title: Maternal knowledge and use of a micronutrient supplement was improved with a programmatically feasible intervention in Mexico.
abstract: In Mexico, the potential impact on child malnutrition from a nutritional supplement (papilla) delivered through a conditional transfer program (Oportunidades) was attenuated by problems of household utilization. A behavioral change through communication intervention was developed to improve supplement utilization. Our study assessed the efficacy of this intervention through the results of a randomized trial. In 2 states (Veracruz and Chiapas) 2 clusters of communities were randomly assigned to intervention or control groups. Data were obtained from 176-198 mothers in intervention and control communities using a survey questionnaire at preintervention baseline and at a 5-mo follow-up. Concordance between reported and observed behaviors was examined through an observational substudy. The 4 behavioral recommendations were: 1) prepare papilla as a pap; 2) administer the preparation every day; 3) administer it between breakfast and dinner; and 4) administer it only to target children. The intervention resulted in a significant increase (P<0.05) in the prevalence of reported correct behaviors in the intervention group compared with the control for 3 of the behaviors: a mean increase of 42.5% for preparing papilla as pap, 64.4% for daily administration, and 61.5% for giving papilla between breakfast and dinner. Administering to a target child increased significantly in Veracruz (from 51.5% to 90.6%), but not in Chiapas (20.6% to 33.3%). Reported behaviors agreed with observed behaviors in the substudy. With the exception of the target-child administration in Chiapas, adopting the recommendations was culturally acceptable and feasible. The results indicate that improvements in household utilization of the supplement can be achieved with a communication intervention that is potentially feasible for implementation on a large scale within the Oportunidades Program.
authors.affiliation: Research Center on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico. bonvecchio@insp.mx
authors.forename: Anabelle
authors.initials: A
authors.lastname: Bonvecchio
authors.forename: Gretel H
authors.initials: GH
authors.lastname: Pelto
authors.forename: Erika
authors.initials: E
authors.lastname: Escalante
authors.forename: Erick
authors.initials: E
authors.lastname: Monterrubio
authors.forename: J P
authors.initials: JP
authors.lastname: Habicht
authors.forename: Fernanda
authors.initials: F
authors.lastname: Nava
authors.forename: Maria-Angeles
authors.initials: MA
authors.lastname: Villanueva
authors.forename: Margarita
authors.initials: M
authors.lastname: Safdie
authors.forename: J A
authors.initials: JA
authors.lastname: Rivera
mesh_terms: D000328:Adult; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D019587:Dietary Supplements; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D007223:Infant; D008297:Male; D008800:Mexico; D018977:Micronutrients / Q000008:administration & dosage*; D009035:Mothers / Q000523:psychology*
chemical_list: D018977:Micronutrients