Smartphone-Based Maternal Education for the Complementary Feeding of Undernourished Children Under 3 Years of Age in Food-Secure Communities: Randomised Controlled Trial in Urmia, Iran

Nutrients. 2020 Feb 24;12(2):587. doi: 10.3390/nu12020587.

Abstract

The mothers' nutritional literacy is an important determinant of child malnourishment. We assessed the effect of a smartphone-based maternal nutritional education programme for the complementary feeding of undernourished children under 3 years of age in a food-secure middle-income community. The study used a randomised controlled trial design with one intervention arm and one control arm (n = 110; 1:1 ratio) and was performed at one well-child clinic in Urmia, Iran. An educational smartphone application was delivered to the intervention group for a 6-month period while the control group received treatment-as-usual (TAU) with regular check-ups of the child's development at the well-child centre and the provision of standard nutritional information. The primary outcome measure was change in the indicator of acute undernourishment (i.e., wasting) which is the weight-for-height z-score (WHZ). Children in the smartphone group showed greater wasting status improvement (WHZ +0.65 (95% Confidence Interval (CI) ± 0.16)) than children in the TAU group (WHZ +0.31 (95% CI ± 0.21); p = 0.011) and greater reduction (89.6% vs. 51.5%; p = 0.016) of wasting caseness (i.e., WHZ < -2; yes/no). We conclude that smartphone-based maternal nutritional education in complementary feeding is more effective than TAU for reducing undernourishment among children under 3 years of age in food-secure communities.

Keywords: child malnutrition; mHealth intervention; middle-income countries; nutritional education; randomised controlled trials.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Child Nutrition Disorders / epidemiology*
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Food Security*
  • Humans
  • Infant
  • Infant, Newborn
  • Iran / epidemiology
  • Male
  • Mothers / education*
  • Nutrition Therapy*
  • Smartphone*