The impact and implementation of a mobile messaging intervention to improve infant and young child nutrition in Senegal

移动消息干预对改善塞内加尔婴幼儿营养的影响和实施

• 批准号: 10465021
• 负责人: Shauna Downs
• 金额: $ 16.94万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-10 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10465021
• 关键词: 2 year old; Accounting; Address; Affect; Age-Months; Anemia; Area; Behavior; Breast Feeding; Car Phone; Caregivers; Cessation of life; Child; Child Nutrition; Communication; Communities; Community Health Aides; Complementary Feeding; Conceptions; Consumption; Control Groups; Counseling; Data; Diet; Economics; Effectiveness; Ensure; Evaluation; Fathers; Food; Geography; Goals; Growth; Growth and Development function; Health Priorities; Hemoglobin; High Prevalence; Hour; Household; Impact evaluation; Infant; Infant Health; Intervention; Interview; Knowledge; Lead; Malnutrition; Measurement; Methods; Morbidity - disease rate; Mothers; Outcome; Penetration; Planning Theory; Prevalence; Process; Productivity; Randomized Controlled Trials; Recommendation; Research; Research Design; Risk Factors; Role; Rural Population; Senegal; Structure; Surveys; Text Messaging; Time; Triad Acrylic Resin; Voice; Vulnerable Populations; Work; age group; aged; base; behavior change; cognitive development; cost; design; deviant; dietary; disability; economic evaluation; effective intervention; effectiveness implementation study; evidence base; experimental group; feeding; gaps in access; hybrid type 1 study; implementation cost; implementation evaluation; implementation intervention; implementation process; improved; intervention cost; intervention delivery; literacy; mHealth; micronutrient deficiency; mobile computing; mortality; nutrition; obesity risk; post intervention; prevent; process evaluation; role model; scale up; treatment as usual; uptake

Abstract Suboptimal infant and young child feeding (IYCF) practices in the first 1000 days, from the time a child is conceived until the time they are two years of age, is contributing to high rates of malnutrition in Senegal. Only 7% of Senegalese children are fed according to global IYCF recommendations from 6-23 months of age, the peak period for growth faltering and micronutrient deficiencies in children. Improving IYCF practices in this age group will promote healthy growth and development and help to address the burden of malnutrition. Community Health Workers (CHWs) are often tasked with delivering IYCF counseling to mothers in Senegal. However, their reach is limited due to time and geographical constraints as well as competing health priorities. Identifying feasible, effective, and scale-able IYCF interventions, using alternative delivery platforms, is critical to improve IYCF practices. Mobile health (mHealth) interventions show promise for improving delivery gaps for IYCF practices in Senegal, given the widespread mobile phone penetration. However, mHealth interventions that address IYCF have not yet been scaled-up in Senegal. In our prior work in Senegal, we conducted formative research to design and pilot a user-centered mHealth IYCF voice messaging intervention based on the theory of planned behavior. The mHealth intervention, which was delivered to both mothers and fathers of children aged 6-23 months, showed a 19.2% increase in the consumption of a minimum acceptable diet (MAD), an indicator of dietary diversity. However, a more rigorous evaluation of its impact is needed. Thus, the overall objective of this project is to conduct an effectiveness-implementation hybrid design study (type 1) to examine the impact, implementation, and costs of a mHealth IYCF messaging intervention that builds on our previous work. First, we will conduct a cluster-randomized control trial with 510 mother, father and child triads in 102 villages in Senegal to determine the impact of the intervention on IYCF practices and nutrition outcomes (Aim 1). The experimental group will receive voice and text messages for a period of 16 weeks. Messages will include both scripted messages of key target IYCF practices as well as unscripted messages from community role models (i.e., “positive deviants”). We will determine anemia prevalence and MAD in children before and after the intervention implementation. We will also examine the implementation, costs and opportunities for scaling-up the mHealth IYCF messaging intervention (Aim 2) by conducting a process evaluation, using mixed- methods, and an economic analysis. Given constraints faced by CHWs, providing rigorous evidence about alternative delivery platforms that are effective, feasible and affordable has the potential to improve the reach and uptake of recommended IYCF practices, breaking the cycle of malnutrition. Without context-specific effective IYCF interventions, malnutrition will continue to be the main driver of death and disability in Senegal.

摘要 在婴儿出生后的前1000天内， 在塞内加尔，婴儿在两岁之前就怀孕，这是造成营养不良率高的原因。只 7%的塞内加尔6-23个月的儿童根据国际儿童年国际合作框架的建议得到喂养， 儿童生长迟缓和微量营养素缺乏的高峰期。在这个时代改进IYCF做法 该小组将促进健康的生长和发展，并帮助解决营养不良的负担。 在塞内加尔，社区卫生工作者经常负责向母亲提供国际家庭年咨询。 然而，由于时间和地理限制以及相互竞争的卫生优先事项，它们的覆盖面有限。 确定可行的、有效的和可扩展的国际森林年干预措施，使用替代的交付平台， 改进IYCF实践。移动的健康干预措施显示出改善以下方面的交付差距的希望： 鉴于移动的电话普及率很高，塞内加尔的国际森林年做法。然而，移动健康干预措施 但在塞内加尔尚未扩大这一合作。在我们之前在塞内加尔的工作中， 形成性研究，设计和试点以用户为中心的mHealth IYCF语音消息干预， 计划行为理论移动健康干预措施，这是交付给母亲和父亲， 6-23个月的儿童，最低可接受饮食的消费量增加了19.2%， (MAD)是饮食多样性的一个指标。然而，需要对其影响进行更严格的评估。因此 本项目的总体目标是进行有效性-实施混合设计研究（类型1）， 检查的影响，实施，和移动健康IYCF信息干预的成本，建立在我们的 以前的工作。首先，我们将对510名母亲、父亲和儿童三联体进行随机分组对照试验 在塞内加尔的102个村庄，确定干预措施对国际儿童年做法和营养结果的影响 (Aim 1）。实验组将接受为期16周的语音和短信。消息将 包括有针对性国际青年合作年做法的脚本信息以及社区的非脚本信息 角色模型（即，“积极的偏差”）。我们将确定贫血患病率和MAD在儿童之前， 干预实施后。我们还将研究以下方面的实施情况、成本和机会： 通过使用混合方法进行过程评估，扩大移动健康国际青年合作框架信息传递干预措施（目标2）， 方法和经济分析。鉴于社区卫生工作者面临的限制， 有效、可行和负担得起的替代交付平台有可能改善覆盖面 并采纳国际青年合作论坛建议的做法，打破营养不良的恶性循环。没有特定背景 尽管国际青年合作年的干预措施没有取得成效，但营养不良仍将是塞内加尔死亡和残疾的主要原因。

项目成果

The impact and implementation of an mHealth intervention to improve infant and young child feeding in Senegal: IIMAANJE protocol for a cluster randomized control trial.

• DOI: 10.3389/fpubh.2023.1258963
• 发表时间: 2023
• 期刊: FRONTIERS IN PUBLIC HEALTH
• 影响因子: 5.2
• 作者: Downs, Shauna M.;Gueye, Daouda;Sall, Medoune;Ndoye, Bamba;Sarr, Ndeye Ndambao;Sarr, Moussa;Mboup, Souleymane;Alam, Neeloy Ashraful;Diouf, Adama;Merchant, Emily V.;Sackey, Joachim
• 通讯作者: Sackey, Joachim