Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
Research Centre of Excellence, Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
PLoS One. 2022 Oct 13;17(10):e0275357. doi: 10.1371/journal.pone.0275357. eCollection 2022.
Childhood undernutrition remains a public health issue that can lead to unfavourable effects in later life. These effects tend to be more devastating among urban poor young children, especially in light of the recent COVID-19 pandemic. There is an immediate need to introduce interventions to reduce childhood undernutrition. This paper described the study protocol of a nutrition programme that was developed based on the positive deviance approach and the evaluation of the effectiveness of the programme among urban poor children aged 3 to 5 years old.
This mixed-method study will be conducted in two phases at low-cost flats in Kuala Lumpur. Phase one will involve a focus group discussion with semi-structured interviews to explore maternal feeding practices and the types of food fed to the children. Phase two will involve a two-armed cluster randomised controlled trial to evaluate the effectiveness of a programme developed based on the positive deviance approach. The programme will consist of educational lessons with peer-led cooking demonstrations, rehabilitation, and growth monitoring sessions. Intervention group will participate in the programme conducted by the researcher for three months whereas the comparison group will only receive all the education materials and menus used in the programme after data collection has been completed. For both groups, data including height, weight, and dietary intake of children as well as the nutritional knowledge and food security status of mothers will be collected at baseline, immediate post-intervention, and 3-month post-intervention.
The positive deviance approach helps to recognise the common feeding practices and the local wisdom unique to the urban poor population. Through this programme, mothers may learn from and be empowered by their peers to adopt new feeding behaviours so that their children can achieve healthy weight gain.
This study was registered with clinicaltrials.gov: NCT04688515 on 29 December 2020, https://www.clinicaltrials.gov/ct2/show/NCT04688515.
儿童期营养不良仍然是一个公共卫生问题，可能会对以后的生活产生不利影响。在最近的 COVID-19 大流行背景下，城市贫困地区的幼儿尤其受到这些影响的影响。目前急需引入干预措施来减少儿童期营养不良。本文介绍了一项营养计划的研究方案，该计划是基于正性偏离方法制定的，并评估了该计划在 3 至 5 岁城市贫困儿童中的有效性。
这项混合方法研究将在吉隆坡的低成本公寓中进行两个阶段。第一阶段将进行焦点小组讨论和半结构式访谈，以探讨产妇喂养习惯和喂养儿童的食物类型。第二阶段将进行两臂整群随机对照试验，以评估基于正性偏离方法制定的方案的有效性。该方案将包括教育课程、同伴主导的烹饪示范、康复和生长监测会议。干预组将参加由研究人员进行的为期三个月的方案，而对照组仅在数据收集完成后才会收到方案中使用的所有教育材料和菜单。在两组中，将收集儿童的身高、体重和饮食摄入量以及母亲的营养知识和粮食安全状况的数据，这些数据将在基线、干预后即刻和干预后 3 个月收集。
正性偏离方法有助于认识到城市贫困人群常见的喂养习惯和当地特有的智慧。通过该方案，母亲们可以从同龄人那里学习并获得授权，采用新的喂养行为，以使她们的孩子获得健康的体重增长。
本研究于 2020 年 12 月 29 日在 clinicaltrials.gov 上注册：NCT04688515，https://www.clinicaltrials.gov/ct2/show/NCT04688515。
