title: A cluster-randomized evaluation of a responsive stimulation and feeding intervention in bangladesh.
abstract: OBJECTIVE
  The goal of this study was to determine if a responsive stimulation and feeding intervention improved developmental and nutritional outcomes compared with a regular information-based parenting program. The hypothesis was that mothers in the intervention would exhibit better parenting skills and children would exhibit better developmental and nutritional outcomes than controls.
  
  
  METHODS
  A cluster-randomized field trial was conducted with 302 children aged 8 to 20 months and their mothers in rural Bangladesh who were randomly assigned according to village to 1 of 3 groups. The control mothers received 12 informational sessions on health and nutrition. The intervention groups received an additional 6 sessions delivered by peer educators who included modeling and coached practice in self-feeding and verbal responsiveness with the child during play. A second intervention group received, along with the sessions, 6 months of a food powder fortified with minerals and vitamins. Developmental outcomes included the Home Observation for Measurement of the Environment (HOME) Inventory, mother-child responsive talk, and language development. Nutritional outcomes included weight, height, self-feeding, and mouthfuls eaten. We used analysis of covariance to compare the 3 groups at the posttest and at follow-up, covarying the pretest levels and confounders.
  
  
  RESULTS
  At follow-up, responsive stimulation-feeding groups had better HOME inventory scores, responsive talking, language, mouthfuls eaten, and hand-washing. Micronutrient fortification resulted in more weight gain.
  
  
  CONCLUSIONS
  A brief behavior-change program that focused on modeling and practice in stimulation and feeding was found to benefit children's nutrition and language development. Micronutrients benefited children's weight but not length.
authors.affiliation: Department of Psychology, McGill University, Montreal, Quebec, Canada H3A 1B1. frances.aboud@mcgill.ca
authors.forename: Frances E
authors.initials: FE
authors.lastname: Aboud
authors.forename: Sadika
authors.initials: S
authors.lastname: Akhter
mesh_terms: D001459:Bangladesh; D016000:Cluster Analysis; D003906:Developing Countries; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007225:Infant Food; D008297:Male; D009035:Mothers / Q000193:education*; D020380:Needs Assessment; D009751:Nutritional Requirements; D016487:Parenting / Q000639:trends*; D015397:Program Evaluation; D036301:Qualitative Research; D012016:Reference Values; D018570:Risk Assessment; D012424:Rural Population; D012959:Socioeconomic Factors