Effectiveness of health promotion regarding diet and physical activity among Nepalese mothers and their young children: The Heart-health Associated Research, Dissemination, and Intervention in the Community (HARDIC) trial

Abstract

Background: Nepal, like many low-and middle-income countries, exhibits rising burden of cardiovascular diseases. Misconceptions, poor behavior, and a high prevalence of risk factors contribute to this development. Health promotion efforts along with primary prevention strategies, including risk factor reduction in both adults and children, are therefore critical. Objectives: This study assessed the effectiveness of a health promotion intervention on mothers' knowledge, attitude and practice (KAP) and their children's behavior regarding diet and physical activity. Methods: The Heart-health Associated Research, Dissemination and Intervention in the Community (HARDIC), a community-based trial, used peer education to target mothers with 1-9-year-old children in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal, during August-November 2016. In the intervention area, 47 peer mothers were trained to conduct four education classes for about 10 fellow mothers (N = 391). After 3 months, all eligible mothers in the intervention and control areas were interviewed and the results were compared with the KAP of all eligible mothers at baseline. Results: Post-intervention, mothers' KAP median scores had improved regarding hearthealthy diet and physical activity. More mothers had 'good' KAP (>75% of maximum possible scores), and mothers with 'good' knowledge increased from 50% to 81%. Corresponding control values increased only from 58% to 63%. Mothers' attitude and practice improved. Additionally, mothers in the intervention area reported improvement in their children's diet and physical activity behavior. Moreover, Difference in Differences analysis showed that the HARDIC intervention significantly increased mothers' KAP scores and children's behavior scores in the intervention area compared to the control area. Conclusions: Our intervention improves KAP scores regarding diet and physical activity and shows potential for expansion via community health workers, volunteers, and/or local women. Moreover, HARDIC can contribute to Nepal's Package of Essential Noncommunicable Diseases Initiative, which currently lacks a specific package for health promotion.

The Effect of the “Colorful Eating Is Healthy Eating” Long-Term Nutrition Education Program for 3- to 6-Year-Olds on Eating Habits in the Family and Parental Nutrition Knowledge

“…Most studies focus on nutrition education for parents or educational programs targeting both preschoolers and their parents [ 26 , 27 ], but there is a general scarcity of research on nutrition education for 3- to 6-year-olds whose eating habits and food preferences are easily modified through imitation and group learning. Healthy eating habits that have been instilled in the preschool period affect later stages of life and minimize the risk of nutrition-related problems in adulthood, because nutrition affects a child’s physical, social and emotional development as well as behavior [ 2 , 13 ].…”

Diabetes Prevalence and Associated Risk Factors among Women in a Rural District of Nepal Using HbA1c as a Diagnostic Tool: A Population-Based Study

“…Previous studies in Nepal have shown differences in prevalence of overweight/obesity and diabetes between the ethnic groups. The highest prevalence has been reported in the Adhivasi/Janajati ethnic group [ 9 , 10 , 60 , 61 ]. Likewise, we observed that a higher proportion of women in this group had diabetes compared to the two other ethnicities, however, this was not significant.…”

Nutrition and physical activity knowledge, attitudes, and practices of inpatient cirrhosis care providers

“…This is relevant as nutrition educational interventions for providers caring for individuals with cirrhosis have been associated with a higher number of dietitian consultations, less days of inadequate nutrition, lower 90-day readmission rates, and improved quality of life and physical function [24]. Research outside of cirrhosis has similarly demonstrated that provider physical activity education can impact physical activity KAP scores [25,26], increase the frequency with which physical activity is prescribed, and improve appropriate referral rates [27]. Important to the feasibility of beginning to close this gap in care, providers in our study were keen to receive additional nutrition and physical activity training directed to cirrhosis.…”