Development of an evidence-based complementary feeding practice module for mothers using the combined Delphi Method

  • Rini Andriani Doctoral Program, Faculty of Medicine, Universitas Indonesia
  • Damayanti Rusli Sjarif Department of Child Health, Faculty of Medicine, Universitas Indonesia, Indonesia
  • Bambang Supriyatno Department of Child Health, Faculty of Medicine, Universitas Indonesia, Indonesia
  • Aria Kekalih Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Indonesia
  • Hartono Gunardi Department of Child Health, Faculty of Medicine, Universitas Indonesia, Indonesia
  • Ika Karlina Idris Public Policy & Management Program, Monash University, Indonesia
Keywords: complementary feeding; Delphi method; infant; malnutrition

Abstract

Background Malnutrition in infants remains a challenge in Indonesia. Malnutrition often arises as a result of errors in complementary feeding practices. An education module for Indonesian mothers may help them correctly implement complementary feeding practices.

Objective To develop a module on correct complementary feeding practices for infants aged 6-9 months that can be read and understood by Indonesian mothers.

Methods We performed qualitative research using the two-round Delphi method combined with group discussions. The first round listed the most important sub-themes of the module, while the second round sought approval for the module from experts. The Delphi team members were included using purposive and snowball sampling methods. Expert opinions were summarized and rearranged using the Steps for Coding and Theorization (SCAT) method.

Results Ten experts were included in the Delphi team, with a mean duration of work experience of 28.5 (SD 12.37) years. The correct practices for giving complementary foods according to scientific evidence was named the ABC-Makanan PendampingASI/MPASI-Press (“Printed ABC of Complementary Feeding”) module and was summarized into four main topics: timely, adequate, safe, and responsive feeding. This module was made using language, photos, and images that were easily understood by mothers and included the suitable nutritional compositions to meet the needs of infants aged 6-9 months.

Conclusion We developed the ABC-MPASI-Press module based on scientific evidence and experts’ reviews using the combined Delphi method. This educational guide is expected to inform mothers about correct complementary feeding practices for infants aged 6-9 months in order to prevent malnutrition.

References

1. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382:427-51. DOI: 10.1016/s0140-6736(13)60937-x.
2. Aboud FE, Akhter S. A cluster-randomized evaluation of a responsive stimulation and feeding intervention in Bangladesh. Pediatrics. 2011;127:1191-7. DOI: 10.1542/peds.2010-2160.
3. Waber DP, Bryce CP, Fitzmaurice GM, Zichlin ML, McGaughy J, Girard JM, et al. Neuropsychological outcomes at midlife following moderate to severe malnutrition in infancy. Neuropsychology. 2014;28:530-40. DOI: 10.1037/neu0000058.
4. Blaney S, Februhartanty J, Sukotjo S. Feeding practices among Indonesian children above six months of age: a literature review on their magnitude and quality (part 1). Asia Pac J Clin Nutr. 2015;24:16-27. DOI: 10.6133/apjcn.2015.24.1.13.
5. Blaney S, Februhartanty J, Sukotjo S. Feeding practices among Indonesian children above six months of age: a literature review on their potential determinants (part 2). Asia Pac J Clin Nutr. 2015;24:28-37. DOI: 10.6133/apjcn.2015.24.1.14.
6. Santika O, Februhartanty J, Ariawan I. Feeding practices of young children aged 12–23 months in different socio-economic settings: a study from an urban area of Indonesia. Br J Nutr. 2016;116 Suppl 1:S1-S7. DOI: 10.1017/s0007114515003438.
7. Andriani R, Supriyatno B, Sjarif D. Gambaran Karakteristik Ibu, Pengetahuan, dan Praktik Pemberian Makanan Pendamping Air Susu Ibu pada Bayi di Kota Pontianak. Sari Pediatri. 2021;22:277-84. DOI: 10.14238/sp22.5.2021.277-84.
8. Boulkedid R, Abdoul H, Loustau M, Sibony O, Alberti C. Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review. PLoS One. 2011;6:e20476. DOI: 10.1371/journal.pone.0020476.
9. Jünger S, Payne SA, Brine J, Radbruch L, Brearley SG. Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations based on a methodological systematic review. Palliat Med. 2017;31:684-706. DOI: 10.1177/0269216317690685.
10. McMillan SS, King M, Tully MP. How to use the nominal group and Delphi techniques. Int J Clin Pharm. 2016;38:655-62. DOI: 10.1007/s11096-016-0257-x.
11. Ikatan Dokter Anak Indonesia. Rekomendasi Praktik Pemberian Makan Berbasis Bukti pada Bayi dan Batita di Indonesia untuk Mencegah Malnutrisi: IDAI; 2015. Available from: https://www.idai.or.id/professional-resources/pedoman-konsensus/rekomendasi-praktik-pemberian-makan-berbasis-bukti-pada-bayi-dan-batita-di-indonesia-untuk-mencegah-malnutrisi.
12. Seki M, Fujinuma Y, Matsushima M, Joki T, Okonogi H, Miura Y, et al. How a problem-based learning approach could help Japanese primary care physicians: a qualitative study. Int J Med Educ. 2019;10:232-40. DOI: 10.5116/ijme.5de7.99c7.
13. Okoli C, Pawlowski S. The Delphi method as a research tool: An example, design considerations and applications. Information & Management. 2004;42:15-29. DOI: 10.1016/j.im.2003.11.002
14. World Health Organization. Global Strategy for Infant and Young Child Feeding. Singapore: WHO; 2003. p. 30.
15. Pan American Health Organization, World Health Organization. Guiding principles for complementary feeding of the breastfed child. Washington DC: Pan American Health Organization, World Health Organization; 2003. p. 37.
16. Warde F, Papadakos J, Papadakos T, Rodin D, Salhia M, Giuliani M. Plain language communication as a priority competency for medical professionals in a globalized world. Can Med Educ J. 2018;9:e52-e9.
17. Quesenberry AC. Plain Language for Patient Education. Journal of Consumer Health on the Internet. 2017;21:209-15. DOI: 10.1080/15398285.2017.1311611.
18. Scheltema E, Reay S, Piper G. Visual representation of medical information: the importance of considering the end-user in the design of medical illustrations. J Vis Commun Med. 2018;41:9-17. DOI: 10.1080/17453054.2018.1405724.
19. Bester N, Di Vito-Smith M, McGarry T, Riffkin M, Kaehler S, Pilot R, et al. The Effectiveness of an Educational Brochure as a Risk Minimization Activity to Communicate Important Rare Adverse Events to Health-Care Professionals. Adv Ther. 2016;33:167-77. DOI: 10.1007/s12325-016-0284-y.
20. Giguère A, Légaré F, Grimshaw J, Turcotte S, Fiander M, Grudniewicz A, et al. Printed educational materials: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012;10(10):CD004398. DOI: 10.1002/14651858.CD004398.pub3.
21. Michaelsen KF, Weaver L, Branca F, Robertson A. Feeding and nutrition of infants and young children: guidelines for the WHO European Region, with emphasis on the former Soviet countries: World Health Organization: 2000. p. 288.
22. Radovi? T, Manzey D. The Impact of a Mnemonic Acronym on Learning and Performing a Procedural Task and Its Resilience Toward Interruptions. Front Psychol. 2019;10:2522. DOI: 10.3389/fpsyg.2019.02522.
Published
2022-06-29
How to Cite
1.
Andriani R, Sjarif D, Supriyatno B, Kekalih A, Gunardi H, Idris I. Development of an evidence-based complementary feeding practice module for mothers using the combined Delphi Method. PI [Internet]. 29Jun.2022 [cited 12Aug.2022];62(3):198-07. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2957
Section
Pediatric Nutrition & Metabolic Disease
Received 2022-01-20
Accepted 2022-02-10
Published 2022-06-29