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Do Mass Media and Mobile Technology Nutrition Education Campaigns Improve Infant and Young Child Feeding Knowledge, Attitudes, and Practices in the Developing World? A Systematic Review of the Evidence
Author(s) -
Graziose Matthew,
O'Brien Quentin,
Downs Shauna,
Fanzo Jessica
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.891.4
Subject(s) - breastfeeding , psychological intervention , mass media , developing country , intervention (counseling) , malnutrition , medicine , inclusion (mineral) , grey literature , systematic review , pediatrics , nutrition education , window of opportunity , family medicine , medical education , psychology , medline , gerontology , nursing , advertising , political science , social psychology , economic growth , real time computing , computer science , business , pathology , economics , law
The first 1000 days from conception until a child reaches two years of age is a critical window of opportunity to optimize the health and nutritional status of children. Improving infant and young child feeding (IYCF) practices during this period can reduce malnutrition and lead to long‐term health gains. The objective of this study was to examine the impact of mass media and mobile technology nutrition education campaigns targeting IYCF knowledge, attitudes and practices in the developing world. A systematic review was conducted using the Pubmed, EMBASE and PsychINFO databases. We also examined the first 20 pages of Google in order to identify grey literature. Studies that examined mass media (e.g., posters, television, radio, etc.) or mobile technology (e.g., text or voice messages) interventions in developing countries, had a pre‐ and post‐test design and were published in English were included in the review. The primary outcomes examined were changes in IYCF practices including breastfeeding. Secondary outcomes were knowledge and attitudes related to IYCF. Two members of the research team (MG and QO) independently screened titles, abstracts and full texts of the studies identified in the searches. The search resulted in 2733 records, which were subsequently screened by title. We then reviewed abstracts (n=565) and determined that 69 were eligible for full text review. Of these, the majority (n=46) were excluded for not meeting the intervention inclusion criteria. Other reasons for exclusion included, the study country (n=8), language (n=8) and design (n=3). In total, 9 studies met our inclusion criteria and were included in the review. These studies were conducted in Nigeria, Mexico, Bolivia and Madagascar, Cambodia, Taiwan, Zimbabwe, and Iran. Two of the reviewed studies used a cluster‐randomized design; the remaining studies employed quasi‐experimental designs. The most common mass media components used in these studies included: songs or dramas (n=3), videos (n=3), radio messages or testimonials (n=2), television messages (n=3) and text and/or voice messages delivered to cellphones (n=1). Seven studies measured exclusive breastfeeding – six found a positive significant effect of the intervention on exclusive breastfeeding rates. Many of the studies provided little detail regarding the content of the messages included and only three explicitly mentioned a behavior change theory used for intervention design. Overall, our review found evidence to suggest that mass media and mobile technology interventions may lead to improved exclusive breastfeeding rates. However, given the small number of studies that met our inclusion criteria, the diversity in the interventions and the overall poor study quality more evidence is required to determine the most effective means of improving IYCF knowledge, attitudes and practices.