Background: The sending of text messages (short messaging service, SMS) has been proven as an effective strategy in behavior change. In Mexico, the Strategy of Comprehensive Care for the Nutrition (EsIAN for its acronym in Spanish ) focuses on improving access to information for the main caregivers of child beneficiaries on the practice of infant feeding and healthy physical activity. Objective: To assess whether the mHealth (or mobile health) strategy or the sending of SMS has an effect on knowledge, attitudes, intentionality, perceived control and practices to prevent childhood malnutrition in a population living in poverty. Design: Randomized effectiveness trial by conglomerates. Participants: 400 primary caregivers of children \<59 months and health personnel working in the health units included in the study. Control group: Healthy child care in standard health units plus exposure to EsIAN. Intervention group: In addition to the control group, the SMS are sent through a cell pone through the RapidPro platform on practices related to prevention of child malnutrition (in primary caregivers) and the reinforcement of counseling for the prevention of infant malnutrition (with health personnel). Randomization: The first level health units were stratified by state (Morelos or Yucatan); rural and urban area and affiliation institution (Secretary of Health or Mexican Institute of Social Security); and randomized to be assigned to the control or intervention group; 400 primary caregivers of children \<59 months in total will be included for the study. Main measures of interest: State of nutrition and knowledge, attitudes or practices on breastfeeding, physical activity, adoption and preparation of healthy foods and beverages in primary caregivers of children\<5 years old; and advice on the key messages of EsIAN by health providers.
RapidPro is a tecnological platform of programming of short messaging service (SMS) for cell phone. Morelos is the name of one of the central states of Mexico Yucatan is the name of one of the south states of Mexico
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
1,000
Standard child care in health unit plus exposure to EsIAN
SMS messages sent through a cell pone through the RapidPro platform on practices related to the prevention of infant malnutrition to primary caregivers and the strengthening of counseling for the prevention of infant malnutrition with health providers.
Ministry of Health of Morelos State
Cuernavaca, Mexico
prevalence of overweight and obesity
Through the measurements of weight and height to children under 60 months, the estimator of body mass index adjusted for age will be calculated to determine prevalence of overweight (+1 SD. Z score ) and obesity (+2 SD Z score).
Time frame: basal and through study completion, an average of 9 months.
Proportion of caregivers / mothers with correct infant feeding practices scale
Practices related to breastfeeding, complementary food and healthy nutrition during childhood (scale of 0-20 values , which high scores \>15 is correct)
Time frame: basal and through study completion, an average of 9 months.
Proportion of caregivers / mothers with correct physical activity practices scale
Practices of physical activity to less 5 years old (scale of 0-20 values , which high scores \>15 is correct)
Time frame: basal and through study completion, an average of 9 months.
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