Nutrition Counseling Training Changes Physician Behavior and Improves Caregiver Knowledge Acquisition

Abstract

Physician behavior and caregiver retention of nutrition advice were examined as potential mediating factors in the success of a nutrition counseling efficacy trial in Pelotas, Brazil, which reduced growth faltering in children 12-24 mo old. After pair-matching on socioeconomic status and nutrition indicators, municipal health centers were randomly assigned to an intervention group, in which physicians were trained with an IMCI-derived (Integrated Management of Childhood Illness) nutrition counseling protocol, or to a control group, without continuing education in nutrition. In a substudy of the larger trial, direct observation of consultations, followed by home interviews with mothers, provided data on physician counseling behavior and mothers' retention of nutrition advice. Trained providers were more likely to engage in nutrition counseling (P < 0.013) and to deliver more extensive advice (P < 0.02). They also used communication skills designed to improve rapport and ensure that mothers understood the advice (P < 0.01). Mothers who received advice from trained providers had high rates of recalling the messages on specific foods (95 vs.27%; P < 0.01) and feeding practice and food preparation recommendations (90 vs. 20%; P < 0.01), whereas the proportions of the messages recalled on breast-feeding (60% vs. 30%) did not differ significantly (P < 0.20). The training course contained several elements that may explain why intervention group mothers were better able to recall nutrition advice. These include locally appropriate messages, tools for assessing individual problems, and counseling skills.

Perceived nutrition benefits and socio-demographic factors affecting consumption of forest foods in eastern and southern Cameroon

“…The elderly have a lifetime experiences that have shaped their individual values, habits and preferences, motivated by convenience, sensory appeal and perceived importance of traditional foods to health. These findings relating age with consumption of forest foods are similar to findings elsewhere (Pelto et al, 2004;Dweba and Mearns, 2011).…”

“…The present study concurs with previous studies which revealed that educated Kenyans, South Africans and Ugandans who earn more than the less educated, viewed traditional and indigenous foods as food for the poor; hence having less preference to consume traditional and indigenous African foods as compared to the western processed foods (Tabuti et al, 2004;Kimiywe et al, 2007;Dweba and Mearns, 2011). In comparison with the consumption levels, of the uneducated in Kenya, South Africa and Uganda, educated populations have been found to consume less of wild and indigenous fruits and vegetables (Oniang'o et al, 2003;Pelto et al, 2004;Tabuti et al, 2004). The educated Kenyans, South Africans and Ugandans are exposed to influences of urbanisation and western lifestyles, which lead to adopting negative perceptions towards local and indigenous African foods (Haddad, 2003;Pingali, 2007).…”

Integrated management of childhood illness with the focus on caregivers: an integrative literature review

“…Pelto, Santos, Gonçalves, Victora, Martines, Habicht (15) To (16) To evaluate the impact of the nutritional counseling component of IMCI in the growth of Brazilian children.…”

The politics of reducing malnutrition: building commitment and accelerating progress

“…A process convened by the New York Academy of Sciences and WHO for setting of research agendas in nutrition emphasises crucial gaps and a framework to undertake implementation research in nutrition. 102 Examples of such research have been emerging in the form of feasibility studies and formative research, [103][104][105][106] operations research and process evaluations, [107][108][109][110][111] and costing studies. [112][113][114] However, the scientifi c literature about implementation through delivery platforms, such as community-based or health-facility-based programmes, is more developed than is that of the use of mass media or market-based approaches to scale up interventions.…”