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Evans WD, Gerard R, Symington L, Shaikh H, Agha S. Implementation practice models for development in low- and middle-income countries: systematic review of peer-reviewed literature. BMC Public Health 2022; 22:1157. [PMID: 35681165 PMCID: PMC9181891 DOI: 10.1186/s12889-022-13530-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 05/18/2022] [Indexed: 02/08/2023] Open
Abstract
Introduction This study operationally defines a relatively small, but growing field of study on implementation practice models for health behavior change in the context of international development. We define ‘implementation practice models’ as theoretical models that take a practical and practitioner-focused approach to behavior change, and we illustrate how these models have been developed and applied. The paper examines the continuum of behavioral theories and their application in the context of development programs and research in low- and middle-income countries (LMICs). We describe implementation practice models, examine how they have been used to design and evaluate theory-based interventions in LMIC, and describe the state of evidence in this field of study. Methods The authors conducted a systematic search of the published, peer-reviewed literature following the widely accepted PRISMA methods for systematic reviews. We aimed to identify all relevant manuscripts published in the English language in health, social science, and business literature that apply implementation practice models, located in an LMIC, with a behavior change objective. We located 1,078 articles through database searching and 106 through other means. Ultimately, we identified 25 relevant articles for inclusion. Results We found that the peer-reviewed literature on implementation practice models for development has been growing in recent years, with 80% of reviewed papers published since 2015. There was a wide range of different models revealed by this review but none demonstrated clear-cut evidence of being most effective. However, the models found in this review share common characteristics of focusing on the three central tenets of Opportunity, Ability, and Motivation (OAM). Conclusions This review found that implementation practice models for development are a promising and growing approach to behavior change in LMICs. Intervention practice models research should be expanded and applied in new domains, such as vaccination.
Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13530-0.
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Affiliation(s)
- William Douglas Evans
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Washington, DC, NW, 20037, USA.
| | - Raquel Gerard
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Washington, DC, NW, 20037, USA
| | | | - Hina Shaikh
- Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, Washington, DC, NW, 20037, USA
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Martin SL, McCann JK, Gascoigne E, Allotey D, Fundira D, Dickin KL. Engaging family members in maternal, infant and young child nutrition activities in low- and middle-income countries: A systematic scoping review. MATERNAL & CHILD NUTRITION 2021; 17 Suppl 1:e13158. [PMID: 34241961 PMCID: PMC8269148 DOI: 10.1111/mcn.13158] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 01/06/2021] [Accepted: 01/12/2021] [Indexed: 12/20/2022]
Abstract
The influence of fathers, grandmothers and other family members on maternal, infant and young child nutrition practices has been well documented for decades, yet many social and behavioural interventions continue to reach only mothers. While recent guidelines recommend involving fathers, grandmothers and other family members in maternal and child nutrition, we lack a comprehensive review of interventions that have engaged them. This scoping review aimed to address this gap by describing social and behavioural interventions to engage family members in maternal and child nutrition in low- and middle-income countries. We systematically searched PubMed, Scopus, Web of Science, Global Health and CINAHL for peer-reviewed studies meeting inclusion criteria. We screened 6,570 abstracts, evaluated 179 full-text articles, and included 87 articles from 63 studies. Studies reported a broad range of approaches to engage fathers, grandmothers and other family members to support maternal nutrition (n = 6); breastfeeding (n = 32); complementary feeding (n = 6) and multiple maternal and child nutrition practices (n = 19). Interventions were facility and community based; included individual and group-based interpersonal communication, community mobilization, mass media and mHealth; and reached mothers and family members together or separately. Most interventions were located within the health sector; rare exceptions included nutrition-sensitive agriculture, social protection, early child development and community development interventions. Few interventions addressed gender norms, decision-making, and family dynamics or described formative research or theories informing intervention design. These diverse studies can shed light on innovative programme approaches to increase family support for maternal and child nutrition.
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Affiliation(s)
- Stephanie L. Martin
- Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Juliet K. McCann
- Program in International Nutrition, Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | - Emily Gascoigne
- Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Diana Allotey
- Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Dadirai Fundira
- Program in International Nutrition, Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | - Katherine L. Dickin
- Program in International Nutrition, Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
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Mothers' perceptions on and learning from infant and young child-feeding videos displayed in Mother and Child Health Centers in Kenya: a qualitative and quantitative approach. Public Health Nutr 2021; 24:3845-3858. [PMID: 34034846 DOI: 10.1017/s1368980021002342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective was to explore mothers’ perceptions on educational videos on infant and young child-feeding practices, and to assess whether viewing frequencies would influence maternal knowledge, attitudes and feeding practices (KAP). DESIGN A set of forty-seven videos were displayed in health centres for 6 months. At 3 months, we conducted focus group discussions (FGD) with mothers and, at 6 months, administered KAP-questionnaire-based interviews to mothers. Using a quasi-experimental design, we compared groups according to video viewing frequencies. SETTING The study was conducted in a slum in Nairobi and a rural area in Machakos, Kenya. We installed TV screens in waiting rooms of six Mother and Child Health Centers, where mothers could choose to watch them. PARTICIPANTS Forty-three mothers with children aged 0–48 months participated in six FGD and 547 mothers of children aged 0–23 months in KAP interviews. RESULTS The mothers from the FGD found the videos acceptable and beneficial. Videos enhanced mothers’ learning and empowered them to support others in learning. The KAP data showed that after adjustments, breast-feeding (P = 0·06), complementary feeding knowledge (P = 0·01), complementary feeding attitudes (P = 0·08) and hygiene knowledge and practices (P = 0·003) were better among mothers who had seen videos three to four times, or five or more times, compared with mothers who had seen the videos once or twice. CONCLUSIONS Videos were an accepted form of education and were beneficial when watched repeatedly. The videos could be a good addition to current infant and young child-feeding education efforts in Kenya.
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Ishikawa M, Eto K, Haraikawa M, Sasaki K, Yamagata Z, Yokoyama T, Kato N, Morinaga Y, Yamazaki Y. Multi-professional meetings on health checks and communication in providing nutritional guidance for infants and toddlers in Japan: a cross-sectional, national survey-based study. BMC Pediatr 2018; 18:325. [PMID: 30322379 PMCID: PMC6190552 DOI: 10.1186/s12887-018-1292-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 09/27/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Health personnel must provide continuous support in response to problematic results from health checks of infants and toddlers (hereinafter "infant[s]"). Among this support, it is important for health personnel to provide nutritional guidance to families as a collaborative effort between the staff from multiple disciplines and community organizations. This study aimed to clarify the factors affecting collaboration with community organizations in providing nutritional guidance to families following health checks for infants in Japan. METHODS The design of this study consisted of a cross-sectional, multilevel survey. A self-administered questionnaire was mailed to all municipalities (1741 towns and cities) in Japan to be completed by the person responsible for nutrition advice. The research was performed in August 2015. We obtained 988 valid responses (response rate of 56.7%). To identify the factors that affect the collaboration with community organizations in providing nutritional guidance, we determined how municipalities responded to infants needing support (five items), how municipalities evaluated health guidance (five items), the number of distributed maternal and child health handbooks, and the number of infants who received follow-up evaluations. RESULTS The results of multivariate analyses showed that the factors related to successful community collaboration in providing nutritional guidance included holding a multi-professional staff meeting after health checks (post-conference; odds ratio [OR], 2.34; P = 0.001); following up children suspected of having developmental and mental disabilities or delays before entering elementary school (OR, 1.77; P = 0.0004); and considering dental caries data from dental checkups in providing health guidance (OR, 1.56; P = 0.003). CONCLUSIONS Holding a multi-professional meeting after infant health checks (post-conference) was strongly associated with community collaboration in providing nutritional guidance for infants.
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Affiliation(s)
- Midori Ishikawa
- Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - Kumi Eto
- Faculty of Nutrition, Kagawa Nutrition University, 3-9-21 Chiyoda, Sakado, Saitama, 350-0288, Japan
| | - Mayu Haraikawa
- Department of Child Studies, Faculty of Child Studies, Seitoku University, 550 Iwase, Matsudo, Chiba, 271-8555, Japan
| | - Kemal Sasaki
- Department of Food and Health Sciences, Jissen Women's University, 4-1-1 Osakaue, Hino, Tokyo, 191-8510, Japan
| | - Zentaro Yamagata
- Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - Noriko Kato
- Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.,Present Address: Department of Early Childhood Care and Education, Jumonji University, 2-1-28 Sugasawa, Niizashi, Saitama, 352-8510, Japan
| | - Yumiko Morinaga
- Faculty of Medicine, School of Nursing Public Health Nursing, Kagawa University, 1750-1, Ikenobe, Miki, Kita, Kagawa, 761-0793, Japan
| | - Yoshihisa Yamazaki
- Child Health Center, Aichi Children's Health and Medical Center, 426-7, Morioka, Obu, Aichi, 474-8710, Japan
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Horii N, Allman J, Martin-Prével Y, Waltisperger D. Determinants of early initiation of breastfeeding in rural Niger: cross-sectional study of community based child healthcare promotion. Int Breastfeed J 2017; 12:41. [PMID: 29021816 PMCID: PMC5622489 DOI: 10.1186/s13006-017-0134-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 09/25/2017] [Indexed: 12/13/2022] Open
Abstract
Background Most child deaths are preventable and caused by behaviorally modifiable factors. By promoting optimal breastfeeding, we can reduce neonatal and child mortality risks by 45%. This paper provides new family and community based perspectives to identify factors interfering with the program impact on promoting early initiation of breastfeeding among the most vulnerable populations in rural Niger. Methods A secondary analysis of a retrospective cross-sectional study evaluated a UNICEF behavior change program on child healthcare. The study sample is based on a post-hoc constitution of two groups exposed and unexposed to the program. All women (n = 1026) aged 14–49 years having at least one child below 24 months of age were included. We measured crude and adjusted odds ratios with chi-square and multivariate logistic regression models. Results Independent variables shown to be associated with early breastfeeding include sales activities compared to household work with no direct income (AOR 7.7; 95% CI 1.3, 47.8) and mutual decision for harvest use (AOR 8.6; 95% CI 2.0, 36.8). Antenatal care did not modify the timing of breastfeeding initiation. Conclusions A high risk group of mothers with social and economic vulnerability are prone to suboptimal breastfeeding within the first hour of birth. Support from family and neighbors positively influenced early breastfeeding. Those who had no direct income and limited access to health services were a high-risk group, prone to delayed initiation of breastfeeding.
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Affiliation(s)
- Naoko Horii
- Independent Consultant in Behavior Change Communication, Maternal Child Health and Nutrition, 39 rue Buffon, 75005 Paris, France
| | - James Allman
- Population and Development Center (CEPED), Université Paris Descartes, 45 rue des Saints-Pères, 75006 Paris, France
| | - Yves Martin-Prével
- Nutripass Research Unit, Institute of Research for Development (IRD), 44 boulevard de Dunkerque, 13572 Marseille, France
| | - Dominique Waltisperger
- National Institute of Demographic Studies (INED), 133 Boulevard Davout, 75020 Paris, France
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Schneider L, Ollila S, Kimiywe J, Lubeka C, Mutanen M. Is competence enough to enable Kenyan mothers to make good infant and young child feeding decisions? MATERNAL AND CHILD NUTRITION 2017; 13. [PMID: 28185418 DOI: 10.1111/mcn.12422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/21/2016] [Accepted: 11/22/2016] [Indexed: 10/20/2022]
Abstract
The aim of this study was to explore factors associated with maternal infant and young child feeding motivation in urban and rural Kenya. We conducted 18 focus group discussions with mothers of children 0 to 23 months of age and healthcare workers. The data were transcribed, translated, and explored following the principles of content analysis. We first explored and coded the data inductively and categorized it according to emerging themes representing the most relevant topics for young child feeding. After this, these themes were theorized into an explanatory framework. Finally, the results yielded seven themes integrated into self-determination theory's three basic motivation-building pillars: autonomy, competence, and relatedness. We found that maternal intrahousehold autonomy on child feeding was substantial. However, this autonomy was lost for a period of time while in close contact with the healthcare staff. The authority of the healthcare workers was at its peak when the child was born and faded gradually as the child grew. Building maternal competence is important for child-feeding outcomes, but our data showed that the health education methods used by the healthcare workers were inadequate to improve maternal to improve the motivation. The competence of Kenyan healthcare workers should be improved in the area of complementary feeding counseling, and they should be trained to provide practical and emotional support as a way of increasing maternal motivation on infant and child feeding.
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Affiliation(s)
- Lauriina Schneider
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Sari Ollila
- Department of Economics and management, University of Helsinki, Helsinki, Finland
| | - Judith Kimiywe
- Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi, Kenya
| | - Crippina Lubeka
- Department of Food, Nutrition and Dietetics, Kenyatta University, Nairobi, Kenya
| | - Marja Mutanen
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
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