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一项评估基于社区的鸡蛋干预对洪都拉斯农村地区幼儿营养和健康状况影响的准实验研究。

A quasi-experimental study assessing the effectiveness of a community-based egg intervention in the nutritional and health status of young children from rural Honduras.

机构信息

Department of Health Policy and Community Health, Jiann Ping Hsu College of Public Health, Georgia Southern University, Savannah, Georgia, United States of America.

Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, United States of America.

出版信息

PLoS One. 2024 Nov 5;19(11):e0312825. doi: 10.1371/journal.pone.0312825. eCollection 2024.

Abstract

OBJECTIVE

This community-public-private-academic coalition project implemented and evaluated the effectiveness of a rural, community-based egg intervention that aimed to support the nutrition and health of children living in rural, poor communities from Intibucá, Honduras, during the COVID-19 pandemic.

DESIGN

This investigator-blind, non-randomized, controlled study was informed by a community health improvement process and participatory research. Women from 13 communities were given a microloan to start an egg farm that supplied 1 egg daily to 201 children ages 6-24 months for 1 year (intervention group). Control communities (n = 14) were selected from neighboring municipalities with similar sociodemographic backgrounds based on size. Sociodemographic-, anthropometric-, and morbidity data were collected biannually between January 2021 to January 2022. Outcome changes were compared with linear-, generalized- or Poisson- mixed models adjusted by sex, age, maternal education, breastfeeding status, assets, adults living at home, baseline outcomes, and community-cluster.

RESULTS

Baseline to 6- and 12-month weekly frequency of egg intake significantly increased in the intervention vs. the control group: 6-month change = 1.86; 95%CI (1.61, 2.14); 12-month change = 1.63; 95%CI (1.42, 1.87 p<0.001), respectively. Baseline to 12-month changes in the intervention group were not significant for length/height-for-age-z-scores = 0.12, p = 0.187; weight-for-length/height-z-scores = -0.02, p = 0.78; and diarrhea prevalence, AOR = 1.69; 95%CI (0.53, 5.42), p = 0.378. Lower odds of respiratory infections were observed for the intervention vs. the control group at 6- and 12-month post: AOR = 0.28; 95%CI (0.12, 0.63), p = 0.002; AOR = 0.30; 95%CI (0.12, 0.75), p = 0.010, respectively.

CONCLUSIONS AND RELEVANCE

Children in the intervention group reported consuming eggs more days per week relative to the control group. Lower odds of respiratory infections were observed in the intervention group throughout the study. Ongoing follow-up will offer more insights on the intervention's effectiveness in linear growth, dietary diversity, food security, and other nutritional outcomes.

摘要

目的

本社区-公私-学术联盟项目实施并评估了一项针对农村社区的鸡蛋干预措施的有效性,该措施旨在支持居住在洪都拉斯因蒂布卡农村贫困社区的儿童的营养和健康,该措施是在 COVID-19 大流行期间实施的。

设计

本研究采用社区健康改善过程和参与式研究,由调查员进行盲法、非随机、对照设计。13 个社区的妇女获得了一笔小额贷款,用于开办一个鸡蛋养殖场,在 1 年内(干预组)每天向 201 名 6-24 个月大的儿童供应 1 个鸡蛋。根据规模,从邻近的市镇中选择了 14 个对照社区。在 2021 年 1 月至 2022 年 1 月期间,每 6 个月收集一次社会人口统计学、人体测量学和发病率数据。通过性别、年龄、母亲教育程度、母乳喂养状况、资产、在家成年人、基线结果和社区聚类,对线性、广义或泊松混合模型进行调整,比较结果变化。

结果

与对照组相比,干预组在第 6 个月和第 12 个月每周摄入鸡蛋的频率显著增加:第 6 个月的变化=1.86;95%CI(1.61,2.14);第 12 个月的变化=1.63;95%CI(1.42,1.87,p<0.001)。干预组在第 12 个月的基线至第 12 个月的长度/身高年龄 z 分数没有显著变化=0.12,p=0.187;体重/身高 z 分数=-0.02,p=0.78;腹泻患病率,AOR=1.69;95%CI(0.53,5.42),p=0.378。与对照组相比,干预组在第 6 个月和第 12 个月时呼吸道感染的几率较低:AOR=0.28;95%CI(0.12,0.63),p=0.002;AOR=0.30;95%CI(0.12,0.75),p=0.010。

结论和相关性

与对照组相比,干预组的儿童每周报告鸡蛋的食用天数更多。在整个研究过程中,干预组呼吸道感染的几率较低。持续的随访将提供更多关于该干预措施在线性生长、饮食多样性、粮食安全和其他营养结果方面有效性的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9c9/11537388/d689d01da12a/pone.0312825.g001.jpg

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