Table 2.

Overview of formative research tools and application in the India study to integrate complementary and responsive feeding and child development to improve child growth and development.

Assessment Tool	Application
24-hour dietary recall	To give a rapid assessment of the current feeding pattern of the child. The instrument included a tool that facilitated a rapid summary description of the actual breastfeeding and complementary feeding practices.
Home observations	To evaluate the current feeding styles, videotaped observations were made of the principal feeding episode during the day (most often the midday meal). The observations were coded using a structured observation form developed for a previous study (Vietnam ref). Observations were also made relating to child development, specifically in relation to feeding.
Semi-structured interviews	Mothers To explore in depth the feeding practices and caregiver-child interactions related to feeding and play and the perceptions, attitudes and reasons around these practices. Aspects of hygiene, sources of information and contact with Anganwadi workers, and women's were explored through the interviews. Photos of contrasting caregiver-child situations during a feeding episode were selected to be presented to the mother during the interview, to explore with her what she sees and her opinion of the presented situations. Similarly, photos of different sized (thin – chubby) young children were used to explore perceptions of a “healthy” child and to understand the expectations of mothers in the community and potential motivations for behavior change. A free-listing attributes exercise was also included in which a list of selected nutrient rich, locally available foods was used to explore caregivers’ perceptions of their use with infants and young children and potential for promotion in the complementary food intervention component. Key informants Interviews with Anganwadi workers and local health workers to learn of their activities with caregivers in the village including the current recommendations they are giving regarding infant and young child nutrition and feeding. Interviews with local leaders explored community norms and traditions, the mapping of the community, and costs and availability of foods in local markets.
Focus group discussions	Conducted with mothers and grandmothers to confirm and explore further some of the results/themes identified in the individual interviews and to assess comprehension and feasibility of behaviour change messages.

Source: Vazir S, Engle P, Balakrishna N, et al. Cluster-randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural indian toddlers. Matern Child Nutr. 2013;9(1):99-117.