Effect of double-duty interventions on double burden of malnutrition among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a cluster randomised controlled trial

Combating the double burden of malnutrition (DBM) in adolescents is a critical public health challenge in low-income countries like Ethiopia. However, past efforts have lacked focus and exhibited diverse governance strategies. Therefore, this study assesses the effect of selected double-duty interve...

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Main Authors: Lemma Getacher, Beyene Wondafrash Ademe, Tefera Belachew
Format: Article
Language:English
Published: Cambridge University Press 2024-01-01
Series:Journal of Nutritional Science
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Online Access:https://www.cambridge.org/core/product/identifier/S2048679024000685/type/journal_article
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author Lemma Getacher
Beyene Wondafrash Ademe
Tefera Belachew
author_facet Lemma Getacher
Beyene Wondafrash Ademe
Tefera Belachew
author_sort Lemma Getacher
collection DOAJ
description Combating the double burden of malnutrition (DBM) in adolescents is a critical public health challenge in low-income countries like Ethiopia. However, past efforts have lacked focus and exhibited diverse governance strategies. Therefore, this study assesses the effect of selected double-duty interventions (DDIs) on DBM among adolescents in Central Ethiopia. The DBM status (thinness, normal, overweight/obesity) was determined using WHO AnthroPlus software. A two-arm parallel cluster randomised controlled trial was used among 708 adolescents (356 for the intervention group [IG] and 352 for the control group [CG]) from 13 October 2022 to 30 June 2023. The intervention’s effect was analysed through difference-in-difference (DID) analysis and a multivariable multinomial generalised estimating equation (GEE) model with significance set at P < 0.05. The overall DBM prevalence decreased by nearly 7% (4.7% for thinness, 2.2% for overweight/obesity) in the DID analysis. After adjusting for possible confounders, the GEE model indicated that adolescents in the IG were 34% less likely to have higher DBM than those in the CG (AOR = 0.66, 95% CI [0.46, 0.94]). Additionally, the probability of DBM decreased by 59% at the end line compared to baseline measurements (AOR = 0.41, 95% CI [0.03, 0.92]). Adolescents in the category of time and IG interaction were 44% less likely to have increased DBM (AOR = 0.56, 95% [CI 0.02, 0.38]). Thus, this study underscores the effectiveness of selected DDIs in addressing DBM among adolescents using a health belief model. These results advocate for the integration of DDI strategies into existing nutrition guidelines, programmes, and policies.
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spelling doaj-art-077cd64f5eae46c488dc53d401b8e2702025-08-20T02:07:23ZengCambridge University PressJournal of Nutritional Science2048-67902024-01-011310.1017/jns.2024.68Effect of double-duty interventions on double burden of malnutrition among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a cluster randomised controlled trialLemma Getacher0https://orcid.org/0000-0002-9237-117XBeyene Wondafrash Ademe1https://orcid.org/0000-0001-9161-1509Tefera Belachew2https://orcid.org/0000-0001-5455-9457School of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, EthiopiaDepartment of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, EthiopiaDepartment of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, EthiopiaCombating the double burden of malnutrition (DBM) in adolescents is a critical public health challenge in low-income countries like Ethiopia. However, past efforts have lacked focus and exhibited diverse governance strategies. Therefore, this study assesses the effect of selected double-duty interventions (DDIs) on DBM among adolescents in Central Ethiopia. The DBM status (thinness, normal, overweight/obesity) was determined using WHO AnthroPlus software. A two-arm parallel cluster randomised controlled trial was used among 708 adolescents (356 for the intervention group [IG] and 352 for the control group [CG]) from 13 October 2022 to 30 June 2023. The intervention’s effect was analysed through difference-in-difference (DID) analysis and a multivariable multinomial generalised estimating equation (GEE) model with significance set at P < 0.05. The overall DBM prevalence decreased by nearly 7% (4.7% for thinness, 2.2% for overweight/obesity) in the DID analysis. After adjusting for possible confounders, the GEE model indicated that adolescents in the IG were 34% less likely to have higher DBM than those in the CG (AOR = 0.66, 95% CI [0.46, 0.94]). Additionally, the probability of DBM decreased by 59% at the end line compared to baseline measurements (AOR = 0.41, 95% CI [0.03, 0.92]). Adolescents in the category of time and IG interaction were 44% less likely to have increased DBM (AOR = 0.56, 95% [CI 0.02, 0.38]). Thus, this study underscores the effectiveness of selected DDIs in addressing DBM among adolescents using a health belief model. These results advocate for the integration of DDI strategies into existing nutrition guidelines, programmes, and policies.https://www.cambridge.org/core/product/identifier/S2048679024000685/type/journal_articleAdolescentsDouble burden of malnutritionDouble-duty interventionsEthiopiaOvernutritionUndernutrition
spellingShingle Lemma Getacher
Beyene Wondafrash Ademe
Tefera Belachew
Effect of double-duty interventions on double burden of malnutrition among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a cluster randomised controlled trial
Journal of Nutritional Science
Adolescents
Double burden of malnutrition
Double-duty interventions
Ethiopia
Overnutrition
Undernutrition
title Effect of double-duty interventions on double burden of malnutrition among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a cluster randomised controlled trial
title_full Effect of double-duty interventions on double burden of malnutrition among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a cluster randomised controlled trial
title_fullStr Effect of double-duty interventions on double burden of malnutrition among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a cluster randomised controlled trial
title_full_unstemmed Effect of double-duty interventions on double burden of malnutrition among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a cluster randomised controlled trial
title_short Effect of double-duty interventions on double burden of malnutrition among adolescents in Debre Berhan Regiopolitan City, Ethiopia: a cluster randomised controlled trial
title_sort effect of double duty interventions on double burden of malnutrition among adolescents in debre berhan regiopolitan city ethiopia a cluster randomised controlled trial
topic Adolescents
Double burden of malnutrition
Double-duty interventions
Ethiopia
Overnutrition
Undernutrition
url https://www.cambridge.org/core/product/identifier/S2048679024000685/type/journal_article
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