The effectiveness of Nutrition Education for Overweight/Obese Mother with Stunted Children (NEO-MOM) in reducing double burden of malnutrition

NEO-MOM project is a randomized controlled trial research with 3 months behavior intervention towards households with stunted children and overweight/obese mother (SCOWT). The intervention in NEO-MOM project will consist of combination of 6 sessions Nutrition Education and 6 sessions of motivational interviewing through home visit. The sessions will be conducted in biweekly basis or every two weeks or twice a months. The 6 nutrition intervention sessions will be administered alternatively with home visit (motivational interviewing session) throughout the intervention period. In total, the intervention will span 3 months. The approximate duration of each nutrition education session is 100 minutes consist of 50 minutes class session followed by 50 minutes hands-on experience. The motivational interviewing session approximately lasted for 1 hour. The nutrition education class will be administered by 3 co-researchers in Indonesia. They are faculty members of Department of Nutrition, Universitas Airlangga with expertise in nutrition and behavioral change intervention. All of them hold master degree in public health or community nutrition. The hands-on experience session will be delivered by 2 trained research assistants that holds bachelor degree in public health nutrition. The motivational interviewing session (through home visit) will be delivered by trained community health worker that live in participants living area. The sessions are administered to mothers only. The general content of the 6 sessions’ nutrition educations are: session 1) 50 minutes nutrition education class on the introduction on the double burden of malnutrition, especially consequences and management of overweight/obesity and child stunting. The session followed by 20 minutes dance session and 30 minutes hands-on experience on making goal setting to improve physical activity (as in daily steps), fruit and vegetable intake for mother and serving animal protein for their children; 2) 50 minutes nutrition education class on healthy grocery shopping followed by 20 minutes dance session and 30 minutes mocked grocery shopping. 3) 50 minutes nutrition education class on Indonesian balance diet and Indonesian version of MyPlate followed by 20 minutes dance session and 30 minutes menu making for under five year old children with emphasize of including animal protein (chicken liver, catfish or egg). 4) 30 minutes nutrition education class on healthy cooking method followed by 20 minutes dance session and 60 minutes cooking demonstration; 5) 50 minutes nutrition education class on Child feeding practice with emphasize of responsive feeding followed by 20 minutes dance session and 30 minutes role play and jingle/song making related to combating child stunting. 6) 50 minutes FGD on how to overcome barriers towards child feeding practice followed by 20 minutes dance session and 30 minutes creation of pledge and strategies to tackle stunted child and overweight/obese mother (SCOWT) from mothers own perspective. The motivational interviewing delivered through home visit (6 times throughout the study administered in alternate week from nutrition education class and hands-on activity session) will focus on providing verbal motivation for mothers to achieve their biweekly goal setting (consist of: improving daily steps, fruit and vegetables intake, and serving child with animal protein), and help them with strategies to overcome barriers. To monitor adherence to the intervention we will make a log of nutrition education sessions including attendance list filled by our research assistants, form of biweekly goal settings filled by mothers at the end of class and hands-on activity sessions. Through collaboration with local grocery store, we will monitor maternal grocery purchase from the recorded grocery voucher that we gave to the mothers each time they attend our class and hands-on session. In addition, to monitor adherence towards physical activity improvement we will monitor maternal daily steps using pedometer during home visit and record it into the log for each participants.