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

基本信息

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
项目类别：
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

项目摘要

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.

抽象的从孩子出生后的前 1000 天内，婴儿和幼儿喂养 (IYCF) 做法不理想仅在两岁时怀孕，就导致了塞内加尔的高营养不良率。 7% 的塞内加尔儿童在 6 至 23 个月大时按照全球 IYCF 建议进行喂养，改善该年龄段儿童生长迟缓和微量营养素缺乏的高峰期。集团将促进健康成长和发展，并帮助解决营养不良的负担。社区卫生工作者 (CHW) 经常负责为塞内加尔的母亲提供 IYCF 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，它们的覆盖范围受到限制。使用替代交付平台确定可行、有效且可扩展的 IYCF 干预措施至关重要改善 IYCF 实践的移动医疗 (mHealth) 干预措施显示出改善服务交付差距的希望。鉴于移动电话的广泛普及，IYCF 在塞内加尔实施了移动医疗干预措施。在我们之前在塞内加尔开展的工作中，该地址尚未在塞内加尔推广。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，该理论已交付给母亲和父亲。 6-23 个月大的儿童的最低可接受饮食摄入量增加了 19.2% （MAD），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。该项目的总体目标是进行有效性-实施混合设计研究（类型 1）检查基于我们的 mHealth IYCF 消息传递干预措施的影响、实施和成本首先，我们将对 510 名母亲、父亲和孩子进行整群随机对照试验。在塞内加尔 102 个村庄进行调查，以确定干预措施对 IYCF 实践和营养成果的影响（目标 1）。实验组将收到为期 16 周的语音和短信。包括关键目标 IYCF 实践的脚本化消息以及来自社区的非脚本化消息我们将在之前和之后确定儿童的贫血患病率和 MAD。实施后我们还将审查实施情况、成本和机会。通过使用混合方法进行流程评估，扩大 mHealth IYCF 消息传递干预（目标 2）考虑到社区卫生工作者面临的限制，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扩大覆盖范围并采用 IYCF 推荐的做法，打破营养不良的循环。通过有效的 IYCF 干预措施，营养不良将继续成为塞内加尔死亡和残疾的主要驱动因素。