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An mHealth voice messaging intervention to improve infant and young child feeding practices in Senegal.

ABSTRACT: Mobile health (mHealth) interventions have the potential to improve infant and young child feeding (IYCF) practices; however, gaps in the literature remain regarding their design, implementation, and effectiveness. The aims of this study were to design an mHealth voice messaging intervention delivered to mothers and fathers targeting IYCF practices and examine its implementation and impact in households with children 6-23 months in three rural villages in Senegal. We conducted focus groups (n = 6) to inform the intervention development. We then conducted a pilot study (n = 47 households) to examine the impact of the intervention on IYCF practices of children 6-23 months. Voice messages were sent to the children's mothers and fathers over a period of 4 weeks (two messages per week; eight messages in total), and 24-hr dietary recalls and food frequency questionnaires (FFQs) were conducted before and immediately after the implementation of the mHealth intervention to examine its impact on IYCF practices. Overall, three of the eight behaviours increased and one decreased. There was a significant increase in the number of children that consumed fish (60% vs. 94%; p = .008) as measured by the 24-hr recall after the completion of the intervention. We also found significantly higher frequency of egg (p = .026), fish (p = .004), and thick porridge (p = .002) consumption in the previous 7 days measured by the FFQ. Our findings suggest that voice messaging IYCF interventions in Senegal have the potential to improve IYCF behaviours among young children in the short term. Future research should entail scaling-up the intervention and examining its sustainability over the long-term.

SUBMITTER: Downs SM

PROVIDER: S-EPMC6860071 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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An mHealth voice messaging intervention to improve infant and young child feeding practices in Senegal.

Downs Shauna M SM Sackey Joachim J Kalaj Jozefina J Smith Stephen S Fanzo Jessica J

Maternal & child nutrition 20190523 4

Mobile health (mHealth) interventions have the potential to improve infant and young child feeding (IYCF) practices; however, gaps in the literature remain regarding their design, implementation, and effectiveness. The aims of this study were to design an mHealth voice messaging intervention delivered to mothers and fathers targeting IYCF practices and examine its implementation and impact in households with children 6-23 months in three rural villages in Senegal. We conducted focus groups (n = ...[more]

PMID: 30950190

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Project description:BACKGROUND: Face-to-face interviews by trained field workers are commonly used in household surveys. However, this data collection method is labor-intensive, time-consuming, expensive, prone to interviewer and recall bias and not easily scalable to increase sample representativeness. OBJECTIVE: To explore the feasibility of using text messaging to collect information on infant and young child feeding practice in rural China. METHODS: Our study was part of a clustered randomized controlled trial that recruited 591 mothers of children aged 12 to 29 months in rural China. We used the test-retest method: first we collected data through face-to-face interviews and then through text messages. We asked the same five questions on standard infant and young child feeding indicators for both methods and asked caregivers how they fed their children yesterday. We assessed the response rate of the text messaging method and compared data agreement of the two methods. FINDING: In the text messaging survey, the response rate for the first question and the completion rate were 56.5% and 48.7%, respectively. Data agreement between the two methods was excellent for whether the baby was breastfed yesterday (question 1) (kappa, ??=?0.81), moderate for the times of drinking infant formula, fresh milk or yoghurt yesterday (question 2) (intraclass correlation coefficient, ICC?=?0.46) and whether iron fortified food or iron supplement was consumed (question 3) (??=?0.44), and poor for 24-hour dietary recall (question 4) (ICC?=?0.13) and times of eating solid and semi-solid food yesterday (question 5) (ICC?=?0.06). There was no significant difference in data agreement between the two surveys at different time intervals. For infant and young child feeding indicators from both surveys, continued breastfeeding at 1 year (P?=?1.000), continued breastfeeding at 2 years (P?=?0.688) and minimum meal frequency (P?=?0.056) were not significantly different, whereas minimum dietary diversity, minimum accepted diet and consumption of iron-rich or iron fortified foods were significantly different (P?<?0.001). CONCLUSIONS: The response rate for our text messaging survey was moderate compared to response rate of other studies using text messaging method and the data agreement between the two methods varied for different survey questions and infant and young child feeding indicators. Future research is needed to increase the response rate and improve data validity of text messaging data collection.

Project description:ObjectiveIn Ethiopia, despite the implementation of several interventions to improve infant and young child feeding (IYCF) practices, no published studies have highlighted the most effective IYCF interventions in the country. This systematic review investigated the impacts of various interventions on IYCF in Ethiopia.Source of informationA systematic search was conducted on seven computerised bibliographic databases (Embase, ProQuest Central, Scopus, PsycINFO, Web of Science, MEDLINE/PubMed and CINAHL) to locate experimental or quasi-experimental studies published between the year 2000 and May 2021.Study eligibility criteriaInterventional studies that measured IYCF indicators (early initiation of breast feeding (EIBF), exclusive breast feeding (EBF), the introduction of complementary foods, minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet) as outcome variables were included.Study appraisal and synthesisAll included studies were examined for biases related to interventional studies (ie, selection bias, performance bias, attrition bias, detection bias and reporting bias). Author reports of effect size measures were used to narratively report the findings of each study.ResultsOf the 23 eligible studies, 14 studies were quasi-experimental and 9 studies were cluster randomised trials (CRTs). Eight quasi-experimental studies had a serious risk of bias, while two CRTs had a high risk of bias. Four studies for EBF and six studies for EIBF showed significant impacts of policy advocacy, health service strengthening, interpersonal communication, community mobilisation and mass media campaigns. Six studies for MDD and three studies for MMF indicated significant effects of community-level and health facility complementary feeding promotions on infants and young children. Interventions that delivered in combination increased the impacts in improving EIBF, MDD and MMF compared with a single intervention.ConclusionOur review showed that 12 out of 21 eligible studies that implemented in the form of community-level and health facility interventions improved EIBF, EBF, and/or MDD in Ethiopia.Protocol registration numberPROSPERO, CRD42020155519.

Project description:BACKGROUND:Interaction within mothers' social networks can theoretically diffuse messages from interventions and campaigns into norms and practices for infant and young child feeding (IYCF). OBJECTIVES:We hypothesized that mothers' social networks, diffusion of information, and social norms differed in intensive [intensive interpersonal counseling (IPC), community mobilization (CM), and mass media (MM)] compared with nonintensive (standard IPC and less-intensive CM and MM) intervention areas, were associated with IYCF practices, and partly explained practice improvement. METHODS:We conducted household surveys at endline in 2014 and follow-up in 2016 (n = ?2000 each round). We used multiple regression to test differences and changes in networks, diffusion, and norms within intervention areas. We analyzed paths from intervention exposure to IYCF practices through networks, diffusion, and norms. RESULTS:Mothers' networks were larger in intensive than in nonintensive areas in 2014 and increased in both areas over time [25-38 percentage points (pp)]. The prevalence of receipt of IYCF information was high, with no changes over time in intensive areas but an increase in nonintensive areas (8-16 pp). In both areas, more family members and health workers provided IYCF information over time. Sharing of information increased 17-23 pp in intensive and 11-41 pp in nonintensive areas over time. Perceived descriptive norms improved 8-16 pp in intensive and 17-28 pp in nonintensive areas. Perceived injunctive norms were high in both areas. Breastfeeding practices were associated with networks, diffusion, and norms (OR: 1.6-4.4 times larger comparing highest with lowest quartile). Minimum dietary diversity was associated with larger networks and diffusion (OR: 1.5-2.2) but not with social norms. Indirect paths from intervention exposure to practices explained 34-78% of total effects. CONCLUSIONS:Diffusion of IYCF information through social networks, reinforced by positive social norms for messages promoted over time, will contribute to positive changes in IYCF practices that may be achieved and sustained through large-scale social and behavior change interventions. This trial was registered at clinicaltrials.gov as NCT0274084.

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An mHealth voice messaging intervention to improve infant and young child feeding practices in Senegal.

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An mHealth voice messaging intervention to improve infant and young child feeding practices in Senegal.

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