AnemiaNCT02593136
Home Fortification of Complementary Foods in Bihar India
A study testing Home Fortification Product (HFP) and Infant and Young Child Feeding (IYCF) Practices Counseling in people with Anemia and Malnutrition, run by Emory University at 1 site in India.
Trial summary
This study evaluates the program effectiveness of home fortification along with infant and young child feeding (IYCF) counseling as a strategy to address anemia and complementary feedings gaps in a program setting of the Integrated Family Health Initiative being implemented by CARE India (a non-profit organization) in… Read more about this study
- Who is it for?
- Ages 6 to 18 months
- Conditions the study is for
- Anemia, Malnutrition
- What is being tested?
- Home Fortification Product (HFP) and Infant and Young Child Feeding (IYCF) Practices Counseling
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 11,861 participants
- Where
- 1 siteIndia
- Study dates
- Jun 2014to Mar 2016
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 6 to 18 months
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Randomly selected children living within Health-Sub Centers (HSC) in West Champaran Bihar
Who cannot join
- Children less than six months of age
- Children greater than eighteen months of age
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Assessing Feasibility and Program Effectiveness of Home Fortification of Complementary Foods in Bihar: A Cluster Randomized Community Pilot
This study evaluates the program effectiveness of home fortification along with infant and young child feeding (IYCF) counseling as a strategy to address anemia and complementary feedings gaps in a program setting of the Integrated Family Health Initiative being implemented by CARE India (a non-profit organization) in partnership with the Government of Bihar. The study also seeks to assess the field level worker experience with counseling and dissemination of home fortification products.
Read the detailed description
This study evaluates the program effectiveness of home fortification along with infant and young child feeding (IYCF) counseling as a strategy to address anemia and complementary feedings gaps in a program setting of the Integrated Family Health Initiative being implemented by CARE India (a non-profit organization) in partnership with the Government of Bihar.The key objectives of this study are to examine acceptability and utilization by target population, assess impact on infant and young child feeding (IYCF) practices, evaluate impact on child growth, evaluate impact on hemoglobin concentration, and assess front line worker experience and motivation to disseminate enhanced counseling and home fortification products.
- Conditions
- Anemia, Malnutrition
- Being tested
- Home Fortification Product (HFP), Infant and Young Child Feeding (IYCF) Practices Counseling
- Keywords
- Vitamins, Public Health, Nutrition
- Medical subject headings
- Anemia, Malnutrition
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Home Fortification Product (HFP)Dietary supplement
The home fortification product (HFP) is a sachet containing multiple vitamins and nutrients as follows:
Iron (Ferrous Fumarate) 12.5 mg Zinc (Zinc Gluconate) 5 mg Folic Acid 0.160 mg Vitamin-A (Vit-A Acetate) 0.30 mg Vitamin-C (Ascorbic Acid) 30 mg Vitamin-B12 0.9 mcg Iodine 90 mcg Maltodextrin (Base)
Infant and Young Child Feeding (IYCF) Practices CounselingOther
Infant and Young Child Feeding (IYCF) Practices Counseling provides direction on breast milk and milk feeding, food variety, and frequency for caregivers of children aged 6 to 18 months. Participants will be visited at least monthly by a field line worker for IYCF counseling and educational materials distribution.
| Study group | Role | What they receive |
|---|---|---|
| Home Fortification and Counseling | Experimental | Participants aged 6 to 18 months will receive a daily supplement of vitamins and minerals in dry powder form to be taken once daily for up to nine months or up to 240 sachets. Participant caregivers will also receive improved young child feeding practices (IYCF) counseling from a front line worker. Receives: Dietary Supplement: Home Fortification Product (HFP); Other: Infant and Young Child Feeding (IYCF) Practices Counseling |
| Improved Child Feeding Practices (IYCF) Counseling | Experimental | Participants ages 6 to 18 months will receive improved young child feeding practices (IYCF) counseling from a front line worker. Receives: Other: Infant and Young Child Feeding (IYCF) Practices Counseling |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of home fortification sachets consumed
The number of sachets consumed versus those received by participants within seven days of distribution.
Measured: Within 7 days (Up to 7 days)
Number of home fortification sachets consumed
The number of sachets consumed versus those received by participants within thirty one days of distribution.
Measured: Within 31 days (Up to 31 days)
Change in hemoglobin concentration
Hemoglobin concentration will be collected by taking a small blood sample via finger or heal prick. A hemoglobin level below 7 g/dl is considered severe anemia.
Measured: Baseline (month 0), Endline (month 12)
Secondary outcomes (13)
Frequency of home visits
The number of times a front-line worker (FLW) visits one home within a twelve month period.
Measured: Up to 12 months
Frequency of home fortification sachet distribution
The number of times a front-line worker (FLW) distributes home fortification sachets within a twelve month period.
Measured: Up to twelve months
Change in body length
Child length will be measured using a SECA 417 length measuring board. Its measuring range is 10-100 cm with a graduation of 1 mm.
Measured: Baseline (month 0), Endline (month 12)
Change in body weight
Child body weight will be measured using a SECA 874 mother-baby digital scale with capacity of 200 kg and graduation of 50 g < 150 kg > 100 g.
Measured: Baseline (month 0), Endline (month 12)
Complementary Feeding Rate
The percent of children initiating complementary feeding at six months.
Measured: Month 6 (Up to six months)
Number of daily meals
The number of meals consumed per child in one day.
Measured: Within 24 hours (Up to one day)
Quantity of food
The amount of food consumed by a child per meal in the home fortification and IYCF arm versus the IYCF alone arm.
Measured: Within 24 hours (Up to one day)
Consistency of foods
The type of food textures (thick versus thin) consumed within 24 hours in the home fortification and IYCF arm versus the IYCF alone arm.
Measured: Within 24 hours (Up to one day)
Diversity of foods
The number of different food groups consumed in one day in the home fortification and IYCF arm versus the IYCF alone arm.
Measured: Within 24 hours (Up to one day)
Front-line worker motivation
Front-line worker (FLW) motivation to disseminate enhanced counseling and home fortification products will be measured at the end of study by the FLW survey. The FLW survey consists of questions regarding experience and perceived impact on work burden.
Measured: Endline (Up to 9 months)
Change Developmental Milestones Checklist-II (DMC-II)
Child development will be measured using the Developmental Milestones Checklist-II (DMC-II). The DMC-II is a 75-item parent report questionnaire evaluating gross motor, fine motor, language, personal-social skill development in children who are 3 to 24 months in age. The DMC-II has been slightly modified for this study by adding 7 items assessing cognitive development. The exact number of items administered depends on responses to previous items and the total range of score varies. Higher scores indicate increased development.
Measured: Baseline (month 0), Endline (month 12)
A-not-B task performance
Child executive function will be measured by direct child assessment using the A-not-B task in children 12-18 months of age only. Whether or not the child correctly identifies the location of a hidden toy is method of assessing development in early life.
Measured: Endline (month 12)
Elicited imitation task performance
Child memory will be measured by direct child assessment using the Elicited imitation tasks in children 12-18 months of age only. Elicited imitation tasks are a tool to diagnose communication deficiencies in children. This test assesses whether or not a child can imitate the order of events of a sequence modeled by the evaluator.
Measured: Endline (month 12)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Oct 2015 (estimated)
- Study startJun 2014
- Primary completionMar 2016
- Study completionMar 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for AnemiaStudies of the same condition, open and under way.
- More trials run by Emory UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 11,861 participants (actual)
Sponsor and investigators
- Lead sponsor
- Emory University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Reynaldo Martorell, Emory University
- Investigators
- Reynaldo Martorell, PhD, Principal investigator, Emory University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02593136
- Sponsor's protocol ID
- IRB00065311
- Status last verified
- Mar 2017
- First submitted
- 29 Oct 2015
- Last updated
- 14 Mar 2017
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Keats EC, Das JK, Bhutta ZA. Micronutrient powders and diarrhoea risk in infants and young children - Authors' reply. Lancet Child Adolesc Health. 2021 Aug;5(8):e29-e30. doi: 10.1016/S2352-4642(21)00164-4. No abstract available.
PubMed 34302748Larson LM, Young MF, Ramakrishnan U, Webb Girard A, Verma P, Chaudhuri I, Srikantiah S, Martorell R. A Cross-Sectional Survey in Rural Bihar, India, Indicates That Nutritional Status, Diet, and Stimulation Are Associated with Motor and Mental Development in Young Children. J Nutr. 2017 Aug;147(8):1578-1585. doi: 10.3945/jn.117.251231. Epub 2017 Jun 14.
PubMed 28615374
Study at a glance
From the registry record, last updated by the sponsor on 14 Mar 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Assessing Feasibility and Program Effectiveness of Home Fortification of Complementary Foods in Bihar: A Cluster Randomized Community Pilot
- ClinicalTrials.gov ID
- NCT02593136
- Acronym / sponsor ID
- IRB00065311
- Conditions
- Anemia, Malnutrition
- Keywords
- Vitamins, Public Health, Nutrition
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 11,861 participants (actual)
- Lead sponsor
- Emory UniversityUniversity, hospital or other
- Study start
- Jun 2014
- Primary completion
- Mar 2016 (actual)
- Study completion
- Mar 2016 (actual)
- First posted
- 30 Oct 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study evaluates the program effectiveness of home fortification along with infant and young child feeding (IYCF) counseling as a strategy to address anemia and complementary feedings gaps in a program setting of the Integrated Family Health Initiative being implemented by CARE India (a non-profit organization) in partnership with the Government of Bihar. The study also seeks to assess the field level worker experience with counseling and dissemination of home fortification products.
Detailed description
This study evaluates the program effectiveness of home fortification along with infant and young child feeding (IYCF) counseling as a strategy to address anemia and complementary feedings gaps in a program setting of the Integrated Family Health Initiative being implemented by CARE India (a non-profit organization) in partnership with the Government of Bihar.The key objectives of this study are to examine acceptability and utilization by target population, assess impact on infant and young child feeding (IYCF) practices, evaluate impact on child growth, evaluate impact on hemoglobin concentration, and assess front line worker experience and motivation to disseminate enhanced counseling and home fortification products.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Home Fortification and Counseling | Experimental | Dietary Supplement: Home Fortification Product (HFP), Other: Infant and Young Child Feeding (IYCF) Practices CounselingParticipants aged 6 to 18 months will receive a daily supplement of vitamins and minerals in dry powder form to be taken once daily for up to nine months or up to 240 sachets. Participant caregivers will also receive improved young child feeding practices (IYCF) counseling from a front line worker. |
| Improved Child Feeding Practices (IYCF) Counseling | Experimental | Other: Infant and Young Child Feeding (IYCF) Practices CounselingParticipants ages 6 to 18 months will receive improved young child feeding practices (IYCF) counseling from a front line worker. |
Who may qualify
- Ages
- 6 to 18 months
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (1 listed)
- Randomly selected children living within Health-Sub Centers (HSC) in West Champaran Bihar
Key exclusion criteria (2 listed)
- Children less than six months of age
- Children greater than eighteen months of age
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Home Fortification Product (HFP)The home fortification product (HFP) is a sachet containing multiple vitamins and nutrients as follows: Iron (Ferrous Fumarate) 12.5 mg Zinc (Zinc Gluconate) 5 mg Folic Acid 0.160 mg Vitamin-A (Vit-A Acetate) 0.30 mg Vitamin-C (Ascorbic Acid) 30 mg Vitamin-B12 0.9 mcg Iodine 90 mcg Maltodextrin (Base) | Dietary supplement | Home Fortification and Counseling |
| Infant and Young Child Feeding (IYCF) Practices CounselingInfant and Young Child Feeding (IYCF) Practices Counseling provides direction on breast milk and milk feeding, food variety, and frequency for caregivers of children aged 6 to 18 months. Participants will be visited at least monthly by a field line worker for IYCF counseling and educational materials distribution. | Other | Home Fortification and Counseling, Improved Child Feeding Practices (IYCF) Counseling |
Primary outcome
Number of home fortification sachets consumed
Time frame: Within 7 days (Up to 7 days)
The number of sachets consumed versus those received by participants within seven days of distribution.
Number of home fortification sachets consumed
Time frame: Within 31 days (Up to 31 days)
The number of sachets consumed versus those received by participants within thirty one days of distribution.
Change in hemoglobin concentration
Time frame: Baseline (month 0), Endline (month 12)
Hemoglobin concentration will be collected by taking a small blood sample via finger or heal prick. A hemoglobin level below 7 g/dl is considered severe anemia.
13 secondary outcomes
Frequency of home visits
Time frame: Up to 12 months
Frequency of home fortification sachet distribution
Time frame: Up to twelve months
Change in body length
Time frame: Baseline (month 0), Endline (month 12)
Change in body weight
Time frame: Baseline (month 0), Endline (month 12)
Complementary Feeding Rate
Time frame: Month 6 (Up to six months)
Number of daily meals
Time frame: Within 24 hours (Up to one day)
Quantity of food
Time frame: Within 24 hours (Up to one day)
Consistency of foods
Time frame: Within 24 hours (Up to one day)
Diversity of foods
Time frame: Within 24 hours (Up to one day)
Front-line worker motivation
Time frame: Endline (Up to 9 months)
Change Developmental Milestones Checklist-II (DMC-II)
Time frame: Baseline (month 0), Endline (month 12)
A-not-B task performance
Time frame: Endline (month 12)
Elicited imitation task performance
Time frame: Endline (month 12)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Mar 2017.
- Derived from this study: PubMed 34302748Keats EC, Das JK, Bhutta ZA. Micronutrient powders and diarrhoea risk in infants and young children - Authors' reply. Lancet Child Adolesc Health. 2021 Aug;5(8):e29-e30. doi: 10.1016/S2352-4642(21)00164-4. No abstract available.
- Derived from this study: PubMed 28615374Larson LM, Young MF, Ramakrishnan U, Webb Girard A, Verma P, Chaudhuri I, Srikantiah S, Martorell R. A Cross-Sectional Survey in Rural Bihar, India, Indicates That Nutritional Status, Diet, and Stimulation Are Associated with Motor and Mental Development in Young Children. J Nutr. 2017 Aug;147(8):1578-1585. doi: 10.3945/jn.117.251231. Epub 2017 Jun 14.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Reynaldo Martorell, PhD principal investigator
Emory University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Home Fortification Product (HFP) and Infant and Young Child Feeding (IYCF) Practices Counseling in people with Anemia and Malnutrition, run by Emory University at 1 site in India.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 14 Mar 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in India. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of home fortification sachets consumed (time frame: Within 7 days (Up to 7 days)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02593136, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Mar 2017.