Dataset Information

Peer Counseling Promotes Appropriate Infant Feeding Practices and Improves Infant Growth and Development in an Urban Slum in Bangladesh: A Community-Based Cluster Randomized Controlled Trial.

ABSTRACT:

Background

Undernutrition and poor cognitive development affect many children in developing countries. Good nutrition and health care are essential for optimal child development and growth.

Objectives

We assessed the impact of peer counseling combined with psychosocial stimulation on feeding practices and child growth and development in slums in Bangladesh.

Methods

We performed a community-based cluster randomized controlled trial in selected slums; 350 mother-infant pairs were allocated to receive peer counseling on feeding practices plus psychosocial stimulation (PC + PCS; n = 175) or usual health messages (control; n = 175) using restricted randomization. Data were collected at enrollment and 1, 3, 5, 7, 9, and 12 mo after delivery. We collected data on infant and young child feeding practices and anthropometric measurements from birth until 12 mo to assess the main outcomes, including feeding practices and growth. We used the Bayley Scale III at 12 mo to assess child development. The effects of the PC + PCS intervention were assessed by using regression models.

Results

More mothers in the PC + PCS group than in the control group reported early initiation of breastfeeding (in the first hour: 89% compared with 78%, respectively; P < 0.05) and exclusive breastfeeding at 5 mo (73% compared with 27%, respectively; P < 0.001). Peer counseling had positively impacted infant length gain at 12 mo (P < 0.005). Children in the PC + PCS group were found to be more socially and emotionally active compared with controls at 12 mo (standardized score: 0.165 compared with -0.219, respectively; P < 0.05).

Conclusion

Combining peer counseling with psychosocial stimulation had positive effects on infant feeding practices and growth at 12 mo and on the social-emotional development of young children. This trial was registered at clinicaltrial.gov as NCT03040375.

SUBMITTER: Ara G

PROVIDER: S-EPMC6635820 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Peer Counseling Promotes Appropriate Infant Feeding Practices and Improves Infant Growth and Development in an Urban Slum in Bangladesh: A Community-Based Cluster Randomized Controlled Trial.

Ara Gulshan G Khanam Mansura M Papri Nowshin N Nahar Baitun B Kabir Iqbal I Sanin Kazi Istiaque KI Khan Sihan Sadat SS Sarker Md Shafiqul Alam MSA Dibley Michael J MJ

Current developments in nutrition 20190618 7

<h4>Background</h4>Undernutrition and poor cognitive development affect many children in developing countries. Good nutrition and health care are essential for optimal child development and growth.<h4>Objectives</h4>We assessed the impact of peer counseling combined with psychosocial stimulation on feeding practices and child growth and development in slums in Bangladesh.<h4>Methods</h4>We performed a community-based cluster randomized controlled trial in selected slums; 350 mother-infant pairs ...[more]

PMID: 31334480

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Project description:BackgroundThe aim of this study is to assess if peer counseling of women improves breastfeeding, complementary feeding practices, and child growth, and thus reduces the prevalence of undernutrition in children up to 4 years of age.ObjectiveLack of exclusive breastfeeding and inappropriate complementary feeding are critical factors in reducing child undernutrition, morbidity, and mortality. There are reported trials of peer counseling to improve breastfeeding; however, they did not examine the efficacy of peer counseling to improve complementary feeding or the long-term impacts on child growth and development.MethodsThis study has used a community-based, cluster-randomized controlled trial with a superiority design and 2 parallel treatment arms. It is assessing the impact of peer counseling, starting in late pregnancy up to 1 year after delivery, on child feeding practices, growth, and development with follow-up until 48 months of age. The study site was Mirpur, a densely populated area in Dhaka. Using satellite maps and geographic information system mapping, we constructed 36 clusters with an average population of 5000 people. We recruited pregnant women in the third trimester aged 16-40 years, with no more than 3 living children. Trained peer counselors visited women at home twice before delivery, 4 times in the first month, monthly from 2 to 6 months, and again at 9 and 12 months. Trained research assistants collected anthropometric measurements. The primary outcome will be differences in child stunting and mean length for age at 6, 12, 15, and 18 months. Secondary outcomes will be differences in the percentage of women exclusively breastfeeding in the mean duration of any breastfeeding and in the percentage of children at 6 and 9 months of age who receive solid, semisolid, or soft foods; and the percentage of children consuming foods from 4 or more food groups at 9, 12, 15, and 18 months. We will assess the mean cognitive function scores from the Ages and Stages Questionnaire (9 and 18 months) and Bayley tests (24 and 36 months).ResultsWe identified 65,535 people in mapped residences, from which we defined 36 clusters and randomly allocated them equally to intervention or control groups stratified by cluster socioeconomic status. From July 2011 to May 2013, we identified 1056 pregnant women and 993 births in the intervention group and 994 pregnancies and 890 births in the control group. At 18 months, 692 children remained in the intervention group and 551 in the control group. From January 2015 to February 2017, we conducted the long-term follow-up of the cohort. We have now completed the data collection and processing and have started analyses.ConclusionsThis study will help fill the evidence gap about the short- and long-term impact of peer counseling on improving infant feeding, preventing childhood undernutrition, and enhancing child cognitive development.Trial registrationClinicalTrials.gov NCT01333995; https://clinicaltrials.gov/ct2/show/NCT01333995.International registered report identifier (irrid)DERR1-10.2196/31475.

Project description:BackgroundThis study explores the impact of HIV/AIDS on urban slum dwellers in Dhaka, Bangladesh, addressing unique socio-economic challenges and limited health resources. Despite low overall prevalence, gender inequalities, economic disparities, and awareness gaps persist. The aim is to assess HIV/AIDS-related knowledge, attitudes, and practices among this population, informing targeted interventions.MethodsA cross-sectional survey was conducted using face-to-face interviews in Dhaka's slum areas between October and November 2023. The sample size was calculated as 453 participants through non-probability (convenient sampling) sampling. A structured questionnaire in Bengali assessed socio-demographic factors, HIV/AIDS-related knowledge, attitudes, and prevention practices. Data were analysed using descriptive statistics, bivariate, and multivariable linear regression by SPSS (version 26) and STATA (version 14).ResultsUrban slum dwellers exhibited limited average HIV/AIDS knowledge of 33.00%, favouring males. Positive association was found between daily physical exercise and knowledge, while insufficient sleep and lack of social media access were negative predictors. Average attitudes were generally positive (81.06%), influenced by factors such as gender, employment status, family history of STDs, and daily physical exercise. The average score of prevention practices was 60.6%, with positive predictors including male gender, cooperative family members, STD history, family history of STDs, acquaintance with HIV patients, and social media usage over 2 h. Younger age was negatively associated with prevention practices.ConclusionThis study pinpoints factors influencing HIV/AIDS knowledge and behaviours in Bangladeshi urban slum dwellers. Tailored interventions focusing on gender, and social media can enhance preventive measures. Acknowledging limitations, the study urges cautious interpretation due to potential biases in convenience sampling and self-reporting.

Project description:BackgroundInteraction within mothers' social networks can theoretically diffuse messages from interventions and campaigns into norms and practices for infant and young child feeding (IYCF).ObjectivesWe 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.MethodsWe 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.ResultsMothers' 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.ConclusionsDiffusion 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.

Dataset Information

Peer Counseling Promotes Appropriate Infant Feeding Practices and Improves Infant Growth and Development in an Urban Slum in Bangladesh: A Community-Based Cluster Randomized Controlled Trial.

Background

Objectives

Methods

Results

Conclusion

Publications

Peer Counseling Promotes Appropriate Infant Feeding Practices and Improves Infant Growth and Development in an Urban Slum in Bangladesh: A Community-Based Cluster Randomized Controlled Trial.

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