Medicine and Health Sciences Commons^™

Social Franchising And A Nationwide Mass Media Campaign Increased The Prevalence Of Adequate Complementary Feeding In Vietnam: A Cluster-Randomized Program Evaluation, Rahul Rawat, Phuong Hong Nguyen, Lan Mai Tran, Nemat Hajeebhoy, Huan Van Nguyen, Jean Baker, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Rigorous evaluations of health system-based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. A cluster-randomized, nonblinded evaluation design with cross-sectional surveys ( = ∼500 children aged 6-23.9 …

Large-Scale Behavior-Change Initiative For Infant And Young Child Feeding Advanced Language And Motor Development In A Cluster-Randomized Program Evaluation In Bangladesh, Edward A. Frongillo Jr., Phuong H. Nguyen, Kuntal K. Saha, Tina Sanghvi, Kaosar Afsana, Raisul Haque, Jean Baker, Marie T. Ruel, Rahul Rawat, Purnima Menon

Faculty Publications

Background: Promoting adequate nutrition through interventions to improve infant and young child feeding (IYCF) has the potential to contribute to child development.

Objective: We examined whether an intensive intervention package that was aimed at improving IYCF at scale through the Alive & Thrive initiative in Bangladesh also advanced language and gross motor development, and whether advancements in language and gross motor development were explained through improved complementary feeding.

Methods: A cluster-randomized design compared 2 intervention packages: intensive interpersonal counseling on IYCF, mass media campaign, and community mobilization (intensive) compared with usual nutrition counseling and mass media campaign (nonintensive). Twenty subdistricts …

Impacts On Breastfeeding Practices Of At Scale Strategies That Combine Intensive Interpersonal Counseling, Mass Media, And Community Mobilization: Results Of Cluster Randomized Program Evaluations In Bangladesh And Viet Nam, Purnima Menon, Phuong Hong Nguyen, Kuntal Kumar Saha, Adiba Khaled, Andrew Kennedy, Lan Mai Tran, Tina Sanghvi, Nemat Hajeebhoy, Jean Baker, Silvia Alayon, Kaosar Afsana, Raisul Haque, Edward A. Frongillo Jr., Marie T. Ruel, Rahul Rawat

Faculty Publications

Background

Despite recommendations supporting optimal breastfeeding, the number of women practicing exclusive breastfeeding (EBF) remains low, and few interventions have demonstrated implementation and impact at scale. Alive & Thrive was implemented over a period of 6 y (2009–2014) and aimed to improve breastfeeding practices through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM) intervention components delivered at scale in the context of policy advocacy (PA) in Bangladesh and Viet Nam. In Bangladesh, IPC was delivered through a large non-governmental health program; in Viet Nam, it was integrated into government health facilities. This study evaluated the population-level impact …

Exposure To Mass Media And Interpersonal Counseling Has Additive Effects On Exclusive Breastfeeding And Its Psychosocial Determinants Among Vietnamese Mothers, Phuong H. Nguyen, Sunny S. Kim, Tuan T. Nguyen, Nemat Hajeebhoy, Lan M. Tran, Silvia Alayon, Marie T. Ruel, Rahul Rawat, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

The pathways through which behavior change interventions impact breastfeeding practices have not been well studied. This study aimed to examine: (1) the effects of exposure to mass media and interpersonal counseling on exclusive breastfeeding (EBF) and hypothesized psychosocial determinants (i.e. knowledge, intention, beliefs, social norms, and self-efficacy); and (2) the pathways through which exposure to mass media and interpersonal counseling are associated with EBF. We used survey data from mothers with children< 2 year (n = 2045) from the 2013 process evaluation of Alive & Thrive’s program in Viet Nam. Multiple linear regression analyses and structural equation modeling were used to estimate effects. Exposure to mass media only, interpersonal counseling only, both or neither was 51%, 5%, 19% and 25%, respectively. Exposure to both mass media and interpersonal counseling had additive effects on EBF as well as on related psychosocial factors, compared with no exposure. For example, EBF prevalence was 26.1 percentage points (pp) higher in the group that received interpersonal counseling only, 3.9 pp higher in the mass media group and 31.8 pp higher in the group that received both interventions. As hypothesized, more than 90% of the total effect of the two interventions on EBF was explained by the psychosocial factors measured. Our findings suggest that combining different behavior change interventions leads to greater changes in psychosocial factors, which in turn positively affects breastfeeding behaviors.