The Effect of Guided Counseling in Improving Dietary Practice, Nutritional Status and Birth Weight of Pregnant Women in West Gojjam Zone, Amhara Region, Ethiopia: A Cluster Randomized Controlled Community Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 712
- 试验地点
- 1
- 主要终点
- Dietary practice (dietary intake)
研究概览
简要总结
Poor dietary intake affects maternal wellbeing, fetal growth, and development. However, many pregnant women in Ethiopia have poor dietary intake. To improve the dietary intake of pregnant women, nutrition education is often given at the community level during a home visit and at the health institution during antenatal care. Yet, there is no evidence on the effect of nutrition education on dietary intake, nutritional status, and birth weight in the study area. Hence, the objective of this study was to evaluate the effect of guided counseling in improving dietary practice, nutritional status and birth weight of pregnant women.
A two-arm parallel cluster randomized community trial was conducted among pregnant women in West Gojjam Zone, Amhara region, Ethiopia from May 2019 to May 2019. Baseline data on dietary practice and nutritional status of pregnant women were collected from May to August 2018 (13weeks). Endline data were collected from October 2018 to May 2019. Guided counseling using the health belief model and theory of planned behavior was given in the intervention arm (11 clusters) for 10 months.
Pregnant women were selected using a cluster sampling method. A validated interviewer-administered structured questionnaire was used for collecting data on the study subjects both at the baseline and after the intervention. Data were checked, coded and double entered into Epi-Info version 7.2.2 and exported to SPSS version 23 for statistical analysis. The outcome of the study finding could be useful for health and nutrition policymakers and other concerned bodies in decision making and to design effective intervention strategies to improve dietary practices of pregnant women as a result to prevent malnutrition. 19,553 US dollar was needed to conduct the study.
详细描述
In the developed countries, pregnant women take relatively adequate and diversified food while pregnant women in the developing countries consume inadequate amount and less diversified diet with very low energy, folate, iron, zinc, and vitamin A content. But, Asian and African pregnant women took more cereals with a small amount of animal products, vegetables, and fruits.
Similarly, the dietary practice of Ethiopian pregnant women has long been an issue of public health concern since almost all pregnant women take inadequate amount of poor quality diet. Their energy and nutrient intake was below the recommended average requirement. In the country, food taboos are highly prevalent; nonetheless, there is a variation on the type of food considered as taboo and the possible reason for food taboo within the country.
In spite of increasing nutrient demand with increasing gestational age, from the literature trend of dietary change was different from country to country and within the country. Pregnant women in developed countries improve their dietary practices with increasing gestational age. However, pregnant women in developing countries experienced "eating down".
Women who had inadequate dietary intake during pregnancy were more likely to develop under-nourishment compared with their counterparts. Under-nourishment in turn associated with intrauterine growth retardation (IUGR), low birth weight (LBW) and premature delivery.
Not only inadequate intake but also excessive consumption of energy-dense foods associated with increases the risk of adverse pregnancy outcomes such as preeclampsia, gestational diabetes mellitus, hemorrhage, cesarean-section delivery, infection, birth trauma, macrosomic infant, delay or failure to lactate, postpartum weight retention.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
outcome assessors are not informed about the intervention and the group to which the intervention is assigned to avoid social desirability bias
入排标准
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •<16weeks of gestation
- •living in the Kebele at least for six months
- •has planned to give birth in the study area.
- •Exclusion criteria:
- •Diabetes millitus
- •Hypertension
排除标准
- 未提供
研究组 & 干预措施
Intervention
Intervention Arm is an arm to which community-based guided counseling using Health Belief Model and Theory of Planned Behavior will be given.
干预措施: guided counseling (Behavioral)
Control
Control Arm is an arm to which the intervention will not be implemented.
结局指标
主要结局
Dietary practice (dietary intake)
时间窗: 10 month of intervention
Improve dietary practice after intervention. Taking more than three meals daily plus the highest tercile of women's dietary diversity score from nine food groups plus the highest tercile of animal source food consumption plus food variety score above the mean
次要结局
- nutritional status(10 months of intervention)
- Birth weight(10 month of intervention)
- Dietary practice(10 weeks (baseline))
研究者
Yeshalem Mulugeta Demilew
Assistant professor
Bahir Dar University