Dietary Intervention Clinical Trial
Official title:
The Use of a Communication Tool About Diet in Public Health Nurse Consultations at the Child Health Centre When the Child is Aged 10 Months to 2 Years
The purpose of this study is to promote optimal nutrition for the child based on the public health nurse's family-focused conversations at the child health centre. An image based communication tool is used in an intervention in order to promote dialogue and active participation by the parents about themes concerning food and feeding practices.
Norway, as other Nordic countries, has a long-standing tradition of extensive and freely
available health care for children under school age at the child health centre. Virtually all
parents with small children use these child health centres, having regular encounters with
public health nurses. This service aims at promoting health and preventing disease in the
population. However, when comes to content and performance of conversation about food and
feeding practices there are no guidelines regarding how to adapt the information to the
individual child and to his or her family after infancy and up to two years of age.
The overall purpose of this study is to promote optimal nutrition for the child based on the
public health nurse's family-focused conversations at the child health centre.
The design of the study is a cluster randomized controlled trial. Statistics Norway has on
the basis of a systematic match drawn samples of five pairs of municipalities in Norway. It
is random which municipality in each match is extracted respectively to intervention or
control municipality.
Public health nurses on child health centres within intervention municipalities will use a
communication tool about food and feeding practices in their encounters with participating
children and parents when the child is 10-, 12- and 15-18 months old. In the control
municipalities corresponding encounters will be as usual, without use of the actual
communication tool. The parents will answer a food frequency questionnaire on behalf of their
child when the child is 10 months old (baseline) and at the age of two years (final
measurement).
Sample size consideration: The aim of the study is to reveal change in vegetable intake. The
investigators keep level of statistical significance at the customary 5 % and statistical
power of 80 % (beta equal to 20 %), the investigators would need 176 children in each group
to reveal the change described above as statistically significant.
The investigators expect some drop out and given that their estimate might be slightly
higher, the investigators want to enroll 300 children in each group to make sure our study is
sufficiently powered.
Plan for missing data: Concerning missing data the investigators will use mixed models for
repeated measure, imputation of missing data will therefore not be necessary. All data will
be analysed according to Intention to treat (ITT) analysis.
Analytical principles: Unadjusted (or crude) differences between intervention and control
group will be assessed with t-tests (for continuous variables) and Chi-square tests (when we
test for association between pairs of categorical data).
In case of continuous outcome variables, the investigators will model the differences between
groups (scores from the questionnaires) using uni- and multiple linear regression methods.
All regression models will be conditioned on district variable and not individual level
because the randomization was performed on district variable level.
The investigators treat this study as an exploratory analysis, however, they will fit several
statistical models and perform several tests therefore a correction for multiple testing will
be performed. P-values < 0,01 will be considered statistically significant.
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