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• W2953444013 abstract "Most growth faltering in developing countries occurs in the first two years of life; therefore, there is a need to identify interventions for vulnerable communities which improve child growth during this critical period. The purpose of this research was to evaluate the effectiveness of a community-based Positive Deviance (PD)/hearth infant and young child feeding intervention to improve growth and nutrition in infants and young children in the Ecuadorian highlands. The first study was with experiences of mothers in rural communities in the Ecuadorian Andes who had previously (2008) participated in a PD/hearth intervention (n=168). Infant and young child feeding practices and predictors of stunting in the Ecuadorian highlands communities were assessed to guide the development of the 2009 intervention. In this cold environment with limited health infrastructure, it was necessary to develop a procedure for adjusting anthropometric measures for clothing weight of infants and young children (n=293). This study used a quasi-experimental non-randomized study design to compare growth and diet of infants and young children in six intervention communities (n=80) to those in nine non-intervention communities (n=184). Intervention mothers and their children participated in a 12-day PD/hearth nutrition intervention. Demographic, nutritional, and anthropometric data were collected at baseline and at six months follow-up. The results were as follows. 1) Mothers credited the 2008 intervention with increasing self-esteem and social support, yet greater importance was placed on social changes than on growth. 2) Stunting was found in 56.2% of the study population at baseline. Older age, respiratory infections, and being male were predictors of lower height-for-age z-score (HAZ), whereas early initiation of breastfeeding, higher socioeconomic status, consumption of iron-rich foods, and higher dietary protein density were protective. 3) Modeling showed that without adjusting for clothing weight 24% of children were misclassified for weight-for-age z-score (WAZ), and 13% for weight-for-height z-score (WHZ). 4) Six months after the 2009 intervention, participants were 1.6 to 5.7 times more likely than comparison children to consume the foods promoted in the intervention. Intervention children consumed more iron, zinc, vitamin A, protein, and energy (p < 0.05). Compared to non-intervention children, intervention children had greater improvement in WAZ (β=0.16; 95% CI: 0.01, 0.32), but not HAZ (β= 0.00; 95% CI: -0.21, 0.17). The intervention was beneficial in eliminating the risk of severe underweight (OR=0.00; 95% CI: 0.00, 0.08). In rural Ecuador, mothers improved their children's diet and weight with peer support, indigenous knowledge, and local foods. Supporting mothers' groups through community PD/hearth nutrition interventions is an effective way to reduce the global burden of underweight in infants and young children.%%%%La majorite des problemes de croissance dans les pays en developpement ont lieu au cours des deux premieres…" @default.
• W2953444013 created "2019-07-12" @default.
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• W2953444013 date "2011-01-01" @default.
• W2953444013 modified "2023-09-27" @default.
• W2953444013 title "A community-based positive deviance/hearth intervention to improve infant and young child nutrition in the Ecuadorian Andes" @default.
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