Exploring audience segmentation: investigating adopter categories to diffuse an innovation to prevent famine in rural Mozambique.

Audience segmentation is a useful tool for designing effective campaigns. Further, the efficiency promised in diffusion science rests to some degree on the existence of adopter categories that can be identified and used to strategically disseminate prevention innovations. This study investigates the potential to identify adopter categories in potential recipients (n = 127) of an innovation to prevent food shortages in Mozambique. A 5-class model was found using latent class analysis, but it showed important differences from existing descriptions of adopter categories. Implications for theory and practice are discussed.

Surveillance considerations for malaria elimination.

Constant malaria monitoring and surveillance systems have been highlighted as critical for malaria elimination. The absence of robust monitoring and surveillance systems able to respond to outbreaks in a timely manner undeniably contributed to the failure of the last global attempt to eradicate malaria. Today, technological advances could allow for rapid detection of focal outbreaks and improved deployment of diagnostic and treatment supplies to areas needing support. However, optimizing diffusion activities (e.g., distributing vector controls and medicines, as well as deploying behaviour change campaigns) requires networks of diverse scholars to monitor, learn, and evaluate data and multiple organizations to coordinate their intervention activities. Surveillance systems that can gather, store and process information, from communities to national levels, in a centralized, widely accessible system will allow tailoring of surveillance and intervention efforts. Different systems and, thus reactions, will be effective in different endemic, geographical or socio-cultural contexts. Investing in carefully designed monitoring technologies, built for a multiple-acter, dynamic system, will help to improve malaria elimination efforts by improving the coordination, timing, coverage, and deployment of malaria technologies.

Investigating preferences for mosquito-control technologies in Mozambique with latent class analysis.

BACKGROUND: It is common practice to seek the opinions of future end-users during the development of innovations. Thus, the aim of this study is to investigate latent classes of users in Mozambique based on their preferences for mosquito-control technology attributes and covariates of these classes, as well as to explore which current technologies meet these preferences. METHODS: Surveys were administered in five rural villages in Mozambique. The data were analysed with latent class analysis. RESULTS: This study showed that users' preferences for malaria technologies varied, and people could be categorized into four latent classes based on shared preferences. The largest class, constituting almost half of the respondents, would not avoid a mosquito-control technology because of its cost, heat, odour, potential to make other health issues worse, ease of keeping clean, or inadequate mosquito control. The other three groups are characterized by the attributes which would make them avoid a technology; these groups are labelled as the bites class, by-products class, and multiple-concerns class. Statistically significant covariates included literacy, self-efficacy, willingness to try new technologies, and perceived seriousness of malaria for the household. CONCLUSIONS: To become widely diffused, best practices suggest that end-users should be included in product development to ensure that preferred attributes or traits are considered. This study demonstrates that end-user preferences can be very different and that one malaria control technology will not satisfy everyone.

Use of the Revised Children's Diet Quality Index to assess preschooler's diet quality, its sociodemographic predictors, and its association with body weight status.

OBJECTIVE: To determine the level of overall diet quality, sociodemographic predictors of diet quality, and the association between diet quality and body weight status in a nationally representative sample of preschoolers. METHODS: Cross-sectional study using a sample of 2-5 years old with sociodemographic, dietary, and anthropometric data (n = 1,521) in the National Health and Examination Survey 1999-2002. Overall diet quality was determined using the Revised Children's Diet Quality Index. Sociodemographic predictors (age, sex, sociodemographic, ethnic group, household income, preschool attendance, federal food program participation) of diet quality were determined using multiple linear regression models in the total sample and stratified by household income for Food Stamp eligible (< 1.3 of the poverty income ratio) or Special Supplemental Program for Women, Infants, and Children eligible (poverty income ratio < 1.85). Association between diet quality and prevalence of childhood obesity was assessed with Pearson chi-square tests. Statistical significance was assumed at p

Uso do Índice de Qualidade da Dieta Infantil Revisado para avaliar a dieta alimentar de pré-escolares, seus preditores sociodemográficos e sua associação com peso corporal / Use of the Revised Children's Diet Quality Index to assess preschooler's diet quality, its sociodemographic predictors, and its association with body weight status

OBJETIVO: Determinar o nível de qualidade global da dieta, preditores sociodemográficos de qualidade da dieta e a associação entre qualidade da dieta e peso corporal em uma amostra nacionalmente representativa de pré-escolares. MÉTODOS: Estudo transversal utilizando uma amostra de crianças de 2 a 5 anos com dados sociodemográficos, alimentares e antropométricos (n = 1.521) do National Health and Examination Survey 1999-2002. A qualidade global da dieta foi determinada através do Índice de Qualidade da Dieta Infantil Revisado. Preditores sociodemográficos (idade, sexo, grupo sociodemográfico e étnico, renda domiciliar, freqüência escolar, participação em programa federal de alimentação) de qualidade da dieta foram determinados através de modelos de regressão linear múltipla na amostra total e estratificados por renda domiciliar para aquelas elegíveis no programa Food Stamp (< 1,3 da razão pobreza/renda) ou no Special Supplemental Program for Women, Infants, and Children (razão pobreza/renda < 1,85). A associação entre qualidade da dieta e a prevalência de obesidade infantil foi avaliada através dos testes de qui-quadrado de Pearson. Significância estatística foi estabelecida em p £ 0,05. Toda a análise foi conduzida por meio de rotinas complexas de delineamento da pesquisa. RESULTADOS: Em média, os pré-escolares consumiram níveis sub-ótimos de grãos integrais, frutas, vegetais e laticínios. A qualidade global da dieta diminuiu proporcionalmente ao aumento de idade (coeficiente beta: -2,38, p < 0,001), mas melhorou proporcionalmente ao aumento de renda domiciliar na amostra integral (coeficiente beta: 1,22, p < 0,001), mas não nas sub-populações de baixa renda. Crianças méxico-americanas apresentaram melhor qualidade de dieta do que crianças brancas não-hispânicas (coeficiente de beta: 2,18, p < 0,033), principalmente no grupo de baixa renda (coeficiente de beta: 3,57, p < 0,006). A prevalência de obesidade infantil diminuiu significativamente...

OBJECTIVE: To determine the level of overall diet quality, sociodemographic predictors of diet quality, and the association between diet quality and body weight status in a nationally representative sample of preschoolers. METHODS: Cross-sectional study using a sample of 2-5 years old with sociodemographic, dietary, and anthropometric data (n = 1,521) in the National Health and Examination Survey 1999-2002. Overall diet quality was determined using the Revised Children's Diet Quality Index. Sociodemographic predictors (age, sex, sociodemographic, ethnic group, household income, preschool attendance, federal food program participation) of diet quality were determined using multiple linear regression models in the total sample and stratified by household income for Food Stamp eligible (< 1.3 of the poverty income ratio) or Special Supplemental Program for Women, Infants, and Children eligible (poverty income ratio < 1.85). Association between diet quality and prevalence of childhood obesity was assessed with Pearson chi-square tests. Statistical significance was assumed at p £ 0.05. All analysis was conducted using complex survey design routines. RESULTS: On average, preschooler consumed suboptimal levels of whole grains, fruits, vegetables, and dairy. Overall diet quality decreased with increasing age (beta-coefficient: -2.38, p < 0.001) but improved with increasing family income in the full sample (beta-coefficient: 1.22, p < 0.001) but not in the low-income subpopulations. Mexican American children had significantly better diet quality than non-Hispanic white children (beta-coefficient: 2.18, p < 0.033) especially in the low income group (beta-coefficient: 3.57, p < 0.006). Childhood obesity prevalence decreased significantly with increasing diet quality. CONCLUSIONS: Preschooler's diet quality needs to be improved to support the prevention of childhood obesity early in life.