title: Toward a Scalable and Sustainable Intervention for Complementary Food Safety.
abstract: Contaminated complementary foods are associated with diarrhea and malnutrition among children aged 6 to 24 months. However, existing complementary food safety intervention models are likely not scalable and sustainable.
  
  
  
  To understand current behaviors, motivations for these behaviors, and the potential barriers to behavior change and to identify one or two simple actions that can address one or few food contamination pathways and have potential to be sustainably delivered to a larger population.
  
  
  
  Data were collected from 2 rural sites in Bangladesh through semistructured observations (12), video observations (12), in-depth interviews (18), and focus group discussions (3).
  
  
  
  Although mothers report preparing dedicated foods for children, observations show that these are not separate from family foods. Children are regularly fed store-bought foods that are perceived to be bad for children. Mothers explained that long storage durations, summer temperatures, flies, animals, uncovered food, and unclean utensils are threats to food safety. Covering foods, storing foods on elevated surfaces, and reheating foods before consumption are methods believed to keep food safe. Locally made cabinet-like hardware is perceived to be acceptable solution to address reported food safety threats.
  
  
  
  Conventional approaches that include teaching food safety and highlighting benefits such as reduced contamination may be a disincentive for rural mothers who need solutions for their physical environment. We propose extending existing beneficial behaviors by addressing local preferences of taste and convenience.
authors.affiliation: International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh jabeen@icddrb.org.
authors.forename: Musarrat J
authors.initials: MJ
authors.lastname: Rahman
authors.affiliation: International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Fosiul A
authors.initials: FA
authors.lastname: Nizame
authors.affiliation: International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Nuruzzaman
authors.affiliation: International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Farhana
authors.initials: F
authors.lastname: Akand
authors.affiliation: International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Mohammad Aminul
authors.initials: MA
authors.lastname: Islam
authors.affiliation: International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Sarker Masud
authors.initials: SM
authors.lastname: Parvez
authors.affiliation: Department of Nutrition, University of California, Davis, CA, USA.
authors.forename: Christine P
authors.initials: CP
authors.lastname: Stewart
authors.affiliation: International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Leanne
authors.initials: L
authors.lastname: Unicomb
authors.affiliation: International Center for Diarrheal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
authors.affiliation: Social and Behavioral Interventions (SBI) Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Winch
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D002675:Child, Preschool; D005260:Female; D017144:Focus Groups; D005506:Food Contamination / Q000517:prevention & control*; D059022:Food Safety; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000592:standards*; D007407:Interviews as Topic; D008875:Middle Aged; D009035:Mothers; D012424:Rural Population; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Bangladesh; complementary feeding; feeding behaviors; food contamination; weaning