Rivera 2004.
| Methods | Study date: 2004. Study design: Cross‐over RCT | |
| Participants | SES or context: Low‐ and middle‐income country: Mexico. Participants were from low‐income households in poor rural communities in 6 central Mexican states. Children and pregnant and lactating women in participating households received fortified nutrition supplements, and the families received nutrition education, health care, and cash transfers. Families enrolled in the programme (Progresa families) received 2 types of cash transfers every 2 months: A universal cash amount for all families and a specific cash transfer associated with school attendance Nutritional status: Included all children in communities Age: 12 months or younger at enrolment Number: 650 children (intervention group = 373, cross‐over intervention group = 277) |
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| Interventions | Intervention. Feeding +take‐home rations + cash incentive for attending clinic. 240 g dry whole milk, sugar, maltodextrins, and micronutrient given in 3 flavours that required hydration before consumption. Packages were distributed at health centres. Mothers given instruction to add 4 spoons of boiled water to 1 ration. Families in program given incentives to attend health clinic Energy: 5 daily rations of 44 g provided 275 kcal/day and 10 g of protein, 6 g lipid Duration: 24 months % DRI for energy: 4 ‐ 5 months = 38.7%, 6 ‐ 12 months = 27.3% % DRI for protein: 4 ‐ 5 months = 69.54%, 6 ‐ 12 months = 66.55% Control: Cross‐over intervention group Provider: National Institute of Public Health, Ministry of Health Supervised: Not mentioned Compliance: Not mentioned |
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| Outcomes | Physical: Weight, height, WAZ, HAZ, WHZ, haemoglobin levels (anaemia) | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Does not say how randomisation was done |
| Allocation concealment (selection bias) | Unclear risk | No mention of how it was done or concealed |
| Baseline outcome measurements | Low risk | No significant differences between groups on any outcome variable |
| Baseline characteristics | Unclear risk | Not applicable |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | They were very clear about attrition rates. At the first follow‐up 10% dropped out. Very little difference |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Low for anaemia; could not reasonably affect outcome. Unclear for growth |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Hard to blind. Mothers were given food packages at daycare, so judged as high risk of bias |
| Protection from contamination | Unclear risk | Not applicable |
| Selective reporting (reporting bias) | Unclear risk | No access to protocol |
| Other bias | High risk | There was some leakage. 10% of control communities got food |