Social Transfers for Exclusive Breastfeeding in Brazil: Protocol for a Randomized Controlled Trial
Notice bibliographique
Résumé
BACKGROUND: According to the World Health Organization's infant and young child feeding guidelines, infants should be exclusively breastfed for the first 6 months of life. Despite public health campaigns to increase exclusive breastfeeding (EBF) rates, socioeconomic inequities persist among low-income breastfeeding mothers, especially in countries with large wealth and health gaps, such as Brazil. Social transfer programs are initiatives that provide financial support to individuals or households to improve their well-being and reduce financial burdens. These may be conditional, requiring recipients to meet specific criteria to receive the transfer, or unconditional, in which recipients receive the transfer without prerequisites. Evidence suggests that conditional and unconditional social transfers may help increase EBF rates while addressing the economic challenges breastfeeding mothers face. A randomized controlled trial (RCT) conducted in Vientiane, Lao People's Democratic Republic, found that a social transfer program significantly improved both EBF rates at 6 months and EBF duration. Building on this study, we aim to evaluate the impact of this intervention in a different socioeconomic and cultural context. OBJECTIVE: This protocol aims to implement an RCT to assess whether conditional and unconditional social transfers improve EBF rates at 6 months postpartum for mothers in low-income communities in São Paulo, Brazil. METHODS: A prospective RCT will be conducted among 400 mothers who gave birth in the last 72 hours and plan to exclusively breastfeed. Participants will be recruited in São Paulo at the University Hospital of São Paulo and Amparo Maternal. Participants will be randomly assigned to one of the following groups: (1) control group-no social transfer; (2) intervention group 1-an unconditional social transfer at 6 months postpartum; and (3) intervention group 2-a social transfer at 6 months postpartum, conditional upon mothers' EBF. All groups will receive educational materials supporting EBF. The study will have visits at birth, 1 month, 6 months, 1 year, and 2 years and will include a questionnaire and biological collections of breast milk samples, infant fecal samples, and blood samples (finger pricks) from both the mother and infant. The main study outcomes are the prevalence of EBF at 6 months and the duration of EBF across the 3 groups, where we hypothesize higher rates of EBF among mothers in the conditional group. RESULTS: Recruitment began on March 6, 2024. As of September 2025, we enrolled 204 participants. Our goal is to recruit 400 mother-infant dyads by October 2025, with study visits expected to be completed by October 2027. CONCLUSIONS: We hypothesize that the Social Transfers for Exclusive Breastfeeding in Brazil (STEBB) intervention will positively impact breastfeeding mothers in São Paulo. If successful, the program may inform national policy to enhance Brazil's existing social transfer program for new mothers. TRIAL REGISTRATION: ClinicalTrials.gov NCT06157697; https://clinicaltrials.gov/study/NCT06157697. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/75796.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,033 | 0,035 |
| Méta-épidémiologie (sens strict) | 0,006 | 0,003 |
| Méta-épidémiologie (sens large) | 0,014 | 0,007 |
| Bibliométrie | 0,003 | 0,004 |
| Études des sciences et des technologies | 0,004 | 0,004 |
| Communication savante | 0,005 | 0,004 |
| Science ouverte | 0,003 | 0,002 |
| Intégrité de la recherche | 0,008 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,085 | 0,010 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».