Efetividade de intervenção educativa em alimentação complementar sobre o conhecimento dos profissionais de saúde da Estratégia de Saúde da Família e sobre as práticas alimentares de crianças menores de um ano

Abstract

This paper aimed on the evaluation of the effectiveness of an educational intervention on complementary feeding (CF) on both the level of knowledge of health professionals within the Family Health Strategy Program (FHSP) and the feeding practices of children less than one year that attended in the municipal healthcare system of Rio de Janeiro. It is a randomized controlled community intervention study. The intervention consisted of a training activity complemented by the availability of materials for professional practice and educational folders to be delivered by these professionals to mothers or guardians of children in care routine. The training activity lasted nine hours, divided into three shifts of three hours, and was focused on specific guidelines on introduction and offering of complementary foods. The outcomes of interest were: the knowledge of health professionals about feeding practices during the first year of life and the dietary habits of infants at four, six, nine, and twelve months of life. The questionnaire about the knowledge of professionals was fulfilled by the Intervention Group (IG) at the beginning of the first round (T1) and at the end of the third turn (T2) of the training activity and also immediately before the beginning of data collection with children (T3). Professionals in the Control Group (CG) fulfilled the questionnaire at T3. Data collection about children feeding practices was performed by household visits to their mothers or guardians when those children completed four, six, nine, and twelve months of age. The level of knowledge of professionals IG in relation to their CF knowledge was compared before the training, immediately after the training and four months after the training activity. Eating habits of children from IG was compared with those of CG in the four accompaniments. The effectiveness of the intervention on dietary habits of children was evaluated by "intention to treat". The statistical significance of the differences observed between the IG and CG was assessed by t-Student and chi-square tests. Multivariate logistic regression analyses were made for each outcome of interest. An increase in the level of knowledge of IG professionals in relation to CF between T1 and T2 and between T1 and T3 was observed. It was also observed a difference between IG and CG in T3. IG children presented higher proportions of breastfeeding and lower proportions of utensils use than those of CG at 12 months of age. The energy density of recommended food and the variety of food were below recommended levels for both groups at all ranges. There was an expressive consumption of ultra processed and not recommended food products. Although IG professionals had a higher level of CF knowledge in the beginning of the children enrolment for this study, dietary profiles were similar and distant from the recommendations for both groups of children for almost all indicators studied during the first year of life