Amagugu Asakhula technical summary

Early childhood obesity is global challenge, including in LMICs. Dietary habits and movement behaviours, including physical activity, sedentary behaviour (screen time, in particular) and sleep are understood to play a role in the prevention of obesity in young children. Furthermore, engaging in the recommended amounts of movement behaviours has been shown to be beneficial for cognitive development in preschool-aged children. The home and family environment are acknowledged as important influencers of these obesity-related behaviours. However, relatively few home-based interventions have been evaluated, and the majority have been implemented in high-income countries. Obesity prevention interventions targeting preschool-aged children that have been implemented in the home setting by community-based workers and tailored to the cultural context have shown promising findings, and Amagugu Asakhula therefore explores the feasibility and acceptability of such an approach in Soweto.

• Aims of the study
• Design
• Investigators
• Status
• Unit role
• Partners and Stakeholders
• Funding
• Data sharing

Aims of the study

The aim of this study is to assess the feasibility and acceptability of a home-based intervention with caregivers of preschool-aged children in a low-income, urban setting to promote nurturing interactions and healthy behaviours.

The specific objectives of this feasibility study of Amagugu Asakhula are:

1. To train community health workers to deliver the intervention.
2. To pilot the intervention to assess its feasibility and acceptability, including:
   a. Recruitment and retention of caregivers and CHWs in the intervention,
   b. Fidelity of implementation of the intervention by CHWs already working in a community,
   c. Integration of the intervention into CHWs’ scope of work.
3. To investigate factors that will influence implementation, such as feasibility, acceptability, adoption, appropriateness, and fidelity of the intervention.
4. To qualitatively investigate CHWs and caregivers’ experiences of the intervention, from the perspective of CHWs and caregivers.
5. To qualitatively investigate the appropriateness of the intervention, as well as its potential adoption, coverage and sustainability, from the perspective of key informants.
6. To inform the design of a randomised controlled trial to evaluate the effectiveness of the intervention.

Design

A mixed methods feasibility study involving process evaluation components. Amagugu Asakhula involves the recruitment and training of community health workers, recruitment of caregivers of preschool-aged children, a six-week intervention, key informant interviews with relevant stakeholders, and focus group discussions with both community health workers and participating caregivers.

Investigators

Sonja Klingberg – University of Cambridge
Dr Catherine Draper – University of the Witwatersrand
Dr Esther van Sluijs – University of Cambridge

Status

The intervention and data collection have been completed in mid 2019, and analysis is underway.

Unit role

Researchers in the Unit are collaborators in this study.

Partners and Stakeholders

MRC/Wits Developmental Pathways to Health Research Unit (DPHRU) at the University of the Witwatersrand
Johannesburg Health District

Funding

MRC, Newton Fund, Oppenheimer Memorial Trust

Data sharing

Data currently unavailable for this study. Data sharing will be facilitated in due course. Please see our Data Sharing pages for more information.