Improving the Quality of Feeding Practices in Early Childhood: an Experiment on Parental beliefs

Last registered on June 06, 2023

Pre-Trial

Trial Information

General Information

Title
Improving the Quality of Feeding Practices in Early Childhood: an Experiment on Parental beliefs
RCT ID
AEARCTR-0011503
Initial registration date
May 30, 2023

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
June 06, 2023, 3:47 PM EDT

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

Locations

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Primary Investigator

Affiliation
Universidad de la Rep├║blica

Other Primary Investigator(s)

PI Affiliation
European University Institute

Additional Trial Information

Status
On going
Start date
2023-03-09
End date
2023-12-31
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
The aim of this study is to analyze the effects of providing information to parents on feeding practices in early childhood. We randomly provide evidence-based recommendations on best practices to the main caregivers of children between 0 and 5 years of age. Parental practices and beliefs regarding feeding and nutrition are gathered through online surveys. This allow us to identify the causal effect of an information policy on parental beliefs and decisions regarding early feeding habits. Our primary outcomes are: feeding practices concerning ultraprocessed food, fish intake, and home-cooked meals. Our secondary outcomes are parental beliefs on feeding practices.

This study is a secondary project from an RCT aimed at studying the effects of providing information on best practices concerning screen exposure in early childhood. The design of the RCT experiment involved an active control group to provide an estimate of social desirability on a similar but unrelated parenting topic, in this case, feeding practices. This allows us to also evaluate the effect of the intervention provided to the active control group as a secondary project, which is the focus of this study.

The experiment takes place in Uruguay. Potential participants receive an invitation to participate in the study and a small survey to determine eligibility. If individuals are eligible, they receive the baseline survey. Those that fill-out the baseline survey are randomly assigned to treatment and control. The information treatment is provided at the end of the baseline survey. The intervention consists on a short video with information on best practices concerning screen exposure in early childhood for the treatment group, and on recommendations on feeding practices in early childhood for the active control group. In both cases the information is based on recognised health-institutions. Moreover, a digital leaflet with personalized tips on the topic is provided. The expected sample size is between 1500 and 3000 caregivers at baseline.
External Link(s)

Registration Citation

Citation
Colombo, Karina and Elisa Failache. 2023. "Improving the Quality of Feeding Practices in Early Childhood: an Experiment on Parental beliefs." AEA RCT Registry. June 06. https://doi.org/10.1257/rct.11503-1.0
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
The objective of the intervention is to promote beneficial practices regarding feeding practices in early childhood. The treatment entails the provision of information to parents on how to improve their child's eating habits. The information is provided through a short video and personalized digital leaflets included in the baseline online survey.

We designed the intervention based on scientific literature on the topic and on recommendations made by trustworthy institutions, such as the American Academy of Pediatrics (AAP), the Spanish Association of Pediatrics (AEP), UNICEF Uruguay and the Uruguayan Ministry of Health (MSP). The information provided focus on the following concepts: nutritional recommendations, foods that should be avoided, and ultraprocessed foods.
Intervention Start Date
2023-03-09
Intervention End Date
2023-05-31

Primary Outcomes

Primary Outcomes (end points)
We plan to evaluate three dimensions of feeding habits:

1) Consumption of ultraprocessed foods.
2) Fish intake.
3) Consumption of home-cooked meals.

Moreover, we will construct a summary index of the child's feeding habits considering all dimensions.
Primary Outcomes (explanation)
We measure each dimension consider the following aspects:

1) Consumption of ultraprocessed foods.
We construct an Index considering the frequency of consumption of several ultraprocessed foods, such as packaged filled cookies, packaged nuggets, hot dogs and hamburgers, sweets, soft drinks, etc.

2) Fish intake.
We measure this by considering the frequency of fish consumption.

3) Consumption of home-cooked meals.
We measure this by considering the frequency of consumption of home-made food (made at home from scratch, without including home made at home using ultraprocessed foods).

Secondary Outcomes

Secondary Outcomes (end points)
- Learning of information provided in the video.
Secondary Outcomes (explanation)
To help understand the potential channels of our effects we collect information on learning of the information provided in the video.

Additionally, we will analyse heterogeneous effects according to:

- Background characteristics of the child and his/her households.

- Caregivers' previous knowledge of recommendations and usefulness of video.

- Caregivers' usefulness and having downloaded/read the personalized digital leaflet.

- Caregivers' risk and time preferences: from the Global Preference Survey from Falk et al. (2016 and 2018).

Experimental Design

Experimental Design
This project is a randomized controlled trial. The unit of randomization are caregivers of children aged 0 to 5 in baseline. The unit of analysis is the parent child dyad. For those caregivers with more than one child in the 0-5 age range, we randomly select the oldest or youngest child for the measurement of children outcomes and parental practices.

The project includes an online baseline survey, a midline survey (6.5 weeks after baseline) and an endline survey (6 months after baseline). The intervention (video and digital leaflet) is embedded in the online baseline survey. There is one treatment arm and one active control group. The treatment group receives a treatment on screen exposure in early childhood and the active control group receives an analogous treatment on feeding practices in early childhood. This project leads to a primary study on early screen exposure and a secondary study on feeding practices. This registration comprises only the secondary study, and focuses on the effects of the intervention in the active control group.

The recruiting was done through mainly two channels. First, participants were recruited from the main university in Uruguay (Universidad de la Rep├║blica). An institutional email with an invitation to participate in the study was sent to a list of potentially eligible students and workers from the university. Second, we also recruited participants by using social media advertisements in Facebook and Instagram through a recruiting company. This allows to increase the heterogeneity of our sample in terms of educational level. Additionally, a minimal part of the recruiting was done through the recruiting company database.
Experimental Design Details
Not available
Randomization Method
Randomization done through the software used for the online baseline survey (Qualtrics).
Randomization Unit
Caregivers are the unit of randomization. For the purpose of shortening the surveys, we ask each caregiver with more than one child in the 0-5 age range to answer for only one of them, chosen at random by the survey software.
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
Between 1,500 and 3,000 caregivers at baseline.
Sample size: planned number of observations
Between 1,500 and 3,000 caregivers at baseline.
Sample size (or number of clusters) by treatment arms
Between 750 and 1,500 caregivers in the treatment group and in the active control group.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
European University Institute
IRB Approval Date
2023-02-14
IRB Approval Number
20220704_COLOMBO AMEND 2