Changes in family knowledge, practices, and perceived competencies after a family-centered home-visiting program for chronic child malnutrition prevention in rural Ecuador: an uncontrolled pre-post study
5 affiliations
- 1Campus Capacitas, Catholic University of Valencia San Vicente Mártir
- 2General Directorate of Research, Innovation and Creation, Universidad Casa Grande
- 3Graduate School, Universidad Casa Grande
- 4Universidad Casa Grande
- 5Social Investment and Development of the Guayaquil Charity Board
Abstract
Introduction: Chronic child malnutrition (CCM) remains a major public health challenge, particularly in socially vulnerable settings, given its association with adverse developmental outcomes. Preventing CCM requires integrated approaches that combine nutritional support, healthcare, and the strengthening of family caregiving capacities.
Objective: To describe pre-to-post changes over 6 months in parental knowledge (primary outcome) and in practices and perceived competencies (secondary outcomes) related to the prevention and management of CCM among 208 pregnant women or mothers of children under 3 years of age participating in a family-support process guided by the principles of Family-Centered Practices (FCP) in a rural community in Santa Elena, Ecuador.
Methods: An uncontrolled longitudinal pre-post study with an embedded exploratory qualitative component was conducted within a community program involving biweekly home visits and monthly food kits. No concurrent comparison group was used. A 34-item, study-specific scale assessing knowledge, practices, and perceived competencies related to CCM prevention and management was administered before and after the intervention. In addition, 25 purposively selected mothers provided written responses to open-ended questions, which were analyzed deductively using four a priori categories.
Results: The total scale score increased significantly from pre- to post-assessment (mean difference = 8.03, 95% CI [4.53, 11.53], p < 0.001, d z = 0.31). The largest and only statistically significant domain-level change was observed in Knowledge ( d z = 0.66), whereas changes in Practices ( p = 0.425) and Competencies ( p = 0.080) were smaller and not statistically significant. Sixteen of 34 item-level comparisons remained significant after Holm-Bonferroni correction. Differences according to baseline nutritional status were descriptive and were not confirmed by the group-by-time interaction test. Qualitative responses illustrated perceived learning related to safe water, dietary practices, and greater confidence in food-related decision-making.
Conclusion: Participation in an integrated home-visiting and food-support program was associated with higher self-reported knowledge related to CCM prevention and management, whereas aggregate changes in practices and perceived competencies were not statistically significant. Given the uncontrolled design, concurrent food support, and use of a study-specific outcome measure, the findings should be considered preliminary. Controlled studies using validated measures and objective nutritional outcomes are needed to evaluate the contribution of family-centered support to CCM prevention.
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BibTeX
@article{escorciamora2026changes,
title = {{Changes in family knowledge, practices, and perceived competencies after a family-centered home-visiting program for chronic child malnutrition prevention in rural Ecuador: an uncontrolled pre-post study}},
author = {Claudia Tatiana Escorcia-Mora and Marcela Frugone-Jaramillo and Pau García-Grau and Carolina Portaluppi and Diana Barros-Cárdenas and María Alejandra Muñoz-Seminario},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1925365},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1925365/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Changes in family knowledge, practices, and perceived competencies after a family-centered home-visiting program for chronic child malnutrition prevention in rural Ecuador: an uncontrolled pre-post study
AU - Claudia Tatiana Escorcia-Mora
AU - Marcela Frugone-Jaramillo
AU - Pau García-Grau
AU - Carolina Portaluppi
AU - Diana Barros-Cárdenas
AU - María Alejandra Muñoz-Seminario
PY - 2026
DA - 2026/10/26
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1925365
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1925365/full
AB - Introduction: Chronic child malnutrition (CCM) remains a major public health challenge, particularly in socially vulnerable settings, given its association with adverse developmental outcomes. Preventing CCM requires integrated approaches that combine nutritional support, healthcare, and the strengthening of family caregiving capacities. Objective: To describe pre-to-post changes over 6 months in parental knowledge (primary outcome) and in practices and perceived competencies (secondary outcomes) related to the prevention and management of CCM among 208 pregnant women or mothers of children under 3 years of age participating in a family-support process guided by the principles of Family-Centered Practices (FCP) in a rural community in Santa Elena, Ecuador. Methods: An uncontrolled longitudinal pre-post study with an embedded exploratory qualitative component was conducted within a community program involving biweekly home visits and monthly food kits. No concurrent comparison group was used. A 34-item, study-specific scale assessing knowledge, practices, and perceived competencies related to CCM prevention and management was administered before and after the intervention. In addition, 25 purposively selected mothers provided written responses to open-ended questions, which were analyzed deductively using four a priori categories. Results: The total scale score increased significantly from pre- to post-assessment (mean difference = 8.03, 95% CI [4.53, 11.53], p < 0.001, d z = 0.31). The largest and only statistically significant domain-level change was observed in Knowledge ( d z = 0.66), whereas changes in Practices ( p = 0.425) and Competencies ( p = 0.080) were smaller and not statistically significant. Sixteen of 34 item-level comparisons remained significant after Holm-Bonferroni correction. Differences according to baseline nutritional status were descriptive and were not confirmed by the group-by-time interaction test. Qualitative responses illustrated perceived learning related to safe water, dietary practices, and greater confidence in food-related decision-making. Conclusion: Participation in an integrated home-visiting and food-support program was associated with higher self-reported knowledge related to CCM prevention and management, whereas aggregate changes in practices and perceived competencies were not statistically significant. Given the uncontrolled design, concurrent food support, and use of a study-specific outcome measure, the findings should be considered preliminary. Controlled studies using validated measures and objective nutritional outcomes are needed to evaluate the contribution of family-centered support to CCM prevention.
SN - 2296-2565
ER -