title: A Community-Based Positive Deviance/Hearth Infant and Young Child Nutrition Intervention in Ecuador Improved Diet and Reduced Underweight.
abstract: Underweight and stunting are serious problems in Ecuador that require interventions in the first 2 years of life. The researchers assessed the effectiveness of a Positive Deviance (PD)/Hearth community-based intervention using local foods to improve infant and young children's nutrition.
  
  
  
  A quasi-experimental nonrandomized study was conducted between March and October, 2009.
  
  
  
  The intervention and study were implemented in the Ecuadorian highlands provinces of Chimborazo and Tungurahua.
  
  
  
  Eighty mother-child pairs in 6 intervention communities and 184 mother-child pairs in 9 comparison communities.
  
  
  
  Mothers met in participatory peer-led PD/Hearth cooking and nutrition education sessions for 12 days.
  
  
  
  Dietary intake and nutritional status were collected at baseline and 6-month follow-up.
  
  
  
  Multiple linear and logistic regression were used for growth outcomes, and ANCOVA for mean dietary intakes.
  
  
  
  Mothers in the intervention were 1.3-5.7 times more likely to feed their children the promoted foods (P < .05). Children in the intervention consumed a higher percentage of recommended intakes for iron, zinc, vitamin A, protein, and energy (P < .05) at follow-up and had improvements in weight-for-age z-score (β = .17; 95% confidence interval, 0.01-0.31). Likelihood of underweight was reduced for children in the intervention (odds ratio = 0.36; 95% confidence interval, 0.13-0.96) CONCLUSIONS AND IMPLICATIONS: The PD/Hearth interventions support mothers to improve infant and young children's nutrition practices and reduce underweight.
authors.affiliation: Research & Evaluation Unit, Micronutrient Initiative, Ottawa, Ontario, Canada; Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada. Electronic address: roche.marion@gmail.com.
authors.forename: Marion L
authors.initials: ML
authors.lastname: Roche
authors.affiliation: Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada.
authors.forename: Grace S
authors.initials: GS
authors.lastname: Marquis
authors.affiliation: Division of Clinical Epidemiology, McGill University Health Centre, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
authors.forename: Theresa W
authors.initials: TW
authors.lastname: Gyorkos
authors.affiliation: Division of Clinical Epidemiology, McGill University Health Centre, Quebec, Canada.
authors.forename: Brittany
authors.initials: B
authors.lastname: Blouin
authors.affiliation: World Vision Ecuador, Quito, Ecuador.
authors.forename: Julieta
authors.initials: J
authors.lastname: Sarsoza
authors.affiliation: Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada; School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada.
authors.forename: Harriet V
authors.initials: HV
authors.lastname: Kuhnlein
mesh_terms: D000328:Adult; D003153:Community Health Services / Q000379:methods; D004032:Diet / Q000379:methods* / Q000706:statistics & numerical data*; D004484:Ecuador; D005260:Female; D006266:Health Education / Q000379:methods*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers; D009752:Nutritional Status; D009753:Nutritive Value; D055815:Young Adult
keywords: Positive Deviance/Hearth; child; complementary feeding; local foods; nutrition intervention; underweight