Clinical trial NCT02903641: Money or Knowledge? Behavioral Aspects of Malnutrition
Official title: Money or Knowledge? Behavioral Aspects of Malnutrition
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Malnutrition
Lead sponsor: Harvard School of Public Health (HSPH)
Sponsor class: OTHER
Collaborators: name: Weiss Family Program Fund
name: Harvard Center for African Studies
name: Harvard Foundations of Human Behavior
name: Vogelheim Hansen Fund
First posted: 2016-09-16
Enrollment: 506
Sex: ALL
Minimum age (years): 14
Maximum age (years): 55
Standard ages: CHILD
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Primary purpose: PREVENTION

Brief summary: Malnutrition accounts for nearly half of child deaths worldwide. Children who are well-nourished are better able to learn in school, grow into more physically capable adults, and require less health care during childhood and adulthood. Moreover, it is difficult to make up for poor childhood nutrition later in life. I present here the proposal for an intervention that builds on a larger study in Ethiopia and will generate insights into the importance of behavioral factors related to persistent malnutrition in low-income settings, allowing for more targeted, cost-effective interventions in the future.

Existing data from the study region, Oromia, Ethiopia, suggest that many mothers know how to correctly respond to a hypothetical situation where a young child exhibits poor growth. On the other hand, however, mothers frequently appear unaware about their own children's growth deficiencies. Together, these facts suggest that false beliefs about the appropriateness of a child's physical size are a more likely contributor to malnutrition, rather than a weak understanding of how to help a malnourished child.

The proposed intervention will provide evidence on the relationship between caregiver beliefs about child nutritional status and the caregiver's behavior, ultimately analyzing how this relationship influences important nutritional choices for young children in a setting with limited resources. The study uses a two-by-two randomized trial; the first treatment is a cash transfer labeled for child food consumption, and the second is the provision of personalized information about the quality of the child's height compared to other children like those of the same age and gender in East Africa. Together the two treatment arms will provide evidence about the relative importance of behavioral versus resource barriers to improved nutrition. Better understanding of the interaction between these key factors is essential in addressing one of the foremost health issues facing developing countries today.


Eligibility criteria: Households for this study were selected from among those who were included in any of the three study groups from a larger study and for whom relevant data had been collected.

Inclusion Criteria:

* inclusion in the larger study required the household to have a child who was 6-35 months old for the main study's baseline survey in July-August 2015 (referred to as the index child) and for the household to have land for crop cultivation

Exclusion Criteria:

* Households that did not meet the inclusion restriction or those who did not have anthropometric data collected during the larger study.

Primary outcomes:
measure: Dietary diversity
timeFrame: 6 weeks after baseline/intervention
measure: Food frequency
timeFrame: 6 weeks after baseline/intervention
measure: Meal frequency
timeFrame: 6 weeks after baseline/intervention
measure: Infant and child feeding index
timeFrame: 6 weeks after baseline/intervention
measure: Household spending
timeFrame: 6 weeks after baseline/intervention
Secondary outcomes:
measure: Caregiver perception of child's relative height
timeFrame: 6 weeks after baseline/intervention
measure: Caregiver satisfaction with child's height
timeFrame: 6 weeks after baseline/intervention
measure: Caregiver knowledge of how to improve child's growth
timeFrame: 6 weeks after baseline/intervention
Other outcomes:
Locations:
Study officials:
affiliation: Harvard University
name: Katherine Donato, MA
role: PRINCIPAL_INVESTIGATOR
References:
citation: Ruel MT, Menon P. Child feeding practices are associated with child nutritional status in Latin America: innovative uses of the demographic and health surveys. J Nutr. 2002 Jun;132(6):1180-7. doi: 10.1093/jn/132.6.1180.
citation: Arimond M, Ruel MT. Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J Nutr. 2004 Oct;134(10):2579-85. doi: 10.1093/jn/134.10.2579.