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Nutrition counseling training changes physician behavior and improves caregiver knowledge acquisition
Gretel H Pelto1, Iná Santos, Helen Gonçalves
1Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA. gp32@cornell.edu
The Journal of Nutrition
|January 30, 2004
Summary
Physician training in nutrition counseling significantly improved children's growth by enhancing mothers' recall of dietary advice. This intervention boosted retention of messages on specific foods and feeding practices.
Area of Science:
- Pediatrics
- Public Health
- Nutrition Science
Background:
- Growth faltering in children is a significant public health concern.
- Effective nutrition counseling by healthcare providers is crucial for improving child nutrition outcomes.
- Previous interventions have shown varying success rates in improving caregiver retention of nutrition advice.
Purpose of the Study:
- To examine physician behavior and caregiver retention of nutrition advice as mediating factors in a nutrition counseling efficacy trial.
- To assess the impact of a specific nutrition counseling training protocol on physician practices and mother's recall of advice.
- To evaluate the effectiveness of the Integrated Management of Childhood Illness (IMCI)-derived nutrition counseling in reducing growth faltering in young children.
Main Methods:
- A pair-matched randomized controlled trial was conducted in Pelotas, Brazil.
- Municipal health centers were assigned to either an intervention group (physicians trained in nutrition counseling) or a control group.
- A substudy utilized direct observation of consultations and home interviews with mothers to assess physician behavior and message recall.
Main Results:
- Trained physicians were more likely to provide extensive nutrition counseling (P < 0.013) and utilized better communication skills (P < 0.01).
- Mothers receiving advice from trained providers demonstrated significantly higher recall rates for specific food recommendations (95% vs. 27%; P < 0.01) and feeding practices (90% vs. 20%; P < 0.01).
- Recall rates for breastfeeding advice did not differ significantly between groups (60% vs. 30%; P = 0.20).
Conclusions:
- Physician training in nutrition counseling, incorporating locally appropriate messages, assessment tools, and counseling skills, significantly enhances caregiver retention of advice.
- Improved caregiver recall of nutrition advice mediated by enhanced physician behavior is a key factor in reducing child growth faltering.
- The IMCI-derived nutrition counseling protocol shows promise for improving child nutrition through effective communication and education strategies.