studies conducted worldwide seemed to be on the effect of behavior change interventions on the adequacy of complementary diets; but not on the timing of initiations. Moreover, many of the interventions targeted only mothers/caregivers of infants, and studies that engaged the family members are scarce. This study aimed to evaluate the effectiveness of complementary feeding behavior change communication delivered through women development army leaderson the time of initiation of complementary foods. Methods We conducted a cluster-randomized controlled trial in rural communities of West Gojjam Zone, Northwest Ethiopia from February 2017 to March 2018. A total of 16 geographic clusters were selected. Trial participants in the intervention group received complementary feeding behavior change intervention for 9 months whereas those in the control group received only the usual health care. Trained women development army leaders delivered the intervention. A pre-tested, structured interviewer-administered questionnaire was used for data collection. Generalized estimated equation (GEE) regression and survival analyses were used to test differences in time of initiation of complementary food between the study groups. Results The intervention significantly improved the likelihood of timely initiation of complementary food by 22 percentage points [RR: 2.6; 95% CI: 1.78–5.86], and reduced the risk of late initiations by 19 percentage points [RR: 2.8; 95% CI: 1.83–4.37]. The complementary food initiation survival curve for the control group after 6 months was constantly above the curve than for the intervention group. The median age at the introduction of complementary food for infants was 6 months in the intervention group, and 6.7 months in the control group and the difference was statistically significant (P-value < 0.001). Conclusions Complementary feeding behavior change communication improved the rate of timely initiation of complementary foods and reduced the risk of late initiations. Trial registration ClinicalTrials.gov, NCT03488680. Registered 5 April 2018-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03488680.

scholarly journals Effectiveness of Specialized Nutritious Foods and Social and Behavior Change Communication Interventions to Prevent Stunting among Children in Badakhshan, Afghanistan: Protocol for a Quasi-Experimental Study

2021 ◽  
Vol 4 (3) ◽  
pp. 55
Author(s):  
Sajid Bashir Soofi ◽  
Gul Nawaz Khan ◽  
Shabina Ariff ◽  
Arjumand Rizvi ◽  
Mohammad Asif Hussainyar ◽  
...  
Keyword(s):  
Behavior Change ◽  
Quantitative Methods ◽  
Intervention Group ◽  
Formative Research ◽  
Control Group ◽  
Behavior Change Communication ◽  
Change Communication ◽  
Low Middle Income Countries ◽  
Quasi Experimental ◽  
And Behavior

Stunting predominantly occurs during the first 1000 days of life and continues to the age of five years. We will aim to assess the effectiveness of specialized nutritious foods (SNF)and social and behavior change communication (SBCC) strategies during the first 1000 days of life to prevent stunting among children in two rural districts of Badakhshan, Afghanistan. This will be a quasi-experimental pre-post study with the control group utilizing qualitative and quantitative methods. Before launching the program, formative research will be conducted on the acceptability, appropriate use and SBCC strategies needed to support the introduction of intervention package. Repeated cross-sectional baseline and endline surveys will be conducted in both the intervention and the control districts. After the formative research and baseline household survey, an intervention focusing on the provision of SNF, targeting pregnant and lactating women and children 6–23 months, and SBCC strategies will be implemented for at least 12 months. The primary outcome will be a reduction in the prevalence of stunting among children under two years in the intervention group compared to the control group. We will aim to compare the intervention and control group between the pre- and post-intervention assessments to isolate the effect of the intervention by difference-in-differences estimates. The program monitoring and evaluation component will examine the quality of implementation, acceptability of intervention, identification of potential barriers and to learn how to enhance the program’s effectiveness through ongoing operational improvements. The results will be beneficial to design interventions to prevent stunting within Afghanistan and other low–middle-income countries.

scholarly journals Transfers, Behavior Change Communication, and Intimate Partner Violence: Postprogram Evidence from Rural Bangladesh

2019 ◽  
Vol 101 (5) ◽  
pp. 865-877 ◽  
Author(s):  
Shalini Roy ◽  
Melissa Hidrobo ◽  
John Hoddinott ◽  
Akhter Ahmed
Keyword(s):  
Intimate Partner Violence ◽  
Behavior Change ◽  
Partner Violence ◽  
Physical Violence ◽  
Well Being ◽  
Intimate Partner ◽  
Control Group ◽  
Behavior Change Communication ◽  
Change Communication ◽  
Nutrition Behavior

Transfer programs have been shown to reduce intimate partner violence (IPV), but little evidence exists on how activities linked to transfers affect IPV or what happens when programs end. We assess postprogram impacts on IPV of randomly assigning women in Bangladesh to receive cash or food, with or without nutrition behavior change communication (BCC). Six to ten months postprogram, IPV did not differ between women receiving transfers and a control group; however, women receiving transfers with BCC experienced 26% less physical violence. Evidence on mechanisms suggests sustained effects of BCC on women's “threat points,” men's social costs of violence, and household well-being.

scholarly journals Social and Behavior Change Communication Interventions Delivered Face-to-Face and by a Mobile Phone to Strengthen Vaccination Uptake and Improve Child Health in Rural India: Randomized Pilot Study (Preprint)

2020 ◽  
Author(s):  
Mira Johri ◽  
Dinesh Chandra ◽  
Karna Georges Kone ◽  
Marie-Pierre Sylvestre ◽  
Alok K Mathur ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Child Health ◽  
Behavior Change ◽  
Mobile Phone ◽  
Control Group ◽  
Behavior Change Communication ◽  
Face To Face ◽  
Change Communication ◽  
Intermediate Outcomes ◽  
And Behavior

BACKGROUND In resource-poor settings, lack of awareness and low demand for services constitute important barriers to expanding the coverage of effective interventions. In India, childhood immunization is a priority health strategy with suboptimal uptake. OBJECTIVE To assess study feasibility and key implementation outcomes for the Tika Vaani model, a new approach to educate and empower beneficiaries to improve immunization and child health. METHODS A cluster-randomized pilot trial with a 1:1 allocation ratio was conducted in rural Uttar Pradesh, India, from January to September 2018. Villages were randomly assigned to either the intervention or control group. In each participating village, surveyors conducted a complete enumeration to identify eligible households and requested participation before randomization. Interventions were designed through formative research using a social marketing approach and delivered over 3 months using strategies adapted to disadvantaged populations: (1) mobile health (mHealth): entertaining educational audio capsules (edutainment) and voice immunization reminders via mobile phone and (2) face-to-face: community mobilization activities, including 3 small group meetings offered to each participant. The control group received usual services. The main outcomes were prespecified criteria for feasibility of the main study (recruitment, randomization, retention, contamination, and adoption). Secondary endpoints tested equity of coverage and changes in intermediate outcomes. Statistical methods included descriptive statistics to assess feasibility, penalized logistic regression and ordered logistic regression to assess coverage, and generalized estimating equation models to assess changes in intermediate outcomes. RESULTS All villages consented to participate. Gaps in administrative data hampered recruitment; 14.0% (79/565) of recorded households were nonresident. Only 1.4% (8/565) of households did not consent. A total of 387 households (184 intervention and 203 control) with children aged 0 to 12 months in 26 villages (13 intervention and 13 control) were included and randomized. The end line survey occurred during the flood season; 17.6% (68/387) of the households were absent. Contamination was less than 1%. Participation in one or more interventions was 94.0% (173/184), 78.3% (144/184) for the face-to-face strategy, and 67.4% (124/184) for the mHealth strategy. Determinants including place of residence, mobile phone access, education, and female empowerment shaped intervention use; factors operated differently for face-to-face and mHealth strategies. For 11 of 13 intermediate outcomes, regression results showed significantly higher basic health knowledge among the intervention group, supporting hypothesized causal mechanisms. CONCLUSIONS A future trial of a new intervention model is feasible. The interventions could strengthen the delivery of immunization and universal primary health care. Social and behavior change communication via mobile phones proved viable and contributed to standardization and scalability. Face-to-face interactions remain necessary to achieve equity and reach, suggesting the need for ongoing health system strengthening to accompany the introduction of communication technologies. CLINICALTRIAL International Standard Randomized Controlled Trial Number (ISRCTN) 44840759; https://doi.org/10.1186/ISRCTN44840759

scholarly journals Social and Behavior Change Communication Interventions Delivered Face-to-Face and by a Mobile Phone to Strengthen Vaccination Uptake and Improve Child Health in Rural India: Randomized Pilot Study

10.2196/20356 ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. e20356 ◽  
Author(s):  
Mira Johri ◽  
Dinesh Chandra ◽  
Karna Georges Kone ◽  
Marie-Pierre Sylvestre ◽  
Alok K Mathur ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Child Health ◽  
Behavior Change ◽  
Mobile Phone ◽  
Control Group ◽  
Behavior Change Communication ◽  
Face To Face ◽  
Change Communication ◽  
Intermediate Outcomes ◽  
And Behavior

Background In resource-poor settings, lack of awareness and low demand for services constitute important barriers to expanding the coverage of effective interventions. In India, childhood immunization is a priority health strategy with suboptimal uptake. Objective To assess study feasibility and key implementation outcomes for the Tika Vaani model, a new approach to educate and empower beneficiaries to improve immunization and child health. Methods A cluster-randomized pilot trial with a 1:1 allocation ratio was conducted in rural Uttar Pradesh, India, from January to September 2018. Villages were randomly assigned to either the intervention or control group. In each participating village, surveyors conducted a complete enumeration to identify eligible households and requested participation before randomization. Interventions were designed through formative research using a social marketing approach and delivered over 3 months using strategies adapted to disadvantaged populations: (1) mobile health (mHealth): entertaining educational audio capsules (edutainment) and voice immunization reminders via mobile phone and (2) face-to-face: community mobilization activities, including 3 small group meetings offered to each participant. The control group received usual services. The main outcomes were prespecified criteria for feasibility of the main study (recruitment, randomization, retention, contamination, and adoption). Secondary endpoints tested equity of coverage and changes in intermediate outcomes. Statistical methods included descriptive statistics to assess feasibility, penalized logistic regression and ordered logistic regression to assess coverage, and generalized estimating equation models to assess changes in intermediate outcomes. Results All villages consented to participate. Gaps in administrative data hampered recruitment; 14.0% (79/565) of recorded households were nonresident. Only 1.4% (8/565) of households did not consent. A total of 387 households (184 intervention and 203 control) with children aged 0 to 12 months in 26 villages (13 intervention and 13 control) were included and randomized. The end line survey occurred during the flood season; 17.6% (68/387) of the households were absent. Contamination was less than 1%. Participation in one or more interventions was 94.0% (173/184), 78.3% (144/184) for the face-to-face strategy, and 67.4% (124/184) for the mHealth strategy. Determinants including place of residence, mobile phone access, education, and female empowerment shaped intervention use; factors operated differently for face-to-face and mHealth strategies. For 11 of 13 intermediate outcomes, regression results showed significantly higher basic health knowledge among the intervention group, supporting hypothesized causal mechanisms. Conclusions A future trial of a new intervention model is feasible. The interventions could strengthen the delivery of immunization and universal primary health care. Social and behavior change communication via mobile phones proved viable and contributed to standardization and scalability. Face-to-face interactions remain necessary to achieve equity and reach, suggesting the need for ongoing health system strengthening to accompany the introduction of communication technologies. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN) 44840759; https://doi.org/10.1186/ISRCTN44840759

scholarly journals Peran modul MP-ASI dalam perilaku pemberian MP-ASI pada ibu anak bawah dua tahun (BADUTA)

2016 ◽  
Vol 5 (1) ◽  
pp. 26-33
Author(s):  
Sri Hapsari SP ◽  
Ani Margawati ◽  
SA. Nugraheni
Keyword(s):  
Feeding Behavior ◽  
Nutrition Education ◽  
Complementary Feeding ◽  
Intervention Group ◽  
Control Group ◽  
Control Group Design ◽  
Post Test ◽  
Quasi Experimental ◽  
Better Than ◽  
Test Control

Background  :  Lack  of  complementary feeding behavior is one of the problems in Indonesia. Nutrition education about complementary feeding among mother from infants aged 6-24 months should be carried out to support compelementary feeding behavior. Module with an easily language punctuated by images and can be learned at home is expected to incerase complementary feeding behavior among mothers from child under two years old.Method : The design of this research was quasi-experimental with non-randomized pre-test and post-test  control  group  design. Training of complementary feedings module were given for four meetings. The annalyze were conducted by SPSS program.  Result  : This study found that the median age of subjects between two group are adults. The median duration of education are 9 years. There was no difference of Financial families outcome in the both of groups is low. Nutrition education with module can increase complementary feeding behavior at intervention group  and the improvement of this scores better than control group. Complementary feeding behavior retention increased significant  among 2 weeks and 1 month after intervention.Conclusion : Nutrition education with module contribute to improve complementary feeding behavior among mothers from child under two years old.

scholarly journals Effectiveness of Behaviour Change Communication for Mothers on Complementary Feeding Practices and Infants’ Nutritional Status in Nigeria

2021 ◽  
pp. 83-97
Author(s):  
Kolade Afolayan Afolabi ◽  
Adebukunola Olajumoke Afolabi
Keyword(s):  
Early Childhood ◽  
Nutritional Status ◽  
Behaviour Change ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Feeding Practices ◽  
Control Group ◽  
Behaviour Change Communication ◽  
Change Communication

Introduction: The quality of feeding in early childhood depends on nutritional knowledge of mothers. Improving maternal nutrition knowledge is therefore pivotal towards promoting effective infants’ feeding behaviour. Objective: Study assessed mothers’ knowledge about complementary feeding and complementary feeding practices. Study also assessed effectiveness of Behaviour Change Communication on mothers’ knowledge and complementary feeding practices, compared the nutritional status of infants whose mothers received intervention to infants of mothers in the control group. Materials and Methods: A quasi-experimental study conducted among 204 mothers in rural and urban local government areas, South-west Nigeria between March and September, 2019. Sample size was estimated using formula for comparison of two proportions, eligible mothers were selected through multistage sampling technique. Study was conducted in three phases: pre-intervention phase, intervention and post intervention phases. Intervention: Selected mothers were randomly assigned into intervention and control groups. Mothers in the intervention group received Behavior Change Communication on complementary feeding and were followed up for six months. Data Analysis: Data was analyzed using SPSS software version 25, Chi-square and repeated analysis of variance evaluated effectiveness of intervention, level of significance was < 0.05. Results: BCC improved mothers’ knowledge about complementary feeding by 31.9% (χ2 = 21.62; p = 0.001), meal frequency by 16% (χ2 = 5.88, p = 0.01), dietary diversity by 19.6% (χ2 = 7.44, p = 0.01), minimum acceptable diet by 20.6% (χ2 = 13.09; p =0.01). Intervention also reduced under-weight by 14% (χ2 = 0.69, p = 0.01; (F(1,191) =275.34; p = 0.04) among intervention group. Conclusion: Effective nutritional intervention for mothers towards improving nutritional status of children should incorporate appropriate behaviour change approach. This approach is capable of improving nutritional status of infants and children and consequently reduce malnutrition and related complications in early childhood.

scholarly journals Systematic review of cost-effectiveness analysis of behavior change communication apps: Assessment of key methods

2021 ◽  
Vol 7 ◽  
pp. 205520762110005
Author(s):  
Cynthia Afedi Hazel ◽  
Sheana Bull ◽  
Elizabeth Greenwell ◽  
Maya Bunik ◽  
Jini Puma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Behavior Change ◽  
Quantitative Measure ◽  
Cost Effectiveness Analysis ◽  
Behavior Change Communication ◽  
Change Communication ◽  
Effectiveness Analysis ◽  
Life Years ◽  
The Cost

Objective Evidence backing the effectiveness of mobile health technology is growing, and behavior change communication applications (apps) are fast becoming a useful platform for behavioral health programs. However, data to support the cost-effectiveness of these interventions are limited. Suggestions for overcoming the low output of economic data include addressing the methodological challenges for conducting cost-effectiveness analysis of behavior change app programs. This study is a systematic review of cost-effectiveness analyses of behavior change communication apps and a documentation of the reported challenges for investigating their cost-effectiveness. Materials and methods Four academic databases: Medline (Ovid), CINAHL, EMBASE and Google Scholar, were searched. Eligibility criteria included original articles that use a cost-effectiveness evaluation method, published between 2008 and 2018, and in the English language. Results Out of the 60 potentially eligible studies, 6 used cost-effectiveness analysis method and met the inclusion criteria. Conclusion The evidence to support the cost-effectiveness of behavior change communication apps is insufficient, with all studies reporting significant study challenges for estimating program costs and outcomes. The main challenges included limited or lack of cost data, inappropriate cost measures, difficulty with identifying and quantifying app effectiveness, representing app effects as Quality-adjusted Life Years, and aggregating cost and effects into a single quantitative measure like Incremental Cost Effectiveness Ratio. These challenges highlight the need for comprehensive economic evaluation methods that balance app data quality issues with practical concerns. This would likely improve the usefulness of cost-effectiveness data for decisions on adoption, implementation, scalability, sustainability, and the benefits of broader healthcare investments.

scholarly journals Scaled-Up Nutrition Education on Pulse-Cereal Complementary Food Practice in Ethiopia: A Cluster-Randomized Trial

2020 ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demelash Mulualem ◽  
Carol J. Henry
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Weight Status ◽  
Dietary Diversity ◽  
Randomized Study ◽  
Intervention Group ◽  
Complementary Food ◽  
Southern Ethiopia ◽  
Control Group ◽  
Cluster Randomized

Abstract Background Improving children's weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to evaluate the effectiveness of a 9-month pulse-nutrition education program on mothers' knowledge, attitude, and practices (KAP) towards pulses, as well as its impact on children's dietary diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midline, and endline. Results At baseline and endline, maternal KAP and the dietary diversity score of the children (mean age at endline 18.8 ± 2.9 mo) were assessed. Results : Intervention mothers’ KAP improved ( p <0.001) at midline and endline compared to that of the control group, as did frequency of pulse consumption and DDS among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group ( p =0.001). Conclusions NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for CF may be an effective way to improve the health of children in Ethiopian communities.

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