Singida Nutrition and Agroecology Project (SNAP)

• ClinicalTrials.gov Identifier: NCT02761876
• Recruitment Status: Completed
• First Posted: May 4, 2016
• Last Update Posted: October 8, 2020
• Sponsor: Cornell University
• Collaborators: Nelson Mandela African Institute of Science and Technology; Action Aid Tanzania; Ilonga Agricultural Research Institute
• Information provided by (Responsible Party): Cornell University

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.

Condition or disease	Intervention/treatment	Phase
Malnutrition	Behavioral: Mentor farmer training (Malawi); Behavioral: Mentor farmer training (Singida, Tanzania); Behavioral: Mentor farmer visits and facilitation	Not Applicable

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.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 700 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Prevention
• Official Title: Singida Nutrition and Agroecology Project
• Study Start Date: February 2016
• Actual Primary Completion Date: February 2019
• Actual Study Completion Date: May 2019

Arms and Interventions

Arm	Intervention/treatment
Experimental: Intervention (Participatory education); Participatory education	Behavioral: Mentor farmer training (Malawi); 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.; Behavioral: Mentor farmer training (Singida, Tanzania); 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.; Behavioral: Mentor farmer visits and facilitation; 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.
No Intervention: Control; Delayed participatory education

Outcome Measures

Primary Outcome Measures :

1. Change in dietary diversity score (mean and proportion of score >4) [ Time Frame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) ]
   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 :

1. Change in mean child's height-for-age z-score [ Time Frame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) ]
   According to World Health Organization growth chart
2. Change in proportion of children who are stunted (HAZ<-2) [ Time Frame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) ]
   According to World Health Organization growth chart
3. Change in mean child's weight-for-height z-score [ Time Frame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) ]
   According to World Health Organization growth chart
4. Change in proportion of children who are wasted (WHZ<-2) [ Time Frame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) ]
   According to World Health Organization growth chart
5. Change in mean Food Insecurity Score [ Time Frame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) ]
   Household Food Insecurity Access Scale (HFIAS)
6. Change in proportion of households with severe or moderate food insecurity [ Time Frame: Twice a year for the first three years of study (2016, 2017, 2018) and once in the final year (2019) ]
   Household Food Insecurity Access Scale (HFIAS)

Eligibility Criteria

• Ages Eligible for Study: up to 100 Years (Child, Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

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

Contacts and Locations

Sponsors and Collaborators

Cornell University

Nelson Mandela African Institute of Science and Technology

Action Aid Tanzania

Ilonga Agricultural Research Institute

Investigators

• Principal Investigator: Rachel N Bezner Kerr, MS PhD; Cornell University
• Principal Investigator: Sera L Young, MA PhD; Cornell University
• Principal Investigator: Elias Mtinda; Action Aid Tanzania

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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.

• Responsible Party: Cornell University
• ClinicalTrials.gov Identifier: NCT02761876
• Other Study ID Numbers: 1511005983
• First Posted: May 4, 2016
• Last Update Posted: October 8, 2020
• Last Verified: October 2020

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Undecided

Additional relevant MeSH terms:

Malnutrition; Nutrition Disorders