Background:
Nutrition
education
programmes
are
frequently
implemented
in
developing
countries
with
the
aim
of
improving
dietary
practices.
Few
studies
have,
to
date,
examined
the
various
steps
in
such
an
education
process
in
a
developing
country
setting.
This
study,
uses
McGuire's
"Communication/Persuasion"
model
to
assess
the
impact
among
poor
rural
women
in
Mozambique
of
two
nutrition
education
delivery
methods:
group
classes
only
versus
group
classes
plus
individual
classes.
Methods:
Study
participants
were
randomly
selected
from
the
total
population
of
RCT
taking
place
in
rural
Mozambique:
the
Towards
Sustainable
Nutrition
Improvement
project.
Participants
were
female,
had
a
child
under
5
years
of
age
and
had
been
randomised
to
receive
the
nutrition
education
program.
McGuire's
output
steps
(exposure,
attention,
understanding,
memorisation/recall,
skills
acquisition,
and
attitude
change)
were
assessed
for
both
nutrition
education
delivery
methods
using
a
range
of
tools
developed
by
the
investigator,
ranging
from
direct
observations
to
questionnaires.
The
sample
size
varied
for
each
output
step
depending
on
pre-defined
criteria.
Results:
The
methods
devised
in
the
current
study
for
the
assessment
of
McGuire's
output
steps
were
able
to
detect
a
good
degree
of
variability
in
response.
Mothers
receiving
both
the
group
and
individual
classes
(intervention
II)
scored
higher
in
most
output
steps
than
those
receiving
only
the
group
classes
(intervention
I),
even
after
adjusting
for
possible
confounding
influences.
For
example,
those
mothers
in
intervention
II
had
significantly
higher
skills
acquisition
scores
than
those
mothers
in
intervention
I
(difference
of
means
1.03,
independent
t-test,
p<0.001).
Within
the
sample
of
intervention
II
mothers,
the
scores
from
measurements
taken
in
individual
classes
were
significantly
higher
than
those
taken
in
the
group
classes.
For
example,
while
there
was
no
difference
in
observed
attention
scores
between
intervention
II
and
intervention
I
mothers
when
assessed
at
group
classes,
observed
attention
scores
at
individual
classes
were
Significantly
higher
(for
intervention
II
mothers)
than
those
of
intervention
I
mothers
at
group
classes
(Independent
t-test,
p=0.031).
Further
analysis
appeared
to
suggest
that
this
advantage
was
due
to
the
added
benefit
of
receiving
individual
classes
in
addition
to
group
classes;
although
this
cannot
be
confirmed
in
the
current
study
given
the
lack
of
a
study
'arm
providing
only
individual
classes.
2
Conclusions:
This
study
has
for
the
first
time
used
McGuire's
model
to
systematically
investigate
and
compare
the
communication
process
in
two
nutrition
education
delivery
methods
in
a
developing
country
and
attempted
to
develop
tools
to
measure
McGuire's
output
steps
in
such
a
setting.
McGuire's
model
emerged
as
a
good
conceptual
framework
to
use
for
this
purpose
as
it
is
practical,
and.
allowed
for
the
breakdown
of
the
process
into
_,
discrete
steps
that
permitted
comparisons
to
be
made
between
two
delivery
methods.
The
analysis
suggested
that
there
was
an
advantage
in
providing
individual
classes
in
addition
to
group
classes,
although
this
clearly
has
important
resource
implications.
