Evaluating a Family-based Nutrition and Garden Intervention in Rural Guatemala

Not Applicable

Completed

Brief Summary: This is a pilot quasi-experimental study to evaluate the impact of adding a family garden intervention to an existing wrap-around nutrition intervention for children with chronic malnutrition and their family. The existing nutrition intervention is provided by community health workers affiliated with Wuqu' Kawoq \| Maya Health Alliance. A single community in rural Guatemala will participate in the intervention, with the goal to recruit approximately 70 families in the combined nutrition/garden intervention. A nearby community, also participating in the nutrition intervention, will serve as a nonrandom contemporaneous control.

Aims of the study include:

1. Evaluate the impact of the garden intervention on maternal and child dietary diversity, child growth and household food insecurity.

2. Use the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework to conduct a preliminary implementation analysis, to guide a future, well-controlled study.

Recruitment & Eligibility

Inclusion Criteria

Children who are already scheduled to be enrolled in Maya Health Alliance's intensive home-based nutrition program (non-investigational, standard of care) who are 6-24 months of age at the time of enrollment with a height-for-age Z scores of <= -2.5
At least one caregiver willing to provide written informed consent
Caregiver of a child enrolled in the study (for caregiver/head of household outcomes), including women who may be pregnant
Planned residence in the study area for the next 18 months

Exclusion Criteria

Children with acute malnutrition (weight for length Z scores of <= -2.0)
Children with a severe medical illness that affects growth (e.g., heart disease, kidney disease, genetic condition) as determined by a Maya Health Alliance staff physician.
Caregivers with cognitive impairments that prevent them from being able to provide informed consent

Primary Outcome Measures

Name	Time	Method
Change From Baseline in Mean Number of Food Groups Consumed Per Day at 6 Months - Child	Baseline, 6 months	Calculated from the World Health Organization Infant and Young Child Feeding Indicators 24 hour diet recall tool
Change From Baseline in Mean Number of Food Groups Consumed Per Day at 6 Months - Female Head of Household	Baseline, 6 months	Calculated from the Food and Agriculture Organization's Minimum Dietary Diversity for Women dietary recall
Change From Baseline in Raw Household Food Insecurity Score at 6 Months	Baseline, 6 months	Standardized food insecurity score, using the Food and Agriculture Organization's Global Food Insecurity Experience Scale (possible score range 0-8), higher scores indicate more food insecurity
Change From Baseline in Mean Number of Solid Meals Consumed Per Day at 6 Months - Child	Baseline, 6 months	Calculated from the World Health Organization Infant and Young Child Feeding Indicators 24 hour diet recall tool

Secondary Outcome Measures

Name	Time	Method
Change in Weight for Height/Length Z Score From Baseline to 6 Months	Baseline, 6 months	These are differences from 0 to 6 months (baseline to 6 months of intervention) z-scores calculated against the World Health Organization pediatric growth reference population (https://www.who.int/tools/child-growth-standards/standards)
Mean Change in Household Crop Species From Baseline to 6 Months Diversity Score	Baseline, 6 months	Raw count of total crop species cultivated in the home
Change in Height/Length for Age Z Score From Baseline to 6 Months	0 months (baseline), 6 months	These are differences from 0 to 6 months (baseline to 6 months of intervention) z-scores calculated against the World Health Organization pediatric growth reference population (https://www.who.int/tools/child-growth-standards/standards)
Change in Weight for Age Z Score From Baseline to 6 Months	0 months (Baseline), 6 months	These are differences from 0 to 6 months (baseline to 6 months of intervention) z-scores calculated against the World Health Organization pediatric growth reference population (https://www.who.int/tools/child-growth-standards/standards)