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.

抽象的 从儿童开始的时候，最初的1000天，次优的婴儿和幼儿喂养（IYCF）做法 直到他们两岁的时间才构思，塞内加尔的营养不良率很高。仅有的 根据6-23个月大的全球IYCF建议，有7％的塞内加尔儿童被喂养 儿童生长伪造和微量营养素缺陷的峰值时期。在这个时代改善IYCF实践 小组将促进健康的成长和发展，并有助于解决营养不良的燃烧。 社区卫生工作者（CHW）通常负责向塞内加尔的母亲提供IYCF咨询。 但是，由于时间和地理约束以及竞争健康的重点，它们的影响力受到限制。 使用替代交付平台确定可行，有效和可扩展的IYCF干预措施至关重要 改善IYCF实践。移动健康（MHealth）干预措施有望改善交付空白 鉴于宽度的手机穿透宽度，塞内加尔的IYCF练习。但是，MHealth干预措施 该地址IYCF尚未在塞内加尔进行扩展。在塞内加尔的先前工作中，我们进行了 基于用户以用户为中心的MHealth IYCF语音消息干预设计和试行的形成性研究 计划行为的理论。 MHealth干预措施已交付给母亲和父亲 6-23个月的儿童显示，最低可接受饮食的消费量增加了19.2％ （疯狂），饮食多样性的指标。但是，需要对其影响进行更严格的评估。那， 该项目的总体目的是进行有效实施混合设计研究（1型） 检查基于我们的MHealth IYCF消息干预的影响，实施和成本 以前的工作。首先，我们将与510个母亲，父亲和孩子三合会进行集群随机的控制试验 在塞内加尔的102个村庄中，确定干预对IYCF实践和营养成果的影响 （目标1）。实验组将在16周内接收语音和短信。消息将 包括关键目标IYCF实践的脚本消息以及社区的无脚本消息 榜样（即“积极的偏差”）。我们将确定贫血的患病率，并在儿童之前和 干预实施后。我们还将研究实施，成本和机会 通过使用混合 - 方法和经济分析。给定CHW面临的限制，提供了严格的证据 有效，可行且负担得起的替代交付平台有可能提高覆盖范围 并吸收了推荐的IYCF实践，打破了营养不良的周期。没有上下文特定的 有效的IYCF干预措施，营养不良将继续是塞内加尔死亡和残疾的主要驱动力。

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