Peer Groups to Improve Infant Feeding Practices and Child Growth in Post-emergency Settlements in Uganda

Summary

The goal of this randomized trial was to examine whether a peer-to-peer integrated intervention using Care Groups combining nutrition education and social support will improve infant growth and complementary feeding practices among refugees in the West-Nile region in Uganda. The aims of the study were to 1) determine the relationship of the intervention using the Care Group model on complementary feeding of infants, and 2) investigate the effects of a peer-led integrated nutrition education intervention using the Care Group model on growth among infants of refugees in Uganda.

Pregnant mothers (390) in their 3rd trimester were enrolled in a peer-led nutrition education intervention using the Care Group model. One treatment arm had moms only in the Care Groups while the other treatment arm had both moms and dads in the groups. Each study arm had a total of 10 Care Groups with 10-20 participants each. The control arm equally had 10 groups, however, did not receive the intervention. Each of the treatment arms participated in a biweekly integrated nutrition training hypothesized to effect behavioral change in infant feeding practices. The biweekly training started in March 2022 and ended in December 2022 with data collection at four-time points during the study (baseline, midline-I, II, and endline). Infant complementary feeding was evaluated using the World Health Organization \& UNICEF guidelines. Infant growth was assessed using length-for-age z-scores, weight-for-age z-scores and weight-for-length z-scores. The Medical Outcomes Study (MOS) Social Support Index was used as a proxy to measure maternal social support. Effects of Care Group intervention on infant complementary feeding and growth were tested by study arm compared to the control arm.

Conditions

• Infant Malnutrition

Interventions

BEHAVIORAL

Peer-led integrated nutrition education intervention delivered through Care Groups

The intervention comprised a peer-led integrated nutrition education training using the Care Group model developed by the TOPS program \[13\]. In the treatment arms, topics trained in the peer support groups included 1) group dynamics and social support, 2) infant feeding 3) adequate basic hygiene, 4) child growth and development, and 5) fathers' involvement. The training modules were adopted and modified from the community health extension workers (CHEWs) handbook \[14\] and the UNICEF IYCF counseling cards for community workers \[15, 16\]. Over the study, the intervention participants also engaged in cooking demonstrations targeting infant complementary foods preparation and backyard kitchen gardening.

Sponsors & Collaborators

• Lutheran World Federation

  collaborator UNKNOWN

• Makerere University

  collaborator OTHER

• Nestlé Foundation for the Study of Problems of Nutrition in the World

  collaborator UNKNOWN

• Oklahoma State University

  lead OTHER

Principal Investigators

• Joel J Komakech, Ph.D. · Oklahoma State University

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

15 Years

Max Age

49 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2020-01-09

Primary Completion

2020-12-21

Completion

2020-12-21

Countries

• Uganda

Study Locations