Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India: study protocol for a cluster randomised controlled trial
Abstract Background Maternal and child undernutrition have adverse consequences for pregnancy outcomes and child morbidity and mortality, and they are associated with low educational attainment, economic productivity as an adult, and human wellbeing. ‘Nutrition-sensitive’ agriculture programs could...
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2018-03-01
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Online Access: | http://link.springer.com/article/10.1186/s13063-018-2521-y |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Suneetha Kadiyala Audrey Prost Helen Harris-Fry Meghan O’Hearn Ronali Pradhan Shibananth Pradhan Naba Kishore Mishra Suchitra Rath Nirmala Nair Shibanand Rath Prasantha Tripathy Sneha Krishnan Peggy Koniz-Booher Heather Danton Diana Elbourne Joanna Sturgess Emma Beaumont Hassan Haghparast-Bidgoli Jolene Skordis-Worrall Satyanarayan Mohanty Avinash Upadhay Elizabeth Allen |
spellingShingle |
Suneetha Kadiyala Audrey Prost Helen Harris-Fry Meghan O’Hearn Ronali Pradhan Shibananth Pradhan Naba Kishore Mishra Suchitra Rath Nirmala Nair Shibanand Rath Prasantha Tripathy Sneha Krishnan Peggy Koniz-Booher Heather Danton Diana Elbourne Joanna Sturgess Emma Beaumont Hassan Haghparast-Bidgoli Jolene Skordis-Worrall Satyanarayan Mohanty Avinash Upadhay Elizabeth Allen Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India: study protocol for a cluster randomised controlled trial Trials Maternal nutrition Child nutrition Dietary diversity Agricultural extension Women’s groups Participatory Learning and Action |
author_facet |
Suneetha Kadiyala Audrey Prost Helen Harris-Fry Meghan O’Hearn Ronali Pradhan Shibananth Pradhan Naba Kishore Mishra Suchitra Rath Nirmala Nair Shibanand Rath Prasantha Tripathy Sneha Krishnan Peggy Koniz-Booher Heather Danton Diana Elbourne Joanna Sturgess Emma Beaumont Hassan Haghparast-Bidgoli Jolene Skordis-Worrall Satyanarayan Mohanty Avinash Upadhay Elizabeth Allen |
author_sort |
Suneetha Kadiyala |
title |
Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India: study protocol for a cluster randomised controlled trial |
title_short |
Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India: study protocol for a cluster randomised controlled trial |
title_full |
Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India: study protocol for a cluster randomised controlled trial |
title_fullStr |
Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India: study protocol for a cluster randomised controlled trial |
title_full_unstemmed |
Upscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India: study protocol for a cluster randomised controlled trial |
title_sort |
upscaling participatory action and videos for agriculture and nutrition (upavan) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural odisha, india: study protocol for a cluster randomised controlled trial |
publisher |
BMC |
series |
Trials |
issn |
1745-6215 |
publishDate |
2018-03-01 |
description |
Abstract Background Maternal and child undernutrition have adverse consequences for pregnancy outcomes and child morbidity and mortality, and they are associated with low educational attainment, economic productivity as an adult, and human wellbeing. ‘Nutrition-sensitive’ agriculture programs could tackle the underlying causes of undernutrition. Methods/design This study is a four-arm cluster randomised controlled trial in Odisha, India. Interventions are as follows: (1) an agricultural extension platform of women’s groups viewing and discussing videos on nutrition-sensitive agriculture (NSA) practices, and follow-up visits to women at home to encourage the adoption of new practices shown in the videos; (2) women’s groups viewing and discussing videos on NSA and nutrition-specific practices, with follow-up visits; and (3) women’s groups viewing and discussing videos on NSA and nutrition-specific practices combined with a cycle of Participatory Learning and Action meetings, with follow-up visits. All arms, including the control, receive basic nutrition training from government community frontline workers. Primary outcomes, assessed at baseline and 32 months after the start of the interventions, are (1) percentage of children aged 6–23 months consuming ≥ 4 out of 7 food groups per day and (2) mean body mass index (BMI) (kg/m2) of non-pregnant, non-postpartum (gave birth > 42 days ago) mothers or female primary caregivers of children aged 0–23 months. Secondary outcomes are percentage of mothers consuming ≥ 5 out of 10 food groups per day and percentage of children’s weight-for-height z-score < -2 standard deviations (SD). The unit of randomisation is a cluster, defined as one or more villages with a combined minimum population of 800 residents. There are 37 clusters per arm, and outcomes will be assessed in an average of 32 eligible households per cluster. For randomisation, clusters are stratified by distance to nearest town (< 10 km or ≥ 10 km), and low (< 30%), medium (30–70%), or high (> 70%) proportion of Scheduled Tribe or Scheduled Caste (disadvantaged) households. A process evaluation will assess the quality of implementation and mechanisms behind the intervention effects. A cost-consequence analysis will compare incremental costs and outcomes of the interventions. Discussion This trial will contribute evidence on the impacts of NSA extension through participatory, low-cost, video-based approaches on maternal and child nutrition and on whether integration with nutrition-specific goals and enhanced participatory approaches can increase these impacts. Trial registration ISRCTN , ISRCTN65922679. Registered on 21 December 2016. |
topic |
Maternal nutrition Child nutrition Dietary diversity Agricultural extension Women’s groups Participatory Learning and Action |
url |
http://link.springer.com/article/10.1186/s13063-018-2521-y |
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doaj-10dbea6848464e26849f9b9178b659072020-11-24T21:32:29ZengBMCTrials1745-62152018-03-0119111610.1186/s13063-018-2521-yUpscaling Participatory Action and Videos for Agriculture and Nutrition (UPAVAN) trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India: study protocol for a cluster randomised controlled trialSuneetha Kadiyala0Audrey Prost1Helen Harris-Fry2Meghan O’Hearn3Ronali Pradhan4Shibananth Pradhan5Naba Kishore Mishra6Suchitra Rath7Nirmala Nair8Shibanand Rath9Prasantha Tripathy10Sneha Krishnan11Peggy Koniz-Booher12Heather Danton13Diana Elbourne14Joanna Sturgess15Emma Beaumont16Hassan Haghparast-Bidgoli17Jolene Skordis-Worrall18Satyanarayan Mohanty19Avinash Upadhay20Elizabeth Allen21London School of Hygiene & Tropical MedicineUniversity College London, Institute for Global HealthLondon School of Hygiene & Tropical MedicineDigital GreenDigital GreenVARRAT (Voluntary Association for Rural Reconstruction and Appropriate Technology)VARRAT (Voluntary Association for Rural Reconstruction and Appropriate Technology)EkjutEkjutEkjutEkjutLondon School of Hygiene & Tropical MedicineStrengthening Partnerships, Results, and Innovations in Nutrition Globally, JSI Research & Training Institute, Inc.Strengthening Partnerships, Results, and Innovations in Nutrition Globally, JSI Research & Training Institute, Inc.London School of Hygiene & Tropical MedicineLondon School of Hygiene & Tropical MedicineLondon School of Hygiene & Tropical MedicineUniversity College London, Institute for Global HealthUniversity College London, Institute for Global HealthDevelopment Corner Consulting Pvt. Ltd. (DCOR)Digital GreenLondon School of Hygiene & Tropical MedicineAbstract Background Maternal and child undernutrition have adverse consequences for pregnancy outcomes and child morbidity and mortality, and they are associated with low educational attainment, economic productivity as an adult, and human wellbeing. ‘Nutrition-sensitive’ agriculture programs could tackle the underlying causes of undernutrition. Methods/design This study is a four-arm cluster randomised controlled trial in Odisha, India. Interventions are as follows: (1) an agricultural extension platform of women’s groups viewing and discussing videos on nutrition-sensitive agriculture (NSA) practices, and follow-up visits to women at home to encourage the adoption of new practices shown in the videos; (2) women’s groups viewing and discussing videos on NSA and nutrition-specific practices, with follow-up visits; and (3) women’s groups viewing and discussing videos on NSA and nutrition-specific practices combined with a cycle of Participatory Learning and Action meetings, with follow-up visits. All arms, including the control, receive basic nutrition training from government community frontline workers. Primary outcomes, assessed at baseline and 32 months after the start of the interventions, are (1) percentage of children aged 6–23 months consuming ≥ 4 out of 7 food groups per day and (2) mean body mass index (BMI) (kg/m2) of non-pregnant, non-postpartum (gave birth > 42 days ago) mothers or female primary caregivers of children aged 0–23 months. Secondary outcomes are percentage of mothers consuming ≥ 5 out of 10 food groups per day and percentage of children’s weight-for-height z-score < -2 standard deviations (SD). The unit of randomisation is a cluster, defined as one or more villages with a combined minimum population of 800 residents. There are 37 clusters per arm, and outcomes will be assessed in an average of 32 eligible households per cluster. For randomisation, clusters are stratified by distance to nearest town (< 10 km or ≥ 10 km), and low (< 30%), medium (30–70%), or high (> 70%) proportion of Scheduled Tribe or Scheduled Caste (disadvantaged) households. A process evaluation will assess the quality of implementation and mechanisms behind the intervention effects. A cost-consequence analysis will compare incremental costs and outcomes of the interventions. Discussion This trial will contribute evidence on the impacts of NSA extension through participatory, low-cost, video-based approaches on maternal and child nutrition and on whether integration with nutrition-specific goals and enhanced participatory approaches can increase these impacts. Trial registration ISRCTN , ISRCTN65922679. Registered on 21 December 2016.http://link.springer.com/article/10.1186/s13063-018-2521-yMaternal nutritionChild nutritionDietary diversityAgricultural extensionWomen’s groupsParticipatory Learning and Action |