Translating the impact of quality protein maize into improved nutritional status for Ethiopian children: study protocol for a randomized controlled trial
Bibliographic record
Abstract
Linear growth failure is the most common form of undernutrition. Childhood stunting impairs human development and health and productivity in adulthood. Ethiopia has a high prevalence of stunting, with diets reliant on staple crops with low nutrient content. Maize is the most highly produced crop in Ethiopia. Unfortunately, conventional maize has poor protein quality due to a poor balance of essential amino acids. Quality protein maize (QPM) varieties are biofortified with these essential amino acids and, in controlled trials, improve child growth. However, evidence on the impact of QPM adoption and consumption on protein status and linear growth of children under natural circumstances is not yet available. A randomized controlled trial was carried out to evaluate the impact of a) nutrition-focused adoption encouragement and provision of QPM seed in small seed packs, and b) a consumption encouragement intervention primarily targeting female caregivers and encouraging earmarking and integration of QPM into diets for infants and young children. The trial (n = 1611) had three randomly assigned arms: a control group; a first intervention group receiving adoption encouragement only; and a second intervention group receiving both adoption and consumption encouragement. The primary outcomes of this study are QPM consumption, protein status, and linear growth of children, assessed using questionnaires, biological specimen collection, and anthropometry over one cycle of agricultural production and post-harvest consumption. Secondary outcomes include child stunting, acute malnutrition, underweight, total intake of utilizable protein, and caregivers’ cooking and child feeding practices. This study addresses important behavioral barriers between the development of a biofortified crop, QPM, and its impact on children’s nutrition and health in a natural setting. The randomized controlled trial design, collection of data in multiple domains along hypothesized impact pathways, and assessment of nutritional status using both biomarkers and anthropometry allow greater understanding on mechanisms of impact. This trial is the first such study to be conducted with a biofortified staple crop in a natural setting and supports the Government of Ethiopia’s current targets for nutrition and agriculture. Prospectively registered in the AEA RCT Registry ( AEARCTR # 0000786 ) on 24 July, 2015, and retrospectively registered on ClinicalTrials.gov ( NCT02710760 ) on 30 January, 2016.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.035 | 0.033 |
| Meta-epidemiology (narrow) | 0.008 | 0.004 |
| Meta-epidemiology (broad) | 0.016 | 0.007 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.004 | 0.005 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.004 | 0.003 |
| Research integrity | 0.009 | 0.009 |
| Insufficient payload (model declined to judge) | 0.078 | 0.013 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".