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. 2024 Oct 31;2(2):e001358.
doi: 10.1136/bmjph-2024-001358. eCollection 2024 Dec.

Exploring the feasibility of a culturally tailored infant nutrition intervention: a qualitative study of perspectives from community facilitators and attendees in a pilot randomised controlled trial - Nurture Early for Optimal Nutrition (NEON) in East London

Logan Manikam  1   2 , Priyanka Patil  1   2 , Ummi Bello  3 , Subarna Chakraborty  3 , Sumire Fujita  3 , Joanna Drazdzewska  4 , Oyinlola Oyebode  5 , Claire Llewellyn  6 , Kelley Webbmartin  7 , Carol Irish  8 , Mfon Archibong  8 , Jenny Gilmour  9 , Phoebe Kalungi  9 , Neha Batura  10 , Rana Conway  6 , Monica Lakhanpaul  11   12   13 , Michelle Heys  12 ; NEON Steering Team
Collaborators, Affiliations

Exploring the feasibility of a culturally tailored infant nutrition intervention: a qualitative study of perspectives from community facilitators and attendees in a pilot randomised controlled trial - Nurture Early for Optimal Nutrition (NEON) in East London

Logan Manikam et al. BMJ Public Health. .

Abstract

Introduction: Appropriate and healthy feeding practices can enhance a child's health, prevent obesity and reduce chronic metabolic disease risks. Given the ethnic variations in feeding practices and metabolic risk, interventions must be community specific. Culturally tailored grassroots interventions targeting infant feeding can induce behavioural changes, mitigating chronic metabolic disease risks in later life.The aim of this study was to explore participant feedback and inform intervention delivery methods within marginalised communities.

Methods: A pilot three-arm cluster randomised controlled trial was conducted in the Tower Hamlets and Newham boroughs of London, involving community participatory learning and action groups. The study recruited 186 South Asian (Indian, Bangladeshi, Pakistani and Sri Lankan) mothers or carers of children aged 0-2 years. Participants in intervention arms were invited to either face to face or online intervention arms, facilitated by trained multilingual community facilitators (CFs), offering culturally informed discussions on child nutrition and care practices. The qualitative study was embedded within this trial, collecting feedback through interviews and focus groups. Thematic analysis was employed to identify key themes, focusing on intervention fidelity and acceptance.

Results: Of the initial attendees, 42 (from the remaining 153 at the study's conclusion) and 9 CFs offered feedback on the intervention's delivery and suggestions for enhancing community-based interventions' success. Key findings highlighted the need for a more flexible approach to boost participation and the significance of providing accessible, translated documents and resources. Participants expressed a strong preference for a hybrid model of intervention delivery, combining face-to-face and online sessions to accommodate diverse needs.

Conclusion: Parenting interventions, particularly for new mothers, may engage more of the target population by adopting a hybrid design. This would provide attendees with the flexibility to select the delivery method, session timings and the option to participate at any stage of the intervention. The study underscores the importance of cultural tailoring and flexible delivery methods in enhancing participation and engagement in community-based health interventions.

Keywords: Community Health; Epidemiologic Research Design; Public Health.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Quotes from community facilitators on participants’ attendance.
Figure 2
Figure 2. Quotes from community facilitators on language and cultural adaptation, training, intervention fidelity and coproduction. PLA, Participatory Learning and Action.
Figure 3
Figure 3. Quotes from community facilitators on logistics and support provided by Research Assistant RA).
Figure 4
Figure 4. Quotes from participants on language barriers, understanding, recruitment and non-participation affecting communication and engagement.
Figure 5
Figure 5. Quotes from participants on Nurture Early for Optimal Nutrition (NEON) intervention.
See this image and copyright information in PMC

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