Cognitive Function Clinical Trial
Official title:
Study on a Locally Prepared Food Supplement to Support Growth and Brain Health
This study is a randomized controlled trial with a main goal to assess the effects of a locally-prepared food for prevention of malnutrition and stunting, in comparison with standard village practices and also a widely available aid food supplement in 8-12 villages in Guinea-Bissau. The supplement intervention will be for 24-30 weeks. The primary outcome will be cognitive tests of executive function. Secondary outcomes will be changes in standard anthropometric benchmarks of growth, hemoglobin and skin carotenoids in young children living in villages in rural Guinea-Bissau. This is a within-village randomization at the level of the family, and all children will receive a dietary intervention.
Up to 1050 children aged 15 months to 6.99 years, and older children if in 1st grade
elementary school, in 8-12 villages in the Oio and Cachau regions of Guinea-Bissau will be
recruited for this study along with their maternal caregiver and father. Child ages will be
based on the official birth records which families possess. The mothers/primary caregivers
and fathers of the children will also be recruited for simple outcome assessments. Villages
will be a convenience sample chosen from villages within the network of our local research
partner International Partnership for Human Development. Each village in this region has one
school and one community health center per village, which will be involved in supplement
distribution and some outcome assessments.
Families with enrolling children will be randomized within 8-12 villages to receive 1 of 3
supplements and if any family (defined based on the father of the children since this is a
polygamous community) has more than one enrolling child all those children will be randomized
to the same supplement arm.
- One supplement will be the locally-prepared bar
- One will be an isocaloric amount of porridge prepared with USAIDs Corn Soy Blend Plus,
prepared as recommended in a 10:3 ratio with fortified vegetable oil.
- One supplement will be an isocaloric amount of cooked rice with vegetable oil, which is
the typical local breakfast.
Villagers will be informed of the randomization after baseline testing is complete.
Following baseline measurements in children of anthropometry and body composition, grip
strength, cognition, hemoglobin, and skin carotenoids, children will receive their
intervention for 24-30 weeks and the same measurements taken at baseline will be repeated
during the last study week. The flexible end data is given to accommodate the local rainy
season and its impact on transportation. Please note that cell phone access to villages is
not influenced by local weather, thus communication regarding safety issues with community
health workers will remain possible throughout the entire trial.
Addendum: The pre-planned primary method of analysis was a per-protocol analysis, predefined
as children consuming ≥75% of their supplement. However, a clerical error in this clinical
trial registration did not describe this predetermined focus on a per-protocol population.
The registration implies an intention-to-treat (ITT) analysis by default. Investigators
therefore revised our analytical approach to designate the ITT cohort as the primary cohort
of interest. The secondary cohort of interest is the predefined per-protocol cohort (children
consuming ≥75% of their supplement).
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