Impact on Nutritional Practices: SMS and Interpersonal Communication

Study Overview
=================
Brief Summary
-----------------
This cluster randomized controlled study aims to add to the evidence base on mHealth interventions by assessing the main effects of delivering nutrition messages on key maternal, infant, and young child nutrition (MIYCN) behaviors and outcomes through three innovative behavior change strategies. The strategies compared will be: (i) an interpersonal communication strategy using the Tanzanian government's Mkoba wa Siku 1000 maternal, infant and young child nutrition (MIYCN) curriculum (MwS) through clinic- and community-based channels, (ii) the mNutrition SMS text messaging module of the government's Wazazi Nipendeni program, and (iii) the combination of both of these strategies (interpersonal and SMS messaging). They will be compared with the current standard of care in Tanzania. The goal will be to determine which has the greatest impact on key MIYCN and hygiene practices and care-seeking behaviors. It will be paired with a costing analysis so that these effects can be understood in the context of their costs.

Official Title
-----------------
Evaluating the Impact of Text Messages and Interpersonal Community Support Groups on MICN Practices in Tanzania

Conditions
-----------------
Nutritional Deficiency

Intervention / Treatment
-----------------
* Behavioral: SMS
* Behavioral: Interpersonal Counselling


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Mothers of children aged 0-12 mo. or pregnant at time of enrollment Consent to participate in the study Exclusion Criteria: Unable to consent to participate in the study

Ages Eligible for Study
-----------------
Minimum Age: 16 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: Four arms: (1) SMS only; (2) SMS + interpersonal; (3) interpersonal only; (4) none
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: SMS<br>Participants will receive SMS messages on nutrition and health related topics | Behavioral: SMS<br>* Receipt of SMS messages on nutrition and health topics<br>|
| Active Comparator: Interpersonal<br>Participants will receive interpersonal counselling on nutrition and health related topics | Behavioral: Interpersonal Counselling<br>* Interpersonal counselling on health and nutrition topics<br>|
| Active Comparator: SMS + Interpersonal<br>Participants will receive SMS messages on nutrition and health related topics as well as interpersonal counselling on nutrition and health related topics | Behavioral: SMS<br>* Receipt of SMS messages on nutrition and health topics<br>Behavioral: Interpersonal Counselling<br>* Interpersonal counselling on health and nutrition topics<br>|
| No Intervention: Usual Care<br> | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Children's Dietary Diversity | % of children 6-29 mo. who consumed the minimum dietary diversity (received foods from ≥4 food groups on the previous day) | 24 h | 
| Women's dietary diversity | % who consumed food items from at least five out of ten defined food groups in the previous 24 hours (WDDS) | 24 h | 
| Children's Minimum Meal Frequency | % of children 6-29 mo. who consumed the minimum meal frequency the prior day (2/day for breastfed infants 6-8 mo.; 3/day for breastfed infants 9-29 mo.; 4/day for non-breastfed infants 6-29 mo.) | 24 h |