The double task of preventing malnutrition and overweight: a quasi-experimental community-based trial

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dc.contributor.author Navarro, Jose I. [UNIFESP]
dc.contributor.author Sigulem, Dirce Maria [UNIFESP]
dc.contributor.author Ferraro, Alexandre A.
dc.contributor.author Polanco, Juan J.
dc.contributor.author Barros, Aluisio J. D.
dc.date.accessioned 2016-01-24T14:31:24Z
dc.date.available 2016-01-24T14:31:24Z
dc.date.issued 2013-03-09
dc.identifier http://dx.doi.org/10.1186/1471-2458-13-212
dc.identifier.citation Bmc Public Health. London: Biomed Central Ltd, v. 13, 12 p., 2013.
dc.identifier.issn 1471-2458
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/36083
dc.description.abstract Background: the Maternal-Child Pastoral is a volunteer-based community organization of the Dominican Republic that works with families to improve child survival and development. A program that promotes key practices of maternal and child care through meetings with pregnant women and home visits to promote child growth and development was designed and implemented. This study aims to evaluate the impact of the program on nutritional status indicators of children in the first two years of age.Methods: A quasi-experimental design was used, with groups paired according to a socioeconomic index, comparing eight geographical areas of intervention with eight control areas. the intervention was carried out by lay health volunteers. Mothers in the intervention areas received home visits each month and participated in a group activity held biweekly during pregnancy and monthly after birth. the primary outcomes were length and body mass index for age. Statistical analyses were based on linear and logistic regression models.Results: 196 children in the intervention group and 263 in the control group were evaluated. the intervention did not show statistically significant effects on length, but point estimates found were in the desired direction: mean difference 0.21 (95%CI -0.02; 0.44) for length-for-age Z-score and OR 0.50 (95%CI 0.22; 1.10) for stunting. Significant reductions of BMI-for-age Z-score (-0.31, 95%CI -0.49; -0.12) and of BMI-for-age > 85th percentile (0.43, 95%CI 0.23; 0.77) were observed. the intervention showed positive effects in some indicators of intermediary factors such as growth monitoring, health promotion activities, micronutrient supplementation, exclusive breastfeeding and complementary feeding.Conclusions: Despite finding effect measures pointing to effects in the desired direction related to malnutrition, we could only detect a reduction in the risk of overweight attributable to the intervention. the findings related to obesity prevention may be of interest in the context of the nutritional transition. Given the size of this study, the results are encouraging and we believe a larger study is warranted. en
dc.description.sponsorship United Nations Children's Fund (UNICEF)
dc.description.sponsorship Ministry of Public Health of the Dominican Republic
dc.description.sponsorship partnership Action for Family Health (Catholic Medical Mission Board)
dc.description.sponsorship partnership Action for Family Health (Pan-American Health Organization (PAHO/WHO))
dc.description.sponsorship partnership Action for Family Health (Brystol-Myers Squibb Foundation)
dc.format.extent 12
dc.language.iso eng
dc.publisher Biomed Central Ltd
dc.relation.ispartof Bmc Public Health
dc.rights Acesso aberto
dc.subject Malnutrition en
dc.subject Overweight en
dc.subject Obesity en
dc.subject Infant en
dc.subject Integrated management of childhood illness en
dc.subject Community health workers en
dc.subject Program evaluation en
dc.subject Nutritional transition en
dc.title The double task of preventing malnutrition and overweight: a quasi-experimental community-based trial en
dc.type Artigo
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Universidade de São Paulo (USP)
dc.contributor.institution Social & Demog Studies Ctr
dc.contributor.institution Univ Fed Pelotas
dc.description.affiliation Universidade Federal de São Paulo, Nutr Post Grad Program, São Paulo, Brazil
dc.description.affiliation Univ São Paulo, Sch Med, Dept Paediat, São Paulo, Brazil
dc.description.affiliation Social & Demog Studies Ctr, Santo Domingo, Dominican Rep
dc.description.affiliation Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Nutr Post Grad Program, São Paulo, Brazil
dc.identifier.file WOS000317766400001.pdf
dc.identifier.doi 10.1186/1471-2458-13-212
dc.description.source Web of Science
dc.identifier.wos WOS:000317766400001



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