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
,
Edward Fottrell,
Michelle Heys,
Gary Tse,
Oyinlola Oyebode,
Mitch Blair,
Monica Lakhanpaul,
Logan Manikam,
Dianna Smith,
Audrey Prost,
Andrew Hayward,
Neha Batura,
Atul Singhal,
Lisa Dikomitis,
Richard Watt,
Lily Islam,
Rajalakshmi Lakshman,
Shereen Allaham,
Lindsay Forbes,
Zhen Ling Ong,
Julia Thomas,
Ian Warwick,
Sonia Ahmed,
Ashlee Teakle,
Nazanin Zand,
Rana Conway,
Clare Llewellyn,
Priyanka Patil,
Joanna Drazdzewska,
Maryan Naman,
Isabel-Cathérine Demel,
Jenny Gilmour,
Kelley Webb-Martin,
Carol Irish,
Mfon Archibong,
Corinne Clarkson,
Daley Delceta,
Seema Bajwa,
Sabiha Malek,
Jasvir Bhachu,
Geromini Pushpakanthan,
Amelie Gonguet,
Gary Wooten,
Vaikuntanath Kakarla,
Phoebe Kalungi,
Keri McCrickerd,
Mari Toomse-Smith,
Scott Elliot,
Aeilish Geldenhuys,
Chris Gedge,
Kristin Bash,
Kate Questa,
Megan Blake,
Queenie LAW Pui Sze,
Gavin Talbot,
Chiong Yee Keow,
Angela Trude,
Lakmini Shah,
Subarna Chakraborty,
Yeqing Zhang,
Sumire Fujita,
Dina Mobashir,
Natasha Chug,
Tala El Khatib,
Delaney Douglas-Hiley
Affiliations
Edward Fottrell
Michelle Heys
Specialist Children and Young People’s Services, East London NHS Foundation Trust, London, UK
Gary Tse
Oyinlola Oyebode
Mitch Blair
Monica Lakhanpaul
Department of Population, Policy & Practice, UCL Great Ormond Street Institute of Child Health, London, UK
Logan Manikam
Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, London, UK
Dianna Smith
Audrey Prost
Andrew Hayward
Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, London, UK
Neha Batura
1 Institute for Global Health, University College London, London, UK
Atul Singhal
5Southwest Rheumatology, Dallas, United States of America
Lisa Dikomitis
Richard Watt
Lily Islam
London Borough of Tower Hamlets, London, UK
Rajalakshmi Lakshman
Public Health Directorate, Cambridgeshire County Council, Cambridge, UK
Shereen Allaham
Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, London, UK
Lindsay Forbes
Zhen Ling Ong
Aceso Global Health Consultants Pte Limited, Singapore
Julia Thomas
Ian Warwick
Sonia Ahmed
Ashlee Teakle
Nazanin Zand
Rana Conway
Clare Llewellyn
Department of Behavioural Science and Health, UCL Institute of Epidemiology and Health Care, London, UK
Priyanka Patil
Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health Care, London, UK
Joanna Drazdzewska
Maryan Naman
Aceso Global Health Consultants Pte Limited, Singapore
Isabel-Cathérine Demel
Aceso Global Health Consultants Pte Limited, Singapore
Jenny Gilmour
Tower Hamlets GP Care Group, Mile End Hospital, London, UK
Kelley Webb-Martin
Children’s Health 0-19 Service, London Borough of Newham, London, UK
Carol Irish
Children’s Health 0-19 Service, London Borough of Newham, London, UK
Mfon Archibong
Children’s Health 0-19 Service, London Borough of Newham, London, UK
Corinne Clarkson
Public Health Directorate, London Borough of Waltham Forest, London, UK
Daley Delceta
Chingford Health Centre Waltham Forest, London, UK
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).
