Building habits and improving child nutrition through a behaviorally-informed food journal

Last registered on December 20, 2022

Pre-Trial

Trial Information

General Information

Title
Building habits and improving child nutrition through a behaviorally-informed food journal
RCT ID
AEARCTR-0010532
Initial registration date
November 28, 2022

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
November 30, 2022, 4:40 PM EST

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Last updated
December 20, 2022, 2:21 PM EST

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Region

Primary Investigator

Affiliation
World Bank Group

Other Primary Investigator(s)

Additional Trial Information

Status
In development
Start date
2022-12-02
End date
2023-06-01
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Under-nutrition and its associated effects cause a wide range of effects across the life course, and constitute a major threat to health and human capital in India. As children transition from breastfeeding to complementary feeding, feeding frequency and quantity changes rapidly and it is hard to establish. This ‘food accounting’ problem makes it hard to track what is fed to a child and how much, when the child was fed prior to planning a next meal, and to adequately increase amounts as the child grows, leading to inadequate feeding practices. This study seeks to address behavioral bottlenecks that inhibit complementary feeding practices. A food journal intended to aid habit formation, in particular with regard to dietary diversity, will be given to mothers of children 6-20m by front line health workers using a cluster randomized control design, where Anganwadi centers (front-line nutrition centers) in the study areas will be randomized to the status quo or to deliver food journals to mothers of age-eligible children. Mothers will be followed and their nutrition knowledge and feeding practices assessed at endline. Children will have their middle-upper arm circumference (MUAC) measured as an indicator of nutritional status.
External Link(s)

Registration Citation

Citation
Moscoe, Ellen. 2022. "Building habits and improving child nutrition through a behaviorally-informed food journal ." AEA RCT Registry. December 20. https://doi.org/10.1257/rct.10532-2.0
Experimental Details

Interventions

Intervention(s)
Intervention Start Date
2022-12-19
Intervention End Date
2023-03-20

Primary Outcomes

Primary Outcomes (end points)
1. Mid-Upper Arm Circumference (MUAC) of the child
2. 24-hour food recall (feeding diversity)
3. Vignettes to assess mother's application of nutrition knowledge to child feeding practices
Primary Outcomes (explanation)
1. Mid-Upper Arm Circumference (MUAC) of the child: Measurement of the arm circumference that indicates the degree of (or absence of) malnutrition. The measurement is taken in centimeters and will be observed at baseline and endline. Within-person changes as well as average MUAC in treatment vs control groups will be assessed.
2. 24-hour food recall (feeding diversity): Mothers will be asked about various food groups fed to the child in the past 24h, observed at baseline and at endline. Scores will be calculated for (1) the total number of groups and (2) the presence of key food groups (animal protein, leafy greens, and vitamin A rich foods).
3. Vignettes to assess mother's application of nutrition knowledge to child feeding practices: Mothers will respond to a series of questions using vignettes and visual aids, where they will see pictures of meals and will be asked to rate the nutritional completeness of the meal, what should be added to the meal (or day's worth of meals) to complete the nutritional needs for the child. Variables will be constructed to identify mothers who correctly identified complete and incomplete meals (or days worth of meals) and who accurately identified key missing food groups (eg a full day with no protein-rich foods.) The vignettes will be measured at endline only.

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
2 arm cluster randomized trial, where the unit of randomization is the anganwadi center (roughly equivalent to village level). Anganwadi centers will be randomized 1:1 to intervention (food journal) or control (no journal). In the intervention areas, anganwadi workers (front line health workers) will receive a training on how to distribute and explain the charts to mothers, and will give them to mothers who have children between 6-20 months of age in their catchment area. The control group will not receive food journals, and anganwadi workers will continue with their usual tasks. The control arm will anganwadi workers will receive a refresher training on infant and young child nutrition as a means of ensuring that both groups have similar amounts of training and that the salience of nutrition is equal in both groups.
Experimental Design Details
Not available
Randomization Method
In office using a computer
Randomization Unit
Anganwadi center
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
342 anganwadi centers
Sample size: planned number of observations
2052 mothers
Sample size (or number of clusters) by treatment arms
171 anganwadi centers in control (with 1026 mothers), and 171 anganwadi centers in treatment (with 1026 mothers).
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
IRB Approval Date
IRB Approval Number
Analysis Plan

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