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Singida Nutrition and Agroecology Project (SNAP)

Primary Purpose

Malnutrition

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Mentor farmer training (Malawi)
Mentor farmer training (Singida, Tanzania)
Mentor farmer visits and facilitation
Sponsored by
Cornell University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Malnutrition

Eligibility Criteria

undefined - 100 Years (Child, Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Are among the most vulnerable, as indicated by food insecurity
  • Have a child who will be <= 1 year old in February 2016
  • Are farmers who have regular access to the same farms/plots (but they do not need to own the land per se)
  • Female headed households are acceptable, so long as not more than half the selected households in the village are female headed (to be able to detect change in gender equity)
  • Willing to stay in study for 3 years, i.e. do not plan to move
  • Interested in experimenting with new farming techniques

Exclusion Criteria:

  • Refuses to take part

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    No Intervention

    Arm Label

    Intervention (Participatory education)

    Control

    Arm Description

    Participatory education

    Delayed participatory education

    Outcomes

    Primary Outcome Measures

    Change in dietary diversity score (mean and proportion of score >4)
    As defined by World Health Organization (see Citations), this refers to the number of food groups (out of 7) consumed by children the previous day ."

    Secondary Outcome Measures

    Change in mean child's height-for-age z-score
    According to World Health Organization growth chart
    Change in proportion of children who are stunted (HAZ<-2)
    According to World Health Organization growth chart
    Change in mean child's weight-for-height z-score
    According to World Health Organization growth chart
    Change in proportion of children who are wasted (WHZ<-2)
    According to World Health Organization growth chart
    Change in mean Food Insecurity Score
    Household Food Insecurity Access Scale (HFIAS)
    Change in proportion of households with severe or moderate food insecurity
    Household Food Insecurity Access Scale (HFIAS)

    Full Information

    First Posted
    March 11, 2016
    Last Updated
    October 6, 2020
    Sponsor
    Cornell University
    Collaborators
    Nelson Mandela African Institute of Science and Technology, Action Aid Tanzania, Ilonga Agricultural Research Institute
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02761876
    Brief Title
    Singida Nutrition and Agroecology Project
    Acronym
    SNAP
    Official Title
    Singida Nutrition and Agroecology Project
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2020
    Overall Recruitment Status
    Completed
    Study Start Date
    February 2016 (undefined)
    Primary Completion Date
    February 2019 (Actual)
    Study Completion Date
    May 2019 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Cornell University
    Collaborators
    Nelson Mandela African Institute of Science and Technology, Action Aid Tanzania, Ilonga Agricultural Research Institute

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this study is to test if a participatory, agroecological peer farmer-led education intervention can be effective at improving legume production, food security, and infant and young child feeding practices in Singida District, Tanzania.
    Detailed Description
    Approximately 40% of under five children in Tanzania are stunted, with higher levels in rural areas. Our inception research in Singida identified five pressing issues faced by smallholder farmers that may contribute to this high rate of stunting. They are (A) hierarchical, or "top down" farmer education, (B) low soil fertility and little knowledge of agroecological solutions, (C) high levels of gender inequality and high workloads for women, (D) food insecurity and low dietary diversity, and (E) sub-optimal infant and young child feeding. Singida Nutrition and Agroecology Project (SNAP) is a randomized effectiveness trial of a participatory, agroecological peer farmer education intervention. Each intervention village will choose 2 mentor farmers, 1 man and 1 woman, who will participate in a field visit to and training by existing mentor farmers in Malawi and a two week long follow-up and refresher trainings in Tanzania integrating agroecology, climate change, nutrition, and gender equality. Mentor farmers will then conduct monthly visits to participating households and support the households in conducting experimentation with agroecological practices and/or new behaviors regarding nutrition and gender equality. Quarterly meetings among mentor farmers and biannual meeting of participating farmers within each village will be held to discuss progress and challenges of peer education and household experimentations.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Malnutrition

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    700 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Intervention (Participatory education)
    Arm Type
    Experimental
    Arm Description
    Participatory education
    Arm Title
    Control
    Arm Type
    No Intervention
    Arm Description
    Delayed participatory education
    Intervention Type
    Behavioral
    Intervention Name(s)
    Mentor farmer training (Malawi)
    Intervention Description
    Mentor farmers, 1 man, 1 woman, from each village will participate in a field visit to and training by existing mentor farmers in Malawi. Only the intervention arm of this study will receive mentor farmer training in Malawi, delayed intervention arm will receive mentor farmer training from farmers participating in the initial intervention in Tanzania.
    Intervention Type
    Behavioral
    Intervention Name(s)
    Mentor farmer training (Singida, Tanzania)
    Intervention Description
    Mentor farmers will receive training in Singida, Tanzania on agroecology practices, climate change, nutrition, and gender equality. Intervention villages will receive training in 2016. Delayed intervention villages will receive training in 2019.
    Intervention Type
    Behavioral
    Intervention Name(s)
    Mentor farmer visits and facilitation
    Intervention Description
    Mentor farmers will conduct monthly visits to participating households and support the households in conducting experimentation with agroecological practices and/or new behavior regarding nutrition and gender equality. Quarterly meetings among farmers within each village will be held to discuss progress and challenges of household experimentations. Intervention households will receive support and facilitation for approximately 2 years. Delayed intervention households will receive support and facilitation for approximately 6 months after end line survey.
    Primary Outcome Measure Information:
    Title
    Change in dietary diversity score (mean and proportion of score >4)
    Description
    As defined by World Health Organization (see Citations), this refers to the number of food groups (out of 7) consumed by children the previous day ."
    Time Frame
    Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
    Secondary Outcome Measure Information:
    Title
    Change in mean child's height-for-age z-score
    Description
    According to World Health Organization growth chart
    Time Frame
    Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
    Title
    Change in proportion of children who are stunted (HAZ<-2)
    Description
    According to World Health Organization growth chart
    Time Frame
    Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
    Title
    Change in mean child's weight-for-height z-score
    Description
    According to World Health Organization growth chart
    Time Frame
    Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
    Title
    Change in proportion of children who are wasted (WHZ<-2)
    Description
    According to World Health Organization growth chart
    Time Frame
    Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
    Title
    Change in mean Food Insecurity Score
    Description
    Household Food Insecurity Access Scale (HFIAS)
    Time Frame
    Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)
    Title
    Change in proportion of households with severe or moderate food insecurity
    Description
    Household Food Insecurity Access Scale (HFIAS)
    Time Frame
    Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019)

    10. Eligibility

    Sex
    All
    Maximum Age & Unit of Time
    100 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Are among the most vulnerable, as indicated by food insecurity Have a child who will be <= 1 year old in February 2016 Are farmers who have regular access to the same farms/plots (but they do not need to own the land per se) Female headed households are acceptable, so long as not more than half the selected households in the village are female headed (to be able to detect change in gender equity) Willing to stay in study for 3 years, i.e. do not plan to move Interested in experimenting with new farming techniques Exclusion Criteria: Refuses to take part
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Rachel N Bezner Kerr, MS PhD
    Organizational Affiliation
    Cornell University
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Sera L Young, MA PhD
    Organizational Affiliation
    Cornell University
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Elias Mtinda
    Organizational Affiliation
    Action Aid Tanzania
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided
    Citations:
    PubMed Identifier
    33973009
    Citation
    Santoso MV, Bezner Kerr RN, Kassim N, Martin H, Mtinda E, Njau P, Mtei K, Hoddinott J, Young SL. A Nutrition-Sensitive Agroecology Intervention in Rural Tanzania Increases Children's Dietary Diversity and Household Food Security But Does Not Change Child Anthropometry: Results from a Cluster-Randomized Trial. J Nutr. 2021 Jul 1;151(7):2010-2021. doi: 10.1093/jn/nxab052.
    Results Reference
    derived

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    Singida Nutrition and Agroecology Project

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