Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 29;13(11):e063885.
doi: 10.1136/bmjopen-2022-063885.

Nurture Early for Optimal Nutrition (NEON) participatory learning and action women's groups to improve infant feeding and practices in South Asian infants: pilot randomised trial study protocol

Logan Manikam  1   2 , Shereen Allaham  3 , Priyanka Patil  3   2 , Maryan Naman  2 , Zhen Ling Ong  2 , Isabel-Cathérine Demel  2   4 , Neha Batura  5 , Clare Llewellyn  6 , Andrew Hayward  3 , Rajalakshmi Lakshman  7   8 , Jenny Gilmour  9 , Kelley Webb-Martin  10 , Carol Irish  10 , Mfon Archibong  10 , Corinne Clarkson  11 , Daley Delceta  12 , Lily Islam  13 , Seema Bajwa  14 , Sabiha Malek  14 , Jasvir Bhachu  14 , Geromini Pushpakanthan  14 , Michelle Heys  15   16 , Monica Lakhanpaul  15   17 ; NEON Steering Team
Collaborators, Affiliations

Nurture Early for Optimal Nutrition (NEON) participatory learning and action women's groups to improve infant feeding and practices in South Asian infants: pilot randomised trial study protocol

Logan Manikam et al. BMJ Open. .

Abstract

Introduction: Feeding practices developed in early life can impact a child's nutrition, growth, dental health, cognitive development and lifetime risk of chronic diseases. Substantial evidence suggests ethnic health inequalities, and non-recommended complementary infant feeding practices among UK's South Asian (SA) population. Nurture Early for Optimal Nutrition aims to use women's group participatory learning and action (PLA) cycles to optimise infant feeding, care and dental hygiene practices in SA infants <2 years in East London.

Methods and analysis: A three-arm pilot feasibility cluster randomised controlled trial will assess feasibility, acceptability, costs and explore preliminary effectiveness for proposed primary outcome (ie, reporting on body mass index (BMI) z-score). Multilingual SA community facilitators will deliver the intervention, group PLA Cycle, to mothers/carers in respective ethnic/language groups. 12 wards are randomised to face-to-face PLA, online PLA and usual care arms in 1:1:1 ratio. Primary outcomes are feasibility and process measures (ie, BMI z-score, study records, feedback questionnaires, direct observation of intervention and sustainability) for assessment against Go/Stop criteria. Secondary outcomes are cluster-level and economic outcomes (ie, eating behaviour, parental feeding practices, network diffusion, children development performance, level of dental caries, general practitioner utilisation, costs, staff time). Outcomes are measured at baseline, every 2 weeks during intervention, 14 weeks and at 6 months by blinded outcome assessors where possible. This study will use concurrent mixed-methods evaluation. Quantitative analyses include descriptive summary with 95% CI and sample size calculation for the definitive trial. The intervention effect with CI will be estimated for child BMI z-score. Implementation will be evaluated qualitatively using thematic framework analysis.

Ethics and dissemination: Ethics approval was obtained from University College London (UCL), National Health Service (Health Research Authority (HRA) and Health and Care Research Wales (HRCW)). Results will be published in peer-reviewed journals, presented at scientific conferences/workshops with commissioners, partners and participating communities. Plain language summaries will be disseminated through community groups, websites and social media.

Trial registration number: IRAS-ID-296259 (ISRCTN10234623).

Keywords: Community child health; NUTRITION & DIETETICS; PAEDIATRICS; PUBLIC HEALTH.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Overview schematic detailing number of wards and PLA groups by East London boroughs. To illustrate, TH will have two face-to-face Bangladeshi/ Bengali and Sylheti PLA groups (one per ward), two groups of Bangladeshi/ Bengali and Sylheti online PLA group (one per ward) and two Bangladeshi/ Bengali and Sylheti control groups (one per ward). The more the ethnic/ language group in the borough, the more the intervention and control groups. PLA, participatory learning and action.
Figure 2
Figure 2
Overview of the NEON pilot feasibility RCT design and participant flow. NEON, Participatory Learning and Action; PLA, participatory learning and action; RCT, randomised controlled trial; SA, South Asian.
Figure 3
Figure 3
NEON Women’s Group PLA Cycle. NEON, Participatory Learning and Action; PLA, participatory learning and action.
See this image and copyright information in PMC

References

    1. World Health Organization (WHO) . Postnatal care for mothers and newborns: highlights from the world health organization 2013 guidelines; 2015. 4. Available: http://www.who.int/maternal_child_adolescent/publications/WHOMCA-PNC-201...
    1. WHO Multicentre Growth Reference Study Group . WHO child growth standards based on length/height, weight and age. Acta Paediatrica 2006;95:76–85. 10.1111/j.1651-2227.2006.tb02378.x - DOI - PubMed
    1. Evandrou M, Falkingham J, Feng Z, et al. Ethnic inequalities in limiting health and self-reported health in later life revisited. J Epidemiol Community Health 2016;70:653–62. 10.1136/jech-2015-206074 - DOI - PMC - PubMed
    1. Brown MS. Religion and economic activity in the South Asian population. Ethnic and Racial Studies 2000;23:1035–61. 10.1080/014198700750018405 - DOI
    1. ASQ-3 . The ages & stages questionnaires, 3rd ed. Available: https://agesandstages.com/products-pricing/asq3 [Accessed 30 Nov 2019].

Publication types