A Feasibility Study of Delivering Adolescent Nutrition Interventions Through School-Based Platforms in Ethiopia

NCT04121559 | Completed

• 1 other identifier: PHND-19-0949
• Study Type: interventional
• Target: 1,712
• Locations: 1 country
• Sites: 1

Brief Summary

Alive \& Thrive (A\&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Ethiopia, A\&T tested the feasibility of implementing a package of locally tailored adolescent nutrition interventions through school-based (flag assemblies, classroom lessons, girls' clubs, peer mentoring, weight and height measurement, and parent-teacher meetings) and community platforms (health post and home visits and community gatherings). The evaluation used a two-arm cluster-randomized, non-masked trial design, consisting of two cross-sectional surveys in 2019 and 2021.

Conditions

Dietary Diversity

Keywords

Adolescent Nutrition; Ethiopia

Outcome Measures

Primary Outcomes (2)

• Dietary diversity among adolescent girls

  Mean number of food groups consumed by adolescent girls on the day preceding the interview.

  Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021

• Minimum dietary diversity among adolescent girls

  Proportion of adolescent girls who consumed 5 or more food groups on the day preceding the interview.

  Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021

Secondary Outcomes (7)

• Meal frequency

  Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021

• Consumption of unhealthy foods

  Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021

• Exposure to nutrition interventions at school and in the community

  Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021

• Nutrition and handwashing knowledge and practices among adolescent girls and their parents

  Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021

• Nutrition and handwashing knowledge among school science teachers, principals, and HEWs

  Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021

Study Arms (2)

Intervention

EXPERIMENTAL

A\&T intervention areas: adolescent-nutrition-focused behavior change interventions delivered through government primary schools and communities

Behavioral: School Interventions; Behavioral: Community Interventions; Behavioral: School System Interventions

Control

NO INTERVENTION

Comparison areas: standard activities at government primary schools

Interventions

School Interventions BEHAVIORAL

1. Classroom lessons on nutrition, dietary diversity, healthy food choices and handwashing. 2. Principals provide messages on nutrition, dietary diversity, healthy food choices and handwashing at flag events or school assemblies. 3. Selected adolescent girls are mentored by science teachers as peer mentors and hold weekly group discussions with other girls to discuss nutrition, dietary diversity, healthy food choices and handwashing. 4. Trained science teachers take anthropometric measurements of adolescent girls to calculate BMI and provide nutrition counseling. 5. Parent-teacher meetings to inform and encourage parents about adolescent nutrition, dietary diversity, healthy snacks, and handwashing.

Intervention

Community Interventions BEHAVIORAL

1. Home visits by HEWs and/or community volunteers to discuss with parents about adolescent nutrition, dietary diversity, healthy food choices, and handwashing. 2. Community gatherings by HEWs and meetings with religious leaders to discuss with parents about adolescent nutrition, dietary diversity, healthy food choices, and handwashing.

Intervention

School System Interventions BEHAVIORAL

1. Workshop on the adolescent nutrition interventions for school principals, science teachers, HEWs, supervisors, and woreda officers. 2. Biweekly supportive supervision on adolescent nutrition activities for schools and HEWs by school supervisors or woreda health/education office.

Intervention

Eligibility Criteria

• Age: 10 Years - 14 Years
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Currently enrolled in primary school grades 4-8
• Parental consent and informed assent received
• Principals, teachers, service providers and primary schools in the areas

You may not qualify if:

• Age \<10 years or \>14 years

Sponsors & Collaborators

• International Food Policy Research Institute: lead
• Addis Continental Institute of Public Health: collaborator
• FHI 360: collaborator

Study Sites (1)

International Food Policy Research Institute

Washington D.C., District of Columbia, 20005, United States

Location

Related Publications (3)

• Das JK, Salam RA, Thornburg KL, Prentice AM, Campisi S, Lassi ZS, Koletzko B, Bhutta ZA. Nutrition in adolescents: physiology, metabolism, and nutritional needs. Ann N Y Acad Sci. 2017 Apr;1393(1):21-33. doi: 10.1111/nyas.13330.

  PMID: 28436102 BACKGROUND

• Spear BA. Adolescent growth and development. J Am Diet Assoc. 2002 Mar;102(3 Suppl):S23-9. doi: 10.1016/s0002-8223(02)90418-9. No abstract available.

  PMID: 11902385 BACKGROUND

• Kim SS, Sununtnasuk C, Berhane HY, Walissa TT, Oumer AA, Asrat YT, Sanghvi T, Frongillo EA, Menon P. Feasibility and impact of school-based nutrition education interventions on the diets of adolescent girls in Ethiopia: a non-masked, cluster-randomised, controlled trial. Lancet Child Adolesc Health. 2023 Oct;7(10):686-696. doi: 10.1016/S2352-4642(23)00168-2. Epub 2023 Sep 1.

  PMID: 37666262 DERIVED

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 8, 2019
• First Posted: October 10, 2019
• Study Start: October 8, 2019
• Primary Completion: April 29, 2021
• Study Completion: April 29, 2021
• Last Updated: March 10, 2022

Record last verified: 2022-02

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: Fully anonymized datasets will be made publicly available one year after the end of the project.

Locations

US (1)