Tools to Improve Parental Recognition of Developmental Deficits in Children

Study Overview
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Brief Summary
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In this study, we aim to improve child nutrition by increasing parents' awareness of their children's physical growth. We use a cluster-randomized trial design to evaluate two interventions that provide parents with regular information on their children's physical development and growth: 1) distribution of full-sized growth charts for measurement of child height within households; and 2) organization of community-based meetings, during which children's height and weight are measured by trained project staff.

Detailed Description
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The target population for the study will be children between the ages of 6 and 18 months at baseline living in small-scale farming households in Chipata District, Zambia. As part of a cluster-randomized trial titled Food Constraints, Yield Uncertainty and 'Ganyu' Labor funded by IZA-DFID (PI: G Fink), 3,100 farming households in approximately 180 rural villages in Eastern Province are currently enrolled in a two-year study, which aims at assessing the effect of food loan programs on agricultural productivity. The study described here uses the Food Constraints population as a sampling frame; all households enrolled in the Food Constraints program that have a child between 6 and 18 months are invited to participate in this add-on trial. We anticipate that there will be around 600 eligible households recruited for this study. Study duration is about 18 months. Selected households will be visited for study enrollment and a short baseline assessment in September 2014, at which time the two interventions will also be rolled out. Final impact of the interventions will be assessed one year later, in September 2015.

Official Title
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Tools to Improve Parental Recognition of Developmental Deficits in Children

Conditions
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Malnutrition, Child Development

Intervention / Treatment
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* Behavioral: Height measurement poster
* Behavioral: Community-based monitoring


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All households with a child between the ages of 6 and 18 months at baseline Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 6 Months
Maximum Age: 18 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Height measurement poster<br> | Behavioral: Height measurement poster<br>* Each household is provided with a poster which study personnel help to hang on the wall. The poster clearly indicates height-for-age benchmarks and stunting cut-offs for study-age children. Parents are provided training on how to measure their children at regular intervals, and interpret height readings to determine whether their child is developing normally or is stunted.<br>|
| Experimental: Community-based monitoring<br> | Behavioral: Community-based monitoring<br>* Once every three months, villages are visited by study staff who measure children's heights and weights, and parents are informed if their children are below the reference measures established by the World Health Organization. If a child's weight is such that the child is classified as severely malnourished, the child is referred to the nearest health center for treatment. If the child is stunted (height-for-age z-score more than 2 standard deviations below the reference median), we provide parents with a supply of Yummy Soy powder, a fortified soy and maize mix popular among parents and widely available in local super markets. Parents are instructed to give one or two tea spoons of the mix to the child each day.<br>|
| No Intervention: Control<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Height-for-age z-score | Children's heights will be measured and height-fore-age z-scores will be determined using standards published by the World Health Organization | At the end of one year | 
| Child development outcomes | Through parental reports and child tasks we will measure various aspects of child development, including motor skills and verbal skills | At the end of one year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mid-upper arm circumference (MUAC) | Children will be measured for mid-upper arm circumference (MUAC) using standard measurement strips | At the end of one year | 
| Dietary intake | Parents will be asked to report on children's dietary intake during the day preceding the survey | At the end of one year |