Faculty of Public Health,Department of Health, Behavior, and Society, Institute of Health, Jimma University, Jimma, Ethiopia.
Department of Communication, Wayne State University, Detroit, Michigan, United States of America.
PLoS One. 2024 Jan 2;19(1):e0266151. doi: 10.1371/journal.pone.0266151. eCollection 2024.
Non-optimal infant and young child feeding practices (IYCFP) are linked to malnutrition and infant mortality in poor countries, notably in Ethiopia. The majority of growth stalls occur within the first two years of life; hence, there is a need to discover interventions that enhance appropriate IYCFP for improving nutritional outcomes during this critical period. Using the experience of mothers who have come up with solutions to their IYCFP problems to educate others, is a potential pathway to initiate and sustain behavioral changes in resource-limited areas. However, such interventions are not widely implemented in Ethiopia.
This study aims to assess the effectiveness of a positive deviance approach (PDA) to improve appropriate feeding and nutritional status in South West region, Ethiopia.
A cluster randomized controlled trial will be conducted to compare the effect of positive deviant intervention versus routine health education. The intervention will be provided by positive deviant mothers based on uncommon practices that potentially benefit IYCFP will be identified. Training of the trainers manual on counselling and supporting non-positive deviant mothers based on the uncommon practices identified and WHO IYCFP guidelines will be provided for facilitating change. Culturally appropriate and scientifically acceptable operational packages of information will be developed. A total of 516 mothers will be recruited from 36 zones. The intervention arm will receive 12 demonstration sessions in groups and every 15th day home visit by positive deviant mothers. Data will be entered into epi data version 3.1 and analyzed using STATA version 16.0. All analyses will be done as intention-to-treat. We will fit the mixed effects linear regression model for continuous outcomes and mixed effects linear probability model for the binary outcomes in the study zone as a random intercept to estimate study arm difference (intervention vs. routine health education) adjusted for the baseline values of the outcome and additional relevant covariates.
We expect that the trial will generate findings informing IYCFP and nutritional policies and practices in Ethiopia.
This trial was registered at ClinicalTrials.gov as PACTR202108880303760, 30/8/2021.
在贫穷国家，特别是在埃塞俄比亚，非最佳婴幼儿喂养实践（IYCFP）与营养不良和婴儿死亡率有关。大多数生长停滞发生在生命的头两年内；因此，需要发现可以改善这一关键时期营养结果的干预措施，以促进适当的 IYCFP。利用已经找到解决 IYCFP 问题方法的母亲的经验来教育其他人，是在资源有限地区启动和维持行为改变的潜在途径。然而，这种干预措施在埃塞俄比亚并没有得到广泛实施。
本研究旨在评估积极偏差方法（PDA）在改善埃塞俄比亚西南部地区适当喂养和营养状况方面的有效性。
将进行一项群组随机对照试验，比较积极偏差干预与常规健康教育的效果。干预将由积极偏差母亲提供，基于可能有益于 IYCFP 的不常见做法进行识别。将提供培训培训师手册，根据确定的不常见做法和世界卫生组织 IYCFP 指南对非积极偏差母亲进行咨询和支持，以促进变革。将制定文化上适宜和科学上可接受的信息操作包。将从 36 个区招募 516 名母亲。干预组将接受 12 次小组示范课程，并由积极偏差母亲每 15 天进行一次家访。数据将输入 epi data 版本 3.1 并使用 STATA 版本 16.0 进行分析。所有分析都将按照意向治疗进行。我们将拟合混合效应线性回归模型用于连续结果，并拟合混合效应线性概率模型用于二元结果，将研究区作为随机截距，以估计研究臂差异（干预与常规健康教育），调整结果的基线值和其他相关协变量。
我们预计该试验将产生有关埃塞俄比亚 IYCFP 和营养政策和实践的发现。
该试验在 ClinicalTrials.gov 注册为 PACTR202108880303760，2021 年 8 月 30 日。
