The double task of preventing malnutrition and overweight: a quasi-experimental community-based trial

BMC Public Health

Aluísio JD Barros²  Juan J Polanco¹  Alexandre A Ferraro³  Dirce M Sigulem⁴  José I Navarro⁴ 

[1] Social and Demographic Studies Center, Santo Domingo, Dominican Republic;Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil;Paediatrics Department, Medical School of the University of São Paulo, São Paulo, SP, Brazil;Nutrition Post Graduation Program, Federal University of São Paulo, São Paulo, SP, Brazil

关键词: Nutritional transition;    Program evaluation;    Community health workers;    Integrated management of childhood illness;    Infant;    Obesity;    Overweight;    Malnutrition;   

Others  :  1162467
DOI  :  10.1186/1471-2458-13-212

 received in 2012-07-11, accepted in 2013-03-04,  发布年份 2013

【 摘 要 】

Background

The Maternal-Child Pastoral is a volunteer-based community organization of the Dominican Republic that works with families to improve child survival and development. A program that promotes key practices of maternal and child care through meetings with pregnant women and home visits to promote child growth and development was designed and implemented. This study aims to evaluate the impact of the program on nutritional status indicators of children in the first two years of age.

Methods

A quasi-experimental design was used, with groups paired according to a socioeconomic index, comparing eight geographical areas of intervention with eight control areas. The intervention was carried out by lay health volunteers. Mothers in the intervention areas received home visits each month and participated in a group activity held biweekly during pregnancy and monthly after birth. The primary outcomes were length and body mass index for age. Statistical analyses were based on linear and logistic regression models.

Results

196 children in the intervention group and 263 in the control group were evaluated. The intervention did not show statistically significant effects on length, but point estimates found were in the desired direction: mean difference 0.21 (95%CI −0.02; 0.44) for length-for-age Z-score and OR 0.50 (95%CI 0.22; 1.10) for stunting. Significant reductions of BMI-for-age Z-score (−0.31, 95%CI −0.49; -0.12) and of BMI-for-age > 85^th percentile (0.43, 95%CI 0.23; 0.77) were observed. The intervention showed positive effects in some indicators of intermediary factors such as growth monitoring, health promotion activities, micronutrient supplementation, exclusive breastfeeding and complementary feeding.

Conclusions

Despite finding effect measures pointing to effects in the desired direction related to malnutrition, we could only detect a reduction in the risk of overweight attributable to the intervention. The findings related to obesity prevention may be of interest in the context of the nutritional transition. Given the size of this study, the results are encouraging and we believe a larger study is warranted.

【 授权许可】

   
2013 Navarro et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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