Mahmudiono Trias, Nindya Triska Susila, Andrias Dini Ririn, Megatsari Hario, Rosenkranz Richard R
Department of Nutrition - Faculty of Public Health, Universitas Airlangga, Jl. Mulyorejo Kampus C, Surabaya, 60115, Indonesia.
Department of Food, Nutrition, Dietetics & Health, Kansas State University, Manhattan, KS, 66506, USA.
BMC Public Health. 2016 Jun 8;16:486. doi: 10.1186/s12889-016-3155-1.
Nutrition transition in developing countries were induced by rapid changes in food patterns and nutrient intake when populations adopt modern lifestyles during economic and social development, urbanization and acculturation. Consequently, these countries suffer from the double burden of malnutrition, consisting of unresolved undernutrition and the rise of overweight/obesity. The prevalence of the double burden of malnutrition tends to be highest for moderate levels (third quintile) of socioeconomic status. Evidence suggests that modifiable factors such as intra-household food distribution and dietary diversity are associated with the double burden of malnutrition, given household food security. This article describes the study protocol of a behaviorally based nutrition education intervention for overweight/obese mothers with stunted children (NEO-MOM) in reducing the double burden of malnutrition.
NEO-MOM is a randomized controlled trial with a three-month behavioral intervention for households involving pairs of 72 stunted children aged 2-5 years old and overweight/obese mothers (SCOWT) in urban Indonesia. The SCOWT pairs were randomly assigned to either an intervention group or to a comparison group that received usual care plus printed educational materials. The intervention consisted of six classroom sessions on nutrition education and home visits performed by trained community health workers using a motivational interviewing approach. The primary outcomes of this study are the prevalence of double burden of malnutrition as measured in SCOWT, child's height-for-age z-score (HAZ) and maternal body mass index (BMI).
Because previous studies are mainly observational in nature, this study advances understanding of the double burden of malnutrition through a fully powered randomized controlled trial. The intervention assists participants in self-administered goal setting to improve diet and child feeding behaviors by improving self-efficacy. Maternal self-efficacy may be enhanced through vicarious and active mastery of experiences gained during six sessions of nutrition education and verbal persuasion during home visits.
The Universal Trial Number (UTN) for this study is U1111-1175-5834. This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) and is allocated the registration number: ACTRN12615001243505 on 12 November 2015.
在经济和社会发展、城市化及文化适应过程中，发展中国家的人口采用现代生活方式，导致食物模式和营养摄入迅速变化，进而引发营养转型。因此，这些国家面临营养不良的双重负担，包括尚未解决的营养不足问题以及超重/肥胖现象的增加。营养不良双重负担的患病率在社会经济地位处于中等水平（第三五分位数）时往往最高。有证据表明，在家庭粮食安全的前提下，家庭内部食物分配和饮食多样性等可改变因素与营养不良的双重负担有关。本文介绍了一项针对患有发育迟缓子女的超重/肥胖母亲开展的基于行为的营养教育干预措施（NEO-MOM），以减轻营养不良的双重负担的研究方案。
NEO-MOM是一项随机对照试验，对印度尼西亚城市中72对年龄在2至5岁的发育迟缓儿童及其超重/肥胖母亲（SCOWT）组成的家庭进行为期三个月的行为干预。SCOWT对被随机分配到干预组或对照组，对照组接受常规护理并外加印刷的教育材料。干预措施包括六次营养教育课堂教学以及由经过培训的社区卫生工作者采用动机访谈法进行的家访。本研究的主要结局指标是SCOWT中测量的营养不良双重负担患病率、儿童年龄别身高Z评分（HAZ）和母亲体重指数（BMI）。
由于先前的研究主要是观察性的，本研究通过一项充分有力的随机对照试验，推进了对营养不良双重负担的理解。该干预措施通过提高自我效能，帮助参与者进行自我管理的目标设定，以改善饮食和儿童喂养行为。通过在六次营养教育课程中获得的替代性和积极的经验掌握以及家访期间的言语劝说，可能会提高母亲的自我效能。
本研究的通用试验编号（UTN）为U1111-1175-5834。该试验已在澳大利亚新西兰临床试验注册中心（ANZCTR）注册，并于2015年11月12日分配注册号：ACTRN********。
