Meals, Education, and Gardens for In-School Adolescents (MEGA) Project

Anemia Clinical Trial

— MEGA  

Official title:

Meals, Education, and Gardens for In-School Adolescents (MEGA) Project

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04788303
• Other study ID #: CNSG Project
• Status: Completed
• Phase: N/A
• Start date: January 24, 2022
• Est. completion date: September 30, 2022

Study information

• Verified date: May 2023
• Source: Harvard School of Public Health (HSPH)
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This purpose of this study is to assess effects of a comprehensive, school-based nutrition intervention package on anemia status, anthropometric indicators, school performance/attendance, and development indicators among adolescents, and the knowledge, attitudes, and practices of nutrition, agriculture, and WASH among parents, in Tanzania.

Description:

The Meals, Education, and Gardens for In-School Adolescents (MEGA) Project aims to implement and evaluate a comprehensive, school-based nutrition intervention package among secondary schools in Dodoma, Tanzania. The intervention will include four primary components: (1) school garden, (2) school meal program, (3) agriculture, nutrition, and water, sanitation, and hygiene (WASH) education, and (4) community workshops.

This will be a cluster randomized trial with 3 arms, containing two schools each. At the beginning of the academic year, six schools will be randomized to intervention or control. Two schools will receive the full intervention package (school lunch, school garden, and education), two schools will receive the partial intervention package (school garden and education), and two schools will serve as control to receive the standard of care. Community workshops will also be provided to parents of adolescents in full and partial intervention schools.

In the full intervention schools, all adolescents will receive a midday meal, while a subset of Forms 1 or 2 adolescents will additionally participate in a school gardening program that includes nutrition, agriculture, and water, sanitation, and hygiene (WASH) education, led by selected teachers. Parents of adolescents in full intervention schools will be invited to participate in community workshops on nutrition, hygiene, and agricultural best practices, led by community Agriculture Extension Workers (AEWs).

In the partial intervention schools, Forms 1 or 2 adolescents will participate in the gardening and education components described above, but will not receive the midday meal. Parents of participating adolescents will also be invited to participate in the community workshops.

Adolescents in control schools will not receive any of these interventions but will be provided with standard of care practices at secondary schools in Dodoma. In addition, teachers in control schools will receive a hard copy of educational materials on nutrition, agriculture, and WASH to enhance their lesson plans. The intervention will take place over the course of one year.

The goal of the MEGA project is to study the effects of the integrated intervention on the nutrition and health of adolescents and their families in Tanzania. Ultimately, we aim to use the findings from this study to inform the scale-up of future school and community-based interventions to improve nutrition through training, improved crop production, and increased consumption of vegetables.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1232
• Est. completion date: September 30, 2022
• Est. primary completion date: September 30, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 14 Years to 17 Years

Eligibility

INCLUSION CRITERIA:

Adolescents:

• Adolescents aged 14-17 years

• Enrolled in secondary school forms 1 or 2 at study initiation

• Member of one of the selected classes in a participating school

• Consent provided by the parent

• Assent provided by the adolescent

• Fluent in Swahili or English

Parents:

• Parent or guardian of participating adolescent

• Provides informed consent

• Fluent in Swahili or English

Teachers:

• Teacher facilitating the meal, garden, and/or education interventions

• Provides informed consent

• Fluent in Swahili or English

EXCLUSION CRITERIA:

Adolescents:

• No informed consent from parent/guardian or assent from adolescent

Parents:

• No informed consent

Teachers:

• No informed consent

Related Conditions & MeSH terms

• Anemia

Intervention

Other:
• School meal, garden, education, and community workshops
School meal: midday meal provided at intervention schools School garden: garden used to grow crops (which will be used to supplement the school meal in the full intervention schools) Education: agriculture, nutrition, and water, sanitation, and hygiene (WASH) curriculum Community workshops: Led by agricultural extension workers and open to community members, the community workshops will cover nutrition messages, agricultural messages, and hands-on activities on nutrition, agriculture, and WASH.
• Garden, education, and community workshops
School garden: garden used to grow crops Education: agriculture, nutrition, and water, sanitation, and hygiene (WASH) curriculum Community workshops: Led by agricultural extension workers and open to community members, the community workshops will cover nutrition messages, agricultural messages, and hands-on activities on nutrition, agriculture, and WASH.

Locations

Country	Name	City	State
Tanzania	University of Dodoma	Dodoma

Sponsors (3)

Lead Sponsor	Collaborator
Harvard School of Public Health (HSPH)	Africa Academy for Public Health, University of Dodoma

Country where clinical trial is conducted

Tanzania, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Anemia status	Anemia status will be defined using the diagnostic criteria by the World Health Organization. Specifically, the following criteria will be used: < 12 g/dL for adolescent girls and adolescent boys aged 14 yrs and < 13 g/dL for adolescent boys aged 15-19 yrs	Up to one year
Secondary	Height	Adolescent height will be measured in centimeters.	Up to one year
Secondary	Weight	Adolescent weight will be measured in kilograms.	Up to one year.
Secondary	BMI	Adolescent BMI (raw and BMI-for-age z-score based on the WHO adolescent growth standards).	Up to one year
Secondary	Knowledge of adolescents regarding nutrition and dietary intake	Adolescents' knowledge of nutrition will be assessed by questions that evaluate their levels of nutrition-related knowledge.	Up to one year
Secondary	Attitudes of adolescents regarding nutrition and dietary intake	Adolescents' attitudes of nutrition will be assessed by evaluating their preferences of food groups using Likert scales.	Up to one year
Secondary	Practices of adolescents regarding nutrition and dietary intake	Nutritional and dietary practices will be assessed using a food frequency questionnaire.	Up to one year
Secondary	Practices of adolescents regarding water, sanitation, and hygiene	Adolescents' practices of WASH will be assessed by questions that evaluate their WASH-related behaviors such as handwashing.	Up to one year
Secondary	Educational outcomes of adolescents (school attendance)	School attendance will be measured as number of school days missed per student.	Up to one year
Secondary	Educational outcomes of adolescents (School retention)	School retention will be measured as number of students who drop out of school.	Up to one year
Secondary	Practices of WASH among parents	To be assessed using questions that evaluate parents' practices on water, sanitation, and hygiene.	Up to one year
Secondary	Home gardening practices among parents	To be assessed using self-reported home gardening practice by parents.	Up to one year
Secondary	Dietary practice among parents	To be assessed using a food frequency questionnaire among parents.	Up to one year
Secondary	Nutrition knowledge among parents	To be assessed using questions that evaluate parents' knowledge on nutrition and dietary intake.	Up to one year