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| Name | Class |
|---|---|
| Addis Continental Institute of Public Health | OTHER |
| FHI 360 | OTHER |
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Alive & Thrive (A&T) is an initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development through improved maternal nutrition, breastfeeding and complementary feeding practices. In Ethiopia, A&T tested the feasibility of implementing a package of locally tailored adolescent nutrition interventions through school-based (flag assemblies, classroom lessons, girls' clubs, peer mentoring, weight and height measurement, and parent-teacher meetings) and community platforms (health post and home visits and community gatherings). The evaluation used a two-arm cluster-randomized, non-masked trial design, consisting of two cross-sectional surveys in 2019 and 2021.
Adolescence is a critical period of physical and psychological development and for achieving human potential. Rapid physical, psychosocial and cognitive growth and development is coupled with increased energy and nutrient requirements (Das et al., 2017; Spear 2002). Poor nutrition during adolescence can have adverse consequences impacting health in adulthood. The significance of nutrition during adolescence is especially important for girls, as poor nutrition can affect their well-being as well as the survival, health and well-being of their children (Das et al. 2017).
A&T Ethiopia implemented a package of adolescent nutrition interventions through school-based (flag assemblies, classroom lessons, girls' clubs, peer mentoring, weight and height measurement, and parent-teacher meetings) and community platforms (health post and home visits and community gatherings). IFPRI tested the feasibility of the behavior-change interventions and examined their impacts on adolescent girls' diets, compared with standard school and community activities in control areas.
The evaluation used a two-arm cluster-randomized, non-masked trial design, consisting of two cross-sectional surveys of in-school adolescent girls aged 10-14 years enrolled in grades 4-8. The unit of randomization is the primary school which includes grades 1-8. The baseline survey was conducted in October-November 2019 (at the beginning of the school year), and the endline survey took place in March-April 2021 (following the end of first semester classes). In 2020, after 3 months of program implementation, program activities were halted from March to October (over 6 months) due to the COVID-19 pandemic, thus the endline survey was postponed to the following school year after implementation was reinitiated.
The overall study objective was to determine the feasibility of delivering adolescent nutrition interventions primarily through school-based platforms and their impact on the diet of adolescent girls.
Research questions include:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | A&T intervention areas: adolescent-nutrition-focused behavior change interventions delivered through government primary schools and communities |
|
| Control | No Intervention | Comparison areas: standard activities at government primary schools |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| School Interventions | Behavioral |
|
| Measure | Description | Time Frame |
|---|---|---|
| Dietary diversity among adolescent girls | Mean number of food groups consumed by adolescent girls on the day preceding the interview. | Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021 |
| Minimum dietary diversity among adolescent girls | Proportion of adolescent girls who consumed 5 or more food groups on the day preceding the interview. | Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021 |
| Measure | Description | Time Frame |
|---|---|---|
| Meal frequency | Number of meal/snack times in the previous 24 hours | Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021 |
| Consumption of unhealthy foods |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| International Food Policy Research Institute | Washington D.C. | District of Columbia | 20005 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28436102 | Background | Das JK, Salam RA, Thornburg KL, Prentice AM, Campisi S, Lassi ZS, Koletzko B, Bhutta ZA. Nutrition in adolescents: physiology, metabolism, and nutritional needs. Ann N Y Acad Sci. 2017 Apr;1393(1):21-33. doi: 10.1111/nyas.13330. | |
| 11902385 | Background | Spear BA. Adolescent growth and development. J Am Diet Assoc. 2002 Mar;102(3 Suppl):S23-9. doi: 10.1016/s0002-8223(02)90418-9. No abstract available. |
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In compliance with donor open access policy requirements, fully anonymized datasets will be made publicly available one year after the end of the project. Metadata and other documentation of data collection procedures (such as the codebook, data collection instruments and interviewer guides/protocols) will also be made publicly available.
Fully anonymized datasets will be made publicly available one year after the end of the project.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jan 15, 2021 | Feb 18, 2022 |
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| Community Interventions | Behavioral |
|
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| School System Interventions | Behavioral |
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Consumption of sweets, baked sweets, sweetened beverages, and fried and salty foods in the previous 24 hours
| Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021 |
| Exposure to nutrition interventions at school and in the community | Proportion of adolescent girls exposed to nutrition interventions at school and in the community | Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021 |
| Nutrition and handwashing knowledge and practices among adolescent girls and their parents | Proportion of adolescent girls and parents with correct knowledge of nutrition and appropriate handwashing practices based on survey responses | Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021 |
| Nutrition and handwashing knowledge among school science teachers, principals, and HEWs | Proportion of school science teachers, principals, and HEWs with correct knowledge of nutrition and appropriate handwashing practices based on survey responses | Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021 |
| Delivery of adolescent nutrition interventions by school science teachers, principals, and HEWs | Proportion of school science teachers, principals, and HEWs providing adolescent nutrition interventions at school and in the community based on survey responses | Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021 |
| Availability of supporting resources | Proportion of primary schools with training and supportive supervision for teachers/staff, educational materials, and healthy food environments based on enumerator observation and survey responses | Approximately 17 months after baseline in a cross-sectional endline survey in March-April 2021 |
| 37666262 | Derived | Kim SS, Sununtnasuk C, Berhane HY, Walissa TT, Oumer AA, Asrat YT, Sanghvi T, Frongillo EA, Menon P. Feasibility and impact of school-based nutrition education interventions on the diets of adolescent girls in Ethiopia: a non-masked, cluster-randomised, controlled trial. Lancet Child Adolesc Health. 2023 Oct;7(10):686-696. doi: 10.1016/S2352-4642(23)00168-2. Epub 2023 Sep 1. |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jul 31, 2021 | Feb 18, 2022 | SAP_001.pdf |
| ICF | No | No | Yes | Informed Consent Form | Jan 15, 2021 | Feb 18, 2022 | ICF_002.pdf |