Public Health Nutrition Editorial Highlight: ‘Systematic review of the design, implementation, and effectiveness of mass media and nutrition education interventions for infant and young child feeding’ Authors Matthew Graziose, Shauna Downs, Jessica Fanzo discuss their research below.

Feeding children between 0 to 2 years is important because what is eaten during this time impacts risk for disease. However, caregivers often encounter conflicting advice on what, when, and how much to feed their children and may hold inaccurate beliefs about the best way to do so.

Finding ways to educate caregivers about the best feeding practices is a challenge that needs tackling. By using feeding practices recommended by the World Health Organization – such as exclusive breastfeeding in the first 6 months, appropriate introduction of complementary foods, and proper preparation of infant foods – caregivers have the opportunity to improve their child’s growth and reduce the risk of disease.

But reaching caregivers at the right time and place is difficult – as is identifying the right message to share. Mass media has long been used as a strategy for sharing messages among large populations. Previous mass media campaigns have observed positive impacts on physical activity and fruit and vegetable consumption behaviors.

In our systematic review, we explored the types of mass media that have been used to educate caregivers within developing countries about feeding practices for their young children. We examined 18 studies that described an intervention for educating caregivers about feeding practices using mass media channels. These studies used television; print media (such as newspapers, posters or pamphlets), voice and/or SMS messages, radio, megaphones/loudspeakers, videos; social media and songs/dramas.

Almost all studies (n=16) observed positive effects of mass media, prevalence of exclusive breastfeeding at 6 months of age (n=4 studies), prevalence of appropriate complementary feeding (n=5 studies), prevalence of early initiation of breastfeeding (n=7 studies) and the use of a micronutrient supplement (n=3 studies). There was mixed evidence as to whether combining mass media approaches with face-to-face education methods was more effective.

There were differences in the design and evaluation of mass media approaches. Nine studies explicitly mentioned the use of formative research to inform the types of messages used, which varied from ethnographies to focus groups to surveys. Only four used an existing behavioral theory to inform their messages. Less than half of studies measured the effectiveness of their messages to change psychosocial factors, such as caregivers’ attitudes, beliefs and self-efficacy, that may impact feeding practices.

While mass media interventions appear effective, our work shows that additional research is needed to identify the best ways to share messages about child feeding practices. In order to open the “black box,” future research should ask broader questions of mass media interventions, including: in which contexts are they effective; using which types of messages; for which audiences; at what intensity; and are they synergistic with traditional approaches? More information about methods used to design effective mass media interventions will help support those seeking to improve infant and child health in developing context.

The full article ‘Systematic review of the design, implementation, and effectiveness of mass media and nutrition education interventions for infant and young child feeding’ is available to download in full, for free until 11th December.

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