Effect of nutrition counselling with a digital job aid on child dietary diversity: Analysis of secondary outcomes from a cluster randomised controlled trial in rural Bangladesh
Adequate dietary diversity among infants is often suboptimal in developing countries. We assessed the impact of nutrition counselling using a digital job aid on dietary diversity of children aged 6–23 months using data from a cluster randomised controlled trial in Bangladesh. The trial had five arms...
| Autores principales: | , , , , , , , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
Wiley
2022
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| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/141376 |
| _version_ | 1855524016697114624 |
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| author | Billah, Sk Masum Ferdous, Tarana E. Kelly, Patrick Raynes-Greenow, Camille Siddique, Abu Bakkar Gillespie, Stuart Hoddinott, John F. Menon, Purnima |
| author_browse | Billah, Sk Masum Ferdous, Tarana E. Gillespie, Stuart Hoddinott, John F. Kelly, Patrick Menon, Purnima Raynes-Greenow, Camille Siddique, Abu Bakkar |
| author_facet | Billah, Sk Masum Ferdous, Tarana E. Kelly, Patrick Raynes-Greenow, Camille Siddique, Abu Bakkar Gillespie, Stuart Hoddinott, John F. Menon, Purnima |
| author_sort | Billah, Sk Masum |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Adequate dietary diversity among infants is often suboptimal in developing countries. We assessed the impact of nutrition counselling using a digital job aid on dietary diversity of children aged 6–23 months using data from a cluster randomised controlled trial in Bangladesh. The trial had five arms, each with 25 clusters. The four intervention arms provided counselling using a digital job aid and different prenatal and post-natal combinations of lipid-based supplements and the comparison arm with usual practice. We enrolled 1500 pregnant women and followed them until the children reached their second birthday. We developed a tablet-based system for intervention delivery, data collection and project supervision. We combined the four intervention arms (n = 855), in which community health workers (CHWs) provided age-appropriate complementary feeding counselling, to compare against the comparison arm (n = 403). We calculated the outcome indicators from the children's 24-h dietary recalls. Overall, the intervention increased the mean dietary diversity score by 0.09 (95% confidence interval [CI]: 0.2–0.16) and odds of minimum dietary diversity by 18% (95% CI: 0.99–1.40). However, there was a significant interaction on the effect of the intervention on dietary diversity by age. The mean dietary diversity score was 0.24 (95% CI: 0.11–0.37) higher in the intervention than in the comparison arm at 9 months and 0.14 (95% CI: 0.01–27) at 12 months of age. The intervention effect was non-significant at an older age. Overall, consumption of flesh food was 1.32 times higher in the intervention arm (odds ratio [OR] 1.32, 95% CI: 1.11–1.57) in 6–23 months of age. The intervention significantly improved child dietary diversity score in households with mild and moderate food insecurity by 0.27 (95% CI: 0.06–0.49) and 0.16 (0.05–27), respectively, but not with food-secure and severely food-insecure households. Although the study did not evaluate the impact of digital job aid alone, the findings indicate the utility of nutrition counselling by CHWs using a digital job aid to improve child feeding practices in broader programmes. |
| format | Journal Article |
| id | CGSpace141376 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Wiley |
| publisherStr | Wiley |
| record_format | dspace |
| spelling | CGSpace1413762025-10-26T13:01:39Z Effect of nutrition counselling with a digital job aid on child dietary diversity: Analysis of secondary outcomes from a cluster randomised controlled trial in rural Bangladesh Billah, Sk Masum Ferdous, Tarana E. Kelly, Patrick Raynes-Greenow, Camille Siddique, Abu Bakkar Gillespie, Stuart Hoddinott, John F. Menon, Purnima child nutrition dietary patterns nutrition education nutrition infant feeding food security experimental design diet rural areas maternal nutrition dietary diversity digital job aid communities Adequate dietary diversity among infants is often suboptimal in developing countries. We assessed the impact of nutrition counselling using a digital job aid on dietary diversity of children aged 6–23 months using data from a cluster randomised controlled trial in Bangladesh. The trial had five arms, each with 25 clusters. The four intervention arms provided counselling using a digital job aid and different prenatal and post-natal combinations of lipid-based supplements and the comparison arm with usual practice. We enrolled 1500 pregnant women and followed them until the children reached their second birthday. We developed a tablet-based system for intervention delivery, data collection and project supervision. We combined the four intervention arms (n = 855), in which community health workers (CHWs) provided age-appropriate complementary feeding counselling, to compare against the comparison arm (n = 403). We calculated the outcome indicators from the children's 24-h dietary recalls. Overall, the intervention increased the mean dietary diversity score by 0.09 (95% confidence interval [CI]: 0.2–0.16) and odds of minimum dietary diversity by 18% (95% CI: 0.99–1.40). However, there was a significant interaction on the effect of the intervention on dietary diversity by age. The mean dietary diversity score was 0.24 (95% CI: 0.11–0.37) higher in the intervention than in the comparison arm at 9 months and 0.14 (95% CI: 0.01–27) at 12 months of age. The intervention effect was non-significant at an older age. Overall, consumption of flesh food was 1.32 times higher in the intervention arm (odds ratio [OR] 1.32, 95% CI: 1.11–1.57) in 6–23 months of age. The intervention significantly improved child dietary diversity score in households with mild and moderate food insecurity by 0.27 (95% CI: 0.06–0.49) and 0.16 (0.05–27), respectively, but not with food-secure and severely food-insecure households. Although the study did not evaluate the impact of digital job aid alone, the findings indicate the utility of nutrition counselling by CHWs using a digital job aid to improve child feeding practices in broader programmes. 2022-01 2024-04-12T13:37:47Z 2024-04-12T13:37:47Z Journal Article https://hdl.handle.net/10568/141376 en Open Access Wiley Billah, Sk Masum; Ferdous, Tarana E.; Kelly, Patrick; Raynes-Greenow, Camille; Siddique, Abu Bakkar; Gillespie, Stuart; Hoddinott, John F.; Menon, Purnima; et al. 2022. Effect of nutrition counselling with a digital job aid on child dietary diversity: Analysis of secondary outcomes from a cluster randomised controlled trial in rural Bangladesh. Maternal and Child Nutrition 18(1): e13267. https://doi.org/10.1111/mcn.13267 |
| spellingShingle | child nutrition dietary patterns nutrition education nutrition infant feeding food security experimental design diet rural areas maternal nutrition dietary diversity digital job aid communities Billah, Sk Masum Ferdous, Tarana E. Kelly, Patrick Raynes-Greenow, Camille Siddique, Abu Bakkar Gillespie, Stuart Hoddinott, John F. Menon, Purnima Effect of nutrition counselling with a digital job aid on child dietary diversity: Analysis of secondary outcomes from a cluster randomised controlled trial in rural Bangladesh |
| title | Effect of nutrition counselling with a digital job aid on child dietary diversity: Analysis of secondary outcomes from a cluster randomised controlled trial in rural Bangladesh |
| title_full | Effect of nutrition counselling with a digital job aid on child dietary diversity: Analysis of secondary outcomes from a cluster randomised controlled trial in rural Bangladesh |
| title_fullStr | Effect of nutrition counselling with a digital job aid on child dietary diversity: Analysis of secondary outcomes from a cluster randomised controlled trial in rural Bangladesh |
| title_full_unstemmed | Effect of nutrition counselling with a digital job aid on child dietary diversity: Analysis of secondary outcomes from a cluster randomised controlled trial in rural Bangladesh |
| title_short | Effect of nutrition counselling with a digital job aid on child dietary diversity: Analysis of secondary outcomes from a cluster randomised controlled trial in rural Bangladesh |
| title_sort | effect of nutrition counselling with a digital job aid on child dietary diversity analysis of secondary outcomes from a cluster randomised controlled trial in rural bangladesh |
| topic | child nutrition dietary patterns nutrition education nutrition infant feeding food security experimental design diet rural areas maternal nutrition dietary diversity digital job aid communities |
| url | https://hdl.handle.net/10568/141376 |
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