Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, Georgia.
Hubert Department of Global Health, Emory University, Atlanta, Georgia.
Matern Child Nutr. 2020 Jan;16(1):e12882. doi: 10.1111/mcn.12882. Epub 2019 Sep 9.
Education and other strategies to promote optimal complementary feeding can significantly improve practices, but little is known about the specific techniques successful interventions use to achieve behaviour change. We reviewed the literature for complementary feeding interventions in low-/middle-income countries (LMIC) published since 2000. We systematically applied a validated taxonomy mapping process to code specific behaviour change techniques (BCTs) used in each intervention; effectiveness ratios for each BCT were estimated. Sixty-four interventions met inclusion criteria, were abstracted, BCTs identified, and coded. Dietary diversity was the most commonly assessed component of complementary feeding, and interpersonal communication, either individually or in groups, was the most commonly used delivery platform. Of the 93 BCTs available for mapping, the 64 interventions included in this review applied a total of 28 BCTs. Interventions used a median of six techniques (max = 13; min = 2). All interventions used "instruction on how to perform the behaviour." Other commonly applied BCTs included "use of a credible source" (n = 46), "demonstration of the behaviour" (n = 35), and "providing information about health consequences" (n = 30). Forty-three interventions reported strategies to shift the physical or social environment. Among BCTs used in >20 interventions, five had effectiveness ratios >0.8: "provision of/enabling social support"; "providing information about health consequences"; "demonstration of the behaviour"; and "adding objects to the environment" namely, food, supplements, or agricultural inputs. The limited reporting of theory-based BCTs in complementary feeding interventions may impede efforts to improve and scale effective programs and reduce the global burden of malnutrition.
教育和其他促进最佳补充喂养的策略可以显著改善实践，但对于成功干预措施使用的具体技术来实现行为改变知之甚少。我们回顾了自 2000 年以来在低收入和中等收入国家（LMIC）发表的补充喂养干预措施的文献。我们系统地应用了经过验证的分类法映射过程，对每个干预措施中使用的特定行为改变技术（BCT）进行编码；为每个 BCT 估计了效果比。64 项干预措施符合纳入标准，进行了摘要、BCT 识别和编码。饮食多样性是补充喂养最常评估的组成部分，人际交流，无论是单独进行还是分组进行，都是最常用的提供平台。在可用于映射的 93 个 BCT 中，本综述中包含的 64 项干预措施共应用了 28 个 BCT。干预措施使用了中位数为 6 种技术（最大值= 13；最小值= 2）。所有干预措施都使用了“关于如何执行行为的指导”。其他常用的 BCT 包括“利用可信来源”（n = 46）、“演示行为”（n = 35）和“提供有关健康后果的信息”（n = 30）。43 项干预措施报告了改变物理或社会环境的策略。在使用超过 20 项干预措施的 BCT 中，有 5 项的效果比> 0.8：“提供/使能社会支持”；“提供有关健康后果的信息”；“演示行为”；以及“向环境中添加对象”，即食物、补充剂或农业投入。补充喂养干预措施中基于理论的 BCT 报告有限，可能会阻碍改善和扩大有效方案的努力，并减少全球营养不良负担。
