Table 4.
General description of studies included in the review.
| Author | Study design | Nutrition training intervention | Outcome of interest |
|---|---|---|---|
| Zaman et al. (22), Pakistan | Cluster RCT | Nutrition-counseling training using IMCI’s “counsel the mother” module for five and a half days. It included infant feeding knowledge and practice sessions for the development of communication and counseling skills | Communication skills |
| Nutrition counseling | |||
| Nutrition management/practice | |||
| Bassichetto and Réa (13), Brazil | Cluster RCT | WHO’s “infant and young child feeding counseling: an integrated course.” The training includes 8 h of practical sessions. Out of 34 sessions, 8 were dedicated to breastfeeding, 6 to HIV and infant and young child feeding, 7 to complementary feeding, 10 to counseling, and 4 to general themes, making a total of 40 h | Nutrition knowledge |
| Nutrition counseling | |||
| Undernutrition management/performance | |||
| Moore et al. (14), UK | Cluster RCT | A nutrition training program was delivered to six intervention practices (health facilities). Emphasis of the training was on increasing motivation to improve quality of dietary consultations and providing them with practical skills adapted from behavior models. Included components in the 7.5-h training were patients’ assessment, education, and goal setting in issues of public health importance including drinking | Nutrition knowledge Counseling |
| Pelto et al. (19), Brazil | Cluster RCT | Physicians from the intervention group received a 20-h training in a program derived from the IMCI nutrition-counseling module. After training, they provided care to caregiver/child pairs who attended their centers | Counseling |
| Practice: communication skills | |||
| Santos et al. (15), Brazil | Cluster RCT | Fourteen doctors received a 20-h nutrition-counseling training using IMCI’s “counsel the mother” and “management of the sick young infant” modules. Based on local adaptation of IMCI feeding guidelines, the key feeding recommendations identified were as follows: increase breast and complementary feeding frequency, provide animal protein and micronutrient-rich foods, add oil to the food, and increase dietary diversity. Of the 20 h of training, 40% was used for practical sessions in a health center | Nutrition knowledge Nutrition counseling: undernutrition management skills/practice |
| Penny et al. (23), Peru | Cluster RCT | Interventions aimed to raise the nutrition profile of the health facility and to integrate nutrition services into existing child health programs though training and provision of simple messages to caregivers. Training included demonstration of preparation of complementary foods and child’s age-specific group sessions for their caregivers. The intervention also included training for health care workers to improve anthropometry skills. An accreditation system was also introduced for institutional change | Nutrition counseling Others: health seeking behavior |
| Cattaneo and Buzzetti (16), Italy | Controlled non-randomized trial | An 18-h UNICEF “Breastfeeding, management, and health proportion in baby-friendly hospitals” course along with a 2-h counseling session from the WHO’s breast-feeding counseling course were implemented | Nutrition knowledge Hospital performance |
| Palermo et al. (37), Australia | Pre–post-intervention study | Thirty-two dieticians were allocated to three intervention groups: two face-to-face groups and one rural video-linked group. The intervention involved a mentoring circle of experienced nutritionists and community-based dieticians. Each participant attended six 2-h sessions every 6 weeks for a 7-month intervention period | Nutrition knowledge and competence |
| Lindorff-Larsen et al. (17), Denmark | Pre–post-intervention study | A follow-up study was conducted in 2004 and compared to a baseline study in 1997. Nutrition training and use of nutrition guidelines were being introduced and used between the two study intervals. Details of such training were not further elaborated | Nutrition knowledge |
| Puoane et al. (38), South Africa | Pre–post-intervention study (with a qualitative design) | A 5-day course developed by the University of West Cape involved practice sessions, group work, role-plays, action plan development, key messages, and question and answer sessions. The course followed the principle of care set out by WHO for managing severe malnutrition. A total of 66 nurses from 11 referral hospitals underwent this course | Health workers’ practice Attitudes |
| Hamer et al. (39), Gambia | Pre–post-intervention study | Nutrition training for nurses was conducted using the IMCI training manual, “assess and classify sick children aged 2 months to 5 years.” Training materials were provided to nurses a week prior to training. The training included both theoretical and practical components toward assessing children with and without wasting and/or edema admitted to the hospital | Nutrition knowledge Undernutrition management/practice |
| Edwards and Wyles (40), UK | Pre–post-intervention study | A total of 24 1-h training sessions were held, reaching 189 staff. Each session consisted of factual information, a brainstorming session about what a pregnant woman eat, and a nutrition game involving calculation of daily requirement for folic acid | Nutrition knowledge Health workers’ practice |
| O’Mahony et al. (41), UK | Pre–post-intervention study | Nutrition training was delivered to nurse participants. It also included the use of the Malnutrition Universal Screening Tool (MUST) | Nutrition knowledge Health workers’ practice |
| Hillenbrand and Larsen (20), US | Pre–post-intervention study | Forty-nine pediatric residents participated in a four-part education series about breastfeeding delivered over four consecutive days. The education intervention was internally designed using additional inputs from lactation experts and fellow pediatricians. The training included lectures, discussions, role-playing, and group exercises | Nutrition knowledge Nutrition counseling Counseling and practice |
| Olsson et al. (42), Sweden | Pre–post-intervention study | Nutrition education for nurses was conducted for 3 months. It was based on the use of nutrition assessments including energy intake, clinical complications of inadequate energy intake, hospital food energy content, patients energy requirements, weighing patients and its necessity, reasons for weight loss during illness, and fluid management | Nutrition knowledge Health workers’ practice |
| Pedersen et al. (43), Denmark | Pre–post-intervention study | Nutrition training was conducted for nurses. It included five modules of 3–4 days duration using the theory of planned change. The training incorporated basic nutrition education elements such as risk assessment, consequences of malnutrition, and assessment of needs and responsibility | Health workers’ practice |
| Gance-Cleverland et al. (21), US | Pre–post-intervention study | Thirty-five nurse practitioners received an intensive 4-h Healthy Eating and Activity Together Clinical Practice Guideline (HEAT CPG) training session | Nutrition knowledge Nutrition counseling |
| Bjerrum et al. (18), Denmark | Pre–post-intervention study | Sixteen nurses participated in a special training program on nutrition. It was based on experimental theories and included five modules spanning 3–4 days, combining theories of planned change and nutrition issues | Nutrition knowledge |
| Kennelly et al. (45), Ireland | Pre–post-intervention study | Seven general practitioners participated in the nutrition education program. A community dietician used a standardized presentation to conduct the program. The content of training included information on causes of malnutrition, effects of malnutrition, use of the MUST tool, practical dietary advice for patients with poor appetite, and evidence supporting the use of oral nutrition supplements (ONS) | Nutrition counseling Health workers’ practice |
| Kennelly et al. (44), Ireland | Pre–post-intervention study | An educational program incorporating the MUST training was implemented in 8 of 10 eligible primary practices, 7 private nursing homes, and 2 health centers. The training program was designed based on consultations with health professional groups, clinical guidelines from expert bodies, and current evidence for ONS use in community settings | Nutrition knowledge Nutrition counseling |
| Simoes et al. (46), Ethiopia | Pre–post-intervention study | A 9-day course using the pre-tested version of the IMCI course was provided to six clinic nurses. The training modules included assessment and classification of the sick child, treatment of the child, counseling the mother, and follow-up. Other modules included practical sessions in the clinic | Nutrition knowledge Nutrition counseling Health workers’ practice |
| Davies-Adetugbo and Adebawa (47), Nigeria | Pre–post-intervention study | A 1-day community mobilization with 6 h of training on breastfeeding and child survival was conducted for health workers and mothers. The training was designed to include the importance of breast-feeding, exclusive breastfeeding, lactation maintenance, expressed breast milk, practical demonstration of attachment, suckling, expression of milk, and cup feeding. An intensive 2-day training was then conducted for health workers using a WHO/UNICEF 18-h breastfeeding course manual. Training included practical, role-playing, and theory sessions | Nutrition and breastfeeding knowledge |
| Newes-Adeyi et al. (48), US | Pre–post-intervention study | A total of 35 women, infants, and children (WIC) staff underwent a 1-day intensive training program to improve their growth monitoring counseling and management of nutrition-related problems. The training included lectures, case studies, discussions, small group work, and role-plays | Nutrition counseling |
| Stark et al. (49), US | Quasi-experimental design | A 6-week online professional development program for nutrition and health practitioners course was delivered to the intervention group. It was based on the PRECEDE-PROCEED health program planning framework involving assessment of underlying factors for a health problem and strategizing the intervention | Nutrition knowledge and skills |
| Charlton et al. (24), Zambia | Pre–post-intervention study | Eight out of 16 health care workers received the Growth Monitoring and Promotion (GMP) training. Details of the training including duration and contents were not described | Nutrition knowledge Nutrition practice |