SPOON: Sustained Program for Improving Nutrition - Guatemala

Primary Investigator

  • Sebastian Martinez, Inter-American Development Bank

Study Period

September 2018 - December 2021

Study Description

The primary goal of the study is to prevent undernutrition and obesity in children under two years old in rural areas of Guatemala. This study is designed to evaluate whether the proposed treatment reduces the prevalence of overweight, underweight and low height-for-age indicators in the rural environment of Baja Verapaz. This study design has been developed in conjunction with colleagues from Fundazúcar, a local foundation in Guatemala.

SPOON Guatemala is an innovative strategy to prevent undernutrition and obesity in children aged 0-24 months living in high-poverty areas of Guatemala. SPOON focuses on improving feeding practices for infant and young children, including exclusive breastfeeding during a child's first six months, and promoting the use of peanut-based SQ-LNS (Small Quantity, Lipid-based Nutrient Supplements), for children 6 to 24 months of age.

The SPOON intervention consists of two different experimental arms: one control group and one treatment group. Communities in the intervention area will be randomly assigned to the control or treatment group. The control group will receive the standard services provided by their local health services, which include the provision of micronutrient powder. This powder is a package of vitamins and minerals that are sprinkled onto the child's food to increase his or her consumption of micronutrients. The treatment group will receive the SQ-LNS supplement in addition to a social communication strategy called Mejores Familiias. Mejores Familias teaches various lessons to the children's caregivers. The lessons include the importance of breastfeeding exclusively before the child is 6 months of age, maintaining hygienic practices in the home while preparing food, and providing nutritious food to the child mixed in with the SQ-LNS supplement.

Measuring the differences in outcomes between the participants in the control and treatment group will enable us to measure the combined impact of the Mejores Familias program and the SQ-LNS supplement.

Study Arms

  • Experimental: Standard Counseling and Micronutrients
  • Experimental: SPOON Counseling and SQ-LNS

Primary Outcomes

  • Change in Height and Weight from Baseline to 8 Months [ Time Frame: Measured when child is 6 months old at baseline and when child is 8 months old ]
  • Change in Height and Weight from 8 to 10 Months [ Time Frame: Measured when child is 8 months old and when child is 10 months old ]
  • Change in Height and Weight from 10 to 12 Months [ Time Frame: Measured when child is 10 months old and when child is 12 months old ]
  • Change in Height and Weight from 12 to 14 Months [ Time Frame: Measured when child is 12 months old and when child is 14 months old ]
  • Change in Height and Weight from 14 to 16 Months [ Time Frame: Measured when child is 14 months old and when child is 16 months old ]
  • Change in Height and Weight from 16 to 18 Months [ Time Frame: Measured when child is 16 months old and when child is 18 months old ]
  • Change in Height and Weight from 18 to 20 Months [ Time Frame: Measured when child is 18 months old and when child is 20 months old ]
  • Change in Height and Weight from 20 to 22 Months [ Time Frame: Measured when child is 20 months old and when child is 22 months old ]
  • Change in Height and Weight from 22 to 24 Months [ Time Frame: Measured when child is 22 months old and when child is 24 months old ]

Study Interventions

  • Standard Lipid-Based Nutrient Supplements (LNS)
  • Behavior change communication (BCC)

Research Gaps

  • Effectiveness

    How well do different food compositions and interventions prevent or treat undernutrition, when implemented "on the ground"?

Study Population

1500