Department of International Studies, Kyunghee University, South Korea.
Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA.
J Nutr. 2023 Feb;153(2):569-578. doi: 10.1016/j.tjnut.2022.12.023. Epub 2022 Dec 28.
Adding food vouchers or paternal nutrition behavior change communication (BCC) activities to maternal BCC may improve child diets and household food security but their effect is unknown.
We assessed whether maternal BCC, maternal and paternal BCC, maternal BCC and a food voucher, or maternal and paternal BCC and a food voucher improved nutrition knowledge, child diet diversity scores (CDDS), and household food security.
We implemented a cluster randomized control trial in 92 Ethiopian villages. Treatments were as follows: maternal (M) BCC only; maternal BCC and paternal BCC (M+P); maternal BCC and food vouchers (M+V); and maternal BCC, food vouchers, and paternal BCC (M+V+P). Effects were assessed using generalized estimating equations.
Maternal BCC and paternal BCC increased the maternal and paternal knowledge of optimal infant and young child feeding practices by 4.2-6.8 percentage points (P < 0.05) and by 8.3-8.4 percentage points (P < 0.01), respectively. Combining maternal BCC with either paternal BCC or the food voucher increased CDDS by 21.0%-23.1% (P < 0.05). The treatments M, M+V, and M+P increased the proportion of children who met minimum acceptable diet standards by 14.5, 12.8, and 20.1 percentage points, respectively (P < 0.01). Adding paternal BCC to the maternal BCC treatment or to the maternal BCC and voucher treatment did not lead to a larger increase in CDDS.
Increased paternal involvement does not necessarily translate into improvements in child feeding outcomes. Understanding the intrahousehold decision-making dynamics that underlie this is an important area for future research. This study was registered at clinicaltrials.gov as NCT03229629.
在产妇的母婴保健沟通（BCC）中加入食物券或父亲营养行为改变沟通（BCC）活动可能会改善儿童的饮食和家庭粮食安全，但效果尚不清楚。
我们评估了产妇 BCC、产妇和父亲 BCC、产妇 BCC 和食物券或产妇和父亲 BCC 和食物券是否改善了营养知识、儿童饮食多样性评分（CDDS）和家庭粮食安全。
我们在 92 个埃塞俄比亚村庄实施了一项集群随机对照试验。处理方法如下：产妇 BCC 单独使用；产妇 BCC 和父亲 BCC（M+P）联合使用；产妇 BCC 和食物券（M+V）联合使用；产妇 BCC、食物券和父亲 BCC（M+V+P）联合使用。使用广义估计方程评估效果。
产妇 BCC 和父亲 BCC 分别使产妇和父亲对婴幼儿最佳喂养实践的知识增加了 4.2-6.8 个百分点（P < 0.05）和 8.3-8.4 个百分点（P < 0.01）。将产妇 BCC 与父亲 BCC 或食物券结合使用，使 CDDS 增加了 21.0%-23.1%（P < 0.05）。处理 M、M+V 和 M+P 分别使符合最低可接受饮食标准的儿童比例增加了 14.5%、12.8%和 20.1%（P < 0.01）。将父亲 BCC 纳入产妇 BCC 处理或产妇 BCC 和券处理中并没有导致 CDDS 更大的增加。
增加父亲的参与并不一定能转化为儿童喂养结果的改善。了解这背后的家庭内决策动态是未来研究的一个重要领域。本研究在 clinicaltrials.gov 上注册为 NCT03229629。
