Nutritional Supplementation for Moderately Stunted School-Aged Children

Wednesday, 24 July 2013

Susan M. Bonnell, PhD, RN, CPNP
Hahn School of Nursing and Health Science, University of San Diego, San Diego, CA

Learning Objective 1: The learner will be able to understand the significance of malnutrition in school aged children in the Dominican Republic.

Learning Objective 2: The learner will understand the preliminary effects of improving malnutrition in school-aged children with Nutrifort to improve their malnutrtion status.

Purpose: Evaluation of effect of increased calories (Nutri-fort) for malnourished children. Results of BMI statistics (January 2012, n =138, ages 5-18) found 23.2% sample to be underweight at an elementary school in El Cercado, Dominican Republic. Review of literature is rich with studies detailing malnutrition management for children under age 5; data is limited regarding school-aged children. The primary aim is to evaluate the effectiveness of providing nutritional supplement in malnourished school-aged children.

Methods: Quantitative, non-randomized, quasi-experimental therapeutic trial. Sample size n = (TBD January 2013). Descriptive data will be collected including height, weight, and BMI z-scores. Parental descriptive data will be collected. A within subjects design, repeated measures ANOVA will be performed to test for significance (p = .05) change across t = 13 measures over time (t = time) where a baseline measure will be followed by monthly measures for a one year time period.

Procedure: Participatory research model; IRB approval obtained. Assessment of children in January 2013 (n = 285 approximately), to identify those ages 5- 18 with BMI z-score -1 through -3. We will meet with parents of identified children to explain aims/purpose of intervention. Consent will be requested, with assent for children ages 12 and older. Children’s monthly growth parameters will be measured for one year. Local lay health care workers who are already involved in growth monitoring of children in the community will be recruited and trained to perform and document parameters. Little evidence exists to support a specific calorie supplement level, therefore a 1 ounce portion daily will be initially added to daily snack of bread/milk over 1 year. Commencement will occur following the 2013 assessment of children at the school, determining the sample size. Children identified in the assessment with malnutrition will be considered for inclusion.  

Results: In process.

Conclusion: Pending