Phillips Erica, Kayanda Rosemary A, Kassim Neema, Ngure Francis M, Turner Paul C, Stoltzfus Rebecca J
Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA.
Division of Nutritional Sciences, Cornell University, Ithaca, NY 14850, USA.
Nutrients. 2024 Dec 13;16(24):4315. doi: 10.3390/nu16244315.
Levels of adherence to recommended protocols in an intervention trial can affect outcomes and confound the results. To broaden the evidence about the selection and utility of adherence measures in varying contexts, we describe the level of adherence to the Mycotoxin Mitigation Trial (MMT) randomized intervention using caregiver-reported survey questions and compare inferences of adherence between multi-module surveys and interactive 24 h dietary recalls based on our program theory.
The MMT was a two-arm cluster-randomized trial conducted in 52 health facilities (clusters) in central Tanzania. Surveys were conducted with all trial participants at three time points and dietary recalls were conducted in a cohort at 12 mo.
The 12 mo survey was conducted with 2112 caregivers and the 18 mo survey was conducted with 2527 caregivers. A cohort of participants ( = 282, 20 clusters) was selected for dietary recalls, balanced by arm. Reported feeding of blended porridge flours, whether MMT-provided or own-sourced, was high at 12 and 18 mo, between 73 and 95%, with only slight differences between the surveys and recalls. Inferences were similar for continuation of breastfeeding, feeding frequency, and dietary diversity. Only the amount of porridge fed the previous day differed statistically by method, with higher amounts reported in the recalls compared to the survey.
Detailed analysis of reported behaviors, based on the MMT program theory, supports high adherence to the recommended trial behaviors. Survey data and 24 h dietary recalls were convergent for almost all indicators, strengthening the trial's conclusions and allowing for either method to be selected for similar research.
在一项干预试验中，对推荐方案的依从程度会影响结果并混淆研究结果。为了拓宽关于在不同背景下选择和使用依从性测量方法的证据，我们使用照料者报告的调查问题描述了对霉菌毒素缓解试验（MMT）随机干预的依从程度，并根据我们的项目理论比较了多模块调查和交互式24小时饮食回忆法之间的依从性推断。
MMT是在坦桑尼亚中部的52个卫生设施（群组）中进行的双臂整群随机试验。在三个时间点对所有试验参与者进行调查，并在12个月时对一组参与者进行饮食回忆。
对2112名照料者进行了12个月的调查，对2527名照料者进行了18个月的调查。选择了一组参与者（n = 282，20个群组）进行饮食回忆，并按组进行了平衡。无论是MMT提供的还是自行采购的混合粥粉，在12个月和18个月时的报告喂食率都很高，在73%至95%之间，调查和回忆之间只有细微差异。在母乳喂养的持续时间、喂食频率和饮食多样性方面的推断相似。只有前一天喂食的粥量在方法上有统计学差异，回忆报告的量高于调查。
基于MMT项目理论对报告行为的详细分析支持对照试验推荐行为的高度依从。几乎所有指标的调查数据和24小时饮食回忆法都是一致的，这加强了试验的结论，并允许在类似研究中选择任何一种方法。
