Evaluation report
Nurture Early for Optimal Nutrition (NEON): A pilot cluster randomised controlled trial of community-facilitator-led participatory learning and action women’s groups to improve infant feeding & care among South Asian families in East London
Logan Manikam, Asna Fatima, Priyanka Patil, Chyntia Aryanti Mayadewi, Tala El Khatib et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This pilot study tested whether community facilitator-led women's groups using participatory learning methods could improve infant feeding practices among South Asian families in East London. The study recruited 263 families across 12 wards and randomly assigned them to face-to-face groups, online groups, or usual care over 14 weeks. While recruitment and participant acceptance were successful, retention dropped to 55% at six months, attendance was only 37%, and most groups did not complete the full program cycle, making it impossible to evaluate whether the intervention actually improved child feeding.
Key points
- Recruitment consent rate was 70.7%, exceeding the 50% feasibility threshold
- Attendance was only 37% overall (59% in Tower Hamlets, 29% in Newham), below the 80% target
- Six-month retention was 54.8%, with significantly lower retention in Newham (48.5%) triggering a 'Definite Stop' criterion
- No usable outcome data were collected: baseline questionnaire completion was 24.5% for feeding behaviour and 23.0% for parental feeding style, with no follow-up data
- All participants who gave feedback reported the intervention acceptable, but no group completed the full participatory learning and action cycle
Limitations
This is a feasibility study that did not successfully evaluate whether the intervention works because retention and engagement fell below thresholds and outcome measures were not completed. The findings cannot determine the effectiveness of participatory learning groups for improving infant feeding in this population.
Abstract
Abstract South Asian communities in the UK experience disproportionate maternal and child health inequalities linked to non-recommended infant feeding practices, limited health literacy, and socioeconomic constraints. Participatory learning and action (PLA) is effective in low- and middle-income countries, but high-income evidence is scarce. This pilot assessed the feasibility of a community facilitator-led PLA intervention to improve infant feeding among South Asian families in East London. A three-arm pilot feasibility cluster randomised controlled trial ( ISRCTN10234623 ) was conducted in Tower Hamlets and Newham, East London (May–September 2022), with 12 wards randomised 1:1:1 to face-to-face PLA, online PLA, or usual care. Multilingual community facilitators delivered eight biweekly sessions over 14 weeks. Feasibility outcomes were assessed against prespecified Go/Stop criteria; exploratory outcomes included child feeding behaviours (Children’s Eating Behaviour Questionnaire, CEBQ), parental feeding style (Parental Feeding Style Questionnaire, PFSQ), and child BMI Z-scores. Of 263 enrolled participants, 261 had a recorded trial arm allocation; consent to the pilot feasibility study was 70.7% (186/263; 95% CI 65.0–75.9%) meeting the ≥50% Go criterion. Attendance was 37% (Tower Hamlets 59%, Newham 29%), below the ≥80% Go threshold. Six-month retention was 54.8% (Tower Hamlets 78%, Newham 48.5%; 95% CI 41.8–55.3%), triggering the Definite Stop criterion. Significant baseline imbalances included BMI Z-score (p = 0.005), ethnicity, borough, and education; no between-arm BMI differences were observed at follow-up (p = 0.249). CEBQ and PFSQ baseline completion was 24.5% and 23.0%, with no usable follow-up data. PLA Phases 3 and 4 were not completed by any group; all participants providing feedback reported it acceptable. Recruitment was feasible and the intervention acceptable, but a Definite Stop criterion was triggered in Newham, no group completed the full PLA cycle, and outcome data were insufficient for evaluation. A definitive trial requires stratified randomisation, digitised multilingual data collection, participant reimbursement, and explicit PLA phase-completion criteria. Trial registration ISRCTN10234623 (IRAS ID: 296259; Ethics Ref: 21/SW/0142).
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Community facilitator-led participatory learning and action (PLA) women's groups delivering eight biweekly sessions over 14 weeks, offered in face-to-face or online formats
- Population
- South Asian families in East London (Tower Hamlets and Newham), with 263 participants enrolled
Key finding
Recruitment consent rate 70.7% (186/263) exceeded the 50% feasibility threshold