title: Can gossip change nutrition behaviour? Results of a mass media and community-based intervention trial in East Java, Indonesia.
abstract: OBJECTIVE
  It is unclear how best to go about improving child feeding practices. We studied the effect of a novel behaviour change intervention, Gerakan Rumpi Sehat (the Healthy Gossip Movement), on infant and young child feeding practices in peri-urban Indonesia.
  
  
  METHODS
  The pilot intervention was designed based on the principles of a new behaviour change theory, Behaviour Centred Design (BCD). It avoided educational messaging in favour of employing emotional drivers of behaviour change, such as affiliation, nurture and disgust and used television commercials, community activations and house-to-house visits as delivery channels. The evaluation took the form of a 2-arm cluster randomised trial with a non-randomised control arm. One intervention arm received TV only, while the other received TV plus community activations. The intervention components were delivered over a 3-month period in 12 villages in each arm, each containing an average of 1300 households. There were two primary outcomes: dietary diversity of complementary food and the provision of unhealthy snacks to children aged 6-24 months.
  
  
  RESULTS
  Dietary diversity scores increased by 0.8 points in the arm exposed to TV adverts only (95% CI: 0.4-1.2) and a further 0.2 points in the arm that received both intervention components (95% CI: 0.6-1.4). In both intervention arms, there were increases in the frequency of vegetable and fruit intake. We found inconsistent evidence of an effect on unhealthy snacking.
  
  
  CONCLUSIONS
  The study suggests that novel theory-driven approaches which employ emotional motivators are capable of having an effect on improving dietary diversity and the regularity of vegetable and fruit intake among children aged 6-24 months. Mass media can have a measurable effect on nutrition-related behaviour, but these effects are likely to be enhanced through complementary community activations. Changing several behaviours at once remains a challenge.
authors.affiliation: Department for Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Sian
authors.initials: S
authors.lastname: White
authors.affiliation: Department for Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Wolf
authors.initials: W
authors.lastname: Schmidt
authors.affiliation: Regional Centre for Food and Nutrition, Southeast Asian Ministers of Education Organization, Jakarta, Indonesia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sahanggamu
authors.affiliation: Regional Centre for Food and Nutrition, Southeast Asian Ministers of Education Organization, Jakarta, Indonesia.
authors.forename: Dewi
authors.initials: D
authors.lastname: Fatmaningrum
authors.affiliation: Global Alliance of Improved Nutrition, Geneva, Switzerland.
authors.forename: Marti
authors.initials: M
authors.lastname: van Liere
authors.affiliation: Department for Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Val
authors.initials: V
authors.lastname: Curtis
mesh_terms: D002675:Child, Preschool; D003256:Community Participation / Q000379:methods; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D008402:Mass Media; D009035:Mothers / Q000193:education / Q000523:psychology; D009042:Motivation; D009752:Nutritional Status; D013690:Television
keywords: Behaviour Centred Design; Diseño Centrado en el Comportamiento; Nutrición; alimentación complementaria; alimentation complémentaire; allaitement; behaviour change; breastfeeding; cambio de comportamiento; changement de comportement; complementary feeding; concept centré sur le comportement; grignotage; lactancia; merienda; nutrition; snacking