The Reach Up Parenting Program, Child Development, and Maternal Depression: A Meta-analysis.

BACKGROUND AND OBJECTIVES: Evidence is needed on effective approaches to build parents' ability to promote child development feasible in low- and middle-income countries. Our objective was to synthesize impact of the Reach Up early childhood parenting program in several low- and middle-income countries and examine moderation by family and implementation characteristics. METHODS: Systematic search using PubMed and Academic Search Elite/EBSCO Host. Randomized controlled trials of the Reach Up program from 1985 to February 2022 were selected. Data were extracted by 2 independent researchers. Primary outcomes were child cognitive, language, and motor development. Secondary outcomes were home stimulation and maternal depressive symptoms. We synthesized pooled effect sizes using random effect inverse-variance weighting and effect modification by testing pooled subgroup effect estimates using the χ2 test for heterogeneity. RESULTS: Average effect size across 18 studies ranged from 0.49 (95% confidence interval [CI] 0.32 to 0.66) for cognition, 0.38 (CI 0.24 to 0.51) for language, 0.27 (CI 0.13 to 0.40) for motor development, 0.37 (CI 0.21 to 0.54) for home stimulation, and -0.09 (CI -0.19 to 0.01) for maternal depressive symptoms. Impacts were larger in studies targeted to undernourished children, with mean enrollment older than age 12 months and intervention duration 6 to 12 months. Quality of evidence assessed with the Cochrane Assessment of Risk of Bias and GRADE system was moderate. Instruments used to assess child development varied. In moderator analyses, some subgroups included few studies. CONCLUSIONS: Reach Up benefits child development and home stimulation and is adaptable across cultures and delivery methods. Child and implementation characteristics modified the effects, with implications for scaling.

Consumer Response to Cake with Apple Pomace as a Sustainable Source of Fibre.

The use of apple pomace flour (APF) as a fibre enrichment strategy was investigated. The aim of this study was to evaluate consumers' response to intrinsic and extrinsic properties of a bakery premix product when using APF. Apple pomace, a by-product from the juice industry, was dried and ground. APF is high in carbohydrates (47.47%) and fibre (38.48%), and it was used to partially substitute wheat flour and sugar in a cake premix. Acceptability, health, and nutrition questions were evaluated with and without information in terms of regular and fibre-enriched cake. The regular cake score was not affected by information, while the enriched cake's score increased with information. Three clusters were identified. Cluster 1 (29%) showed high liking scores for regular cake, cluster 2 (31%) for the fibre-enriched cake, and cluster 3 (40%) showed similar liking for both. Consumers described the samples and ideal cake using a check-all-that-apply (CATA) questionnaire. Penalty analyses explained differences in acceptability among consumers. Healthiness, tastiness, and fibre content were the main reasons to buy the enriched cake for cluster 2; taste for consumers in cluster 1; and healthiness and taste for consumers in cluster 3. APF as a functional ingredient may be a consumers' choice as a sustainable use of apple pomace.