A Mixed Methods Study on How Urban Slum Food Environments Influence Caregivers' Feeding Practices for Children Under Five Years in Pune, India

NCT07146477 | Not Yet Recruiting

• 1 other identifier: MCH-FEFC-2025-07
• Study Type: observational
• Target: 370
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this observational study is to examine how urban slum food environments influence caregivers' feeding practices for children under five years of age in Pune. The main questions it aims to answer are:

• What are the characteristics of the food environment in selected slums of Pune using the 5 A's framework: availability, accessibility, affordability, acceptability, and accommodation?
• What are caregivers' perceptions of food safety, food prestige, and convenience as additional drivers of food choice within the slum context?
• Are caregivers' aware, and have understanding about the use of packaged food labels, especially in relation to identifying foods for young children?
• How do the local food environment and food choice (FEFC) drivers interact to influence caregivers' feeding practices, with a particular focus on the consumption of unhealthy foods and sugar-sweetened beverages among children under five years of age? Participants will be interviewed using digital forms to assess their food environment and food choice drivers. Anthropometric measurements of all children under five years of age in the household will be taken.

Conditions

Feeding Practices; Food Choices; Maternal and Child Health

Keywords

Food Choice Drivers; Food Environment; Urban Slums; India; Family; Infant Feeding

Outcome Measures

Primary Outcomes (7)

• Percentage food items in each of the 28 food groups available in each of the 4 study locations

  Food Availability in each study location will be assessed as the percentage food items available for purchase in each of the 28 food groups. The Food Outlet Census (https://sites.rutgers.edu/food-environment-toolbox/community-food-environment-mapping-food-outlet-census/) tool is being used to collect data on the foods available but the tool does not have any specific scoring criteria.

  An average of 1 year

• Percentage of families in each study location who can afford to buy a healthy diet

  Food Affordability of families will be assessed as the percentage of families who can afford a healthy diet. For this purpose then investigators will calculate Cost of a Healthy Diet (CoHD) using the tool available from Tufts University: https://sites.tufts.edu/foodpricesfornutrition/tools/. Per capita income of each household will also be calculated. These two parameters will help the investigators calculate the percentage of families in each location who can afford a healthy diet.

  An average of 1 Year

• Percentage of food items considered convenient by households in each location

  Convenience will be assessed as percentage of food items in each of the 28 food groups which participants consider convenient because their ease of storage, low perishability, ease of preparation.

  An average of 1 year

• Gender and Family Role of the primary food-related decision maker

  The gender and family role of primary food-related decision maker will be assessed as percentages and illustrated using pie-charts

  An average of 1 year

• Percentage of participants concerned with food safety

  Percentage of participants worried of safety of food due to poor hygiene or use of pesticides will be asessed

  An average of 1 year

• Percentage of households with label awareness

  The percentage of households who were aware of food labeling (read labels, knew where the label was located) will be assessed

  An average of 1 year

• Correlation of food environment characteristics with infant and young child feeding practices

  The correlation of different food environment characteristics such as accessibility, availability, affordability, with infant and young child feeding indicators such as ultra-processed food consumption, zero fruit and vegetable consumption

  An average of 1 year

Secondary Outcomes (2)

• Number and types of food outlets in the study location

  An average of 1 year

• Type of foods being promoted in the study locations

  An average of 1 year

Study Arms (2)

Family or Household

Family or Households (n = 250) include all the members residing in one house sharing food and other amenities and who have children under 5 years of age.

Food Vendors

Food Vendors (n = 120) who operate in the 500 m radius of the household cluster will be interviewed in depth to characterize the type of foods sold so that the food environment of the family can be characterized.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

1. The study population will consist of Infant and young child caregivers living in slums who have a child or children less than five years of age and had enrolled in an earlier study to assess utilization of maternal healthcare services in these slums. 2. Food vendors (stores, mobile informal vendors and hawkers, and restaurants) who function in the 500 m radius of the household.

You may qualify if:

• For Family Units:
• Families who had participated in the previous house-to-house survey to determine maternal healthcare utilization and infant and young child feeding practices.
• Families where all the female caregivers are willing to participate.
• For Food Vendors:
• Food vendors who regularly carry out business in the 500 m radius of the household.
• Willingness to participate in the study.

You may not qualify if:

• \. Families who were a part of the earlier project but have moved out of the survey area.

Sponsors & Collaborators

• Hirabai Cowasji Jehangir Medical Research Institute: lead

Study Sites (1)

Hirabai Cowasji Jehangir Medical Research Institute

Pune, Maharashtra, 411001, India

Location

Central Study Contacts

Anuradha V Khadilkar

CONTACT

9120+26057004; anuradhavkhadilkar@gmail.com

Rubina M Mandlik

CONTACT

9120+26057004; rubymandlik@hotmail.com

Study Design

• Study Type: observational
• Observational Model: FAMILY BASED
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Deputy Director

Study Record Dates

• First Submitted: August 16, 2025
• First Posted: August 28, 2025
• Study Start: September 29, 2025
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2027
• Last Updated: September 24, 2025

Record last verified: 2025-09

Locations

IN (1)