The prEgnanCy and eArly Childhood nutrItion triaL (ECAIL) (ECAIL)

Effectiveness of an Early Intervention Aiming at Promoting Healthy Diet, Lifestyle and Growth of Children Living in Situation of Social Disadvantage : the prEgnanCy and eArly Childhood nutrItion triaL (ECAIL)

The purpose of this study is to conduct a randomized controlled trial among 800 socially disadvantaged pregnant women and their families to test the effectiveness of a multi-component home visitation nutrition program, compared to usual care, in promoting healthy feeding practices, lifestyle behaviors and growth in young children.

Study Overview

• Status: Recruiting
• Conditions: Physical Activity; Growth; Diet; Sedentary Behavior; Infant
• Intervention / Treatment: Behavioral: Experimental: Intervention Program; Behavioral: Active comparator: Usual Care

Detailed Description

This randomized controlled trial will test an early home based multi-component intervention program designed to promote healthy feeding practices and lifestyle behaviors in socially disadvantaged pregnant women and their families. It first seeks to build knowledge, skills and social support regarding maternal diet and feeding practices (with a focus on breastfeeding and complementary feeding), and lifestyle behaviors, within the frame of the French Nutrition and Health Program (Programme National Nutrition Santé, PNNS) while accounting for the cultural background and barriers of the targeted population (component 1). It also involves fresh fruit and vegetable baskets, kitchen utensils and cooking devices, being made available at a reduced price from the 3rd trimester of pregnancy to when the toddler is aged 24 months (component 2), along with the provision of follow-on formula, baby and family food vouchers from 6 to 24 months (component 3). The intervention group (n=400) will benefit from these 3 program components. The control group (n=400) will receive usual care, restricted to general information on healthy eating provided by the food guides of the PNNS. The ECAIL study will assess the program's effectiveness on lifestyle behaviors and growth in the first 2 years of life.

Noteworthy, the program evaluated for effectiveness with the ECAIL trial is an existing program, called the MALIN program (https://www.programme-malin.com/), which has been progressively implemented in mainland France since 2012, to the exception of the ECAIL study area. Since 2019, counselling on movement behaviors, including the promotion of physical activity and the prevention of sedentary behaviors (e.g. screen time), has been added to the diet and feeding practices educational component; discount vouchers have further encompassed other healthy foods and products appropriate for all family members; and online sales for kitchen utensils and cooking devices have been started too.

• Study Type: Interventional
• Enrollment (Estimated): 800
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sandrine Lioret, PhD; Phone Number: 00 33 1 45 59 51 78; Email: sandrine.lioret@inserm.fr
• Study Contact Backup: Name: Blandine de Lauzon-Guillain, PhD; Phone Number: 00 33 1 45 59 50 19; Email: blandine.delauzon@inserm.fr

Study Locations

• France
  • Lille, France, 59037
    • Completed
    • University Hospital
  • Valenciennes, France, 59300
    • Recruiting
    • Valenciennes Hospital, Monaco Hospital maternity
    • Contact: Pauline Devouge, Dr; Email: devouge-p@ch-valenciennes.fr
    • Contact: Aurore Dehon; Email: dehon-a@ch-valenciennes.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Pregnant woman at her 3rd term of pregnancy
• Healthy
• Aged ≥ 18 years
• From a socially disadvantaged background
• Living in Lille, Lomme, Loos, Faches-Thumesnil, Ronchin, Hellemmes, Haubourdin, La Madeleine, Lambersart, Mons-en-Baroeul, Saint-André-Lez-Lille, Wattignies, Villeneuve-d'Ascq, Marcq-en-Barœul or Wasquehal; or in the Valenciennes conurbation.
• Willing and able to sign informed consent
• Who, in the Investigator's judgement, is able to comply with the protocol or study procedures (including French speaking)
• If twins are born from this pregnancy, only one will be randomly selected for inclusion

Exclusion Criteria:

• Pregnant woman under guardianship
• Participation in any other interventional clinical trial that is not compatible with the participation into the ECAIL study
• No permanent mailing address
• Housed in emergency accommodation centres, hotels, movable dwellings or homeless
• Planning to move outside the study area prior to the child's first birthday
• Serious illness during pregnancy that could interfere with optimal participation in the ECAIL study
• Hard drug consumption
• Multiple pregnancy (≥3 foetuses).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Program; Experimental: Intervention Program	Behavioral: Experimental: Intervention Program; The home based educational component from the 3rd trimester of pregnancy to when the child is aged 24 months seeks to build knowledge, skills and social support (social cognitive theory, anticipatory guidance) to the parents regarding feeding practices (focussing on breastfeeding and complementary feeding), and lifestyle behaviors, consistent with the French Nutrition and Health Program (PNNS) guidelines (component 1). Fresh fruit and vegetable baskets, kitchen utensils and cooking devices are made available at a reduced price from the 3rd trimester of pregnancy to when the toddler is aged 24 m (component 2), along with the provision of follow-on formula, baby and family food vouchers from 6 to 24 m (component 3). One home visit is scheduled during the 3rd trimester of pregnancy. Another visit will take place in the maternity ward after the child is born. Five further home visits will take place when the child is aged 3, 6, 12, 18 and 24 m.
Active Comparator: Usual Care; Active comparator: Usual Care	Behavioral: Active comparator: Usual Care; Usual Care reflects the standard treatment currently provided within the frame of the French health care system. One home visit is scheduled during the 3rd trimester of pregnancy. Another visit will take place in the maternity ward after the child is born. Five further home visits will take place when the child is aged 3, 6, 12, 18 and 24 m. If nutritional questions are raised by parents, dieticians will restrict their responses based on the food guides of the PNNS.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frequency of vegetable consumption (times/day) at age 2 years	Measured at 2 years using a food frequency questionnaire	2 years of age

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Breastfeeding initiation rate	Measured at different time points from birth to 2 y (scheduled at birth, 3 months, 6 months, 12 months, 18 months and 24 months of age) using questionnaires	Up to 2 years of age
Predominant and any breastfeeding durations	Measured at different time points from birth to 2 y (scheduled at birth, 3 months, 6 months, 12 months, 18 months and 24 months of age) using questionnaires	Up to 2 years of age
Age at complementary feeding introduction	Measured at different time points from birth to 2 y (scheduled at birth, 3 months, 6 months, 12 months, 18 months and 24 months of age) using questionnaires	Up to 2 years of age
Age at first introduction of processed (but not baby-specific) foods	Measured at different time points from birth to 2 y (scheduled at birth, 3 months, 6 months, 12 months, 18 months and 24 months of age) using questionnaires	Up to 2 years of age
Frequency of vegetable consumption (times/day) at age 1 year	Measured at 1 year using a food frequency questionnaire	1 year of age
Dietary patterns at age 1 year	Measured at 1 year using a food frequency questionnaire	1 year of age
Lifestyle patterns at age 1 year	Measured at 1 year using dietary variables from the food frequency questionnaire; and movement behavioral variables (physical activity and sedentary behaviors) measured with a questionnaire. Lifestyle patterns will be derived using principal component analysis	1 year of age
Weight growth velocity over the six first months of life	Weight measured at different time points from birth to 6 months of age	Up to 6 months of age
BMI at age 2 years	Weight, length and BMI measured at different time points from birth to 2 y	2 years of age
Proportion of children that are overweight or obese at age 2 years	Weight, length and BMI measured at different time points from birth to 2 y	2 years of age
Dietary patterns at age 2 years	Measured at 2 years using a food frequency questionnaire	2 years of age
Lifestyle patterns at age 2 years	Measured at 2 years using dietary variables from the food frequency questionnaire; and movement behavioral variables (physical activity and sedentary behaviors) measured with a questionnaire. Lifestyle patterns will be derived using principal component analysis	2 years of age
Weight growth curves from birth to 2 y	Weight measured at different time points from birth to 2 y	Up to 2 years of age
Length growth curves from birth to 2 y	Length measured at different time points from birth to 2 y	Up to 2 years of age
BMI curves from birth to 2 y	BMI measured at different time points from birth to 2 y	Up to 2 years of age

Collaborators and Investigators

• Sponsor: French Red Cross
• Collaborators: Institut National de la Santé Et de la Recherche Médicale, France; University Hospital, Lille; Association Programme MALIN; Société Française de Pédiatrie; Association Française de Pédiatrie Ambulatoire
• Investigators: Principal Investigator: Sandrine Lioret, PhD, Institut National de la Santé Et de la Recherche Médicale, France; Principal Investigator: Delphine Ley, MD, PhD, University Hospital, Lille

Study record dates

Study Major Dates

• Study Start (Actual): April 3, 2017
• Primary Completion (Estimated): July 1, 2027
• Study Completion (Estimated): December 1, 2027

Study Registration Dates

• First Submitted: December 21, 2016
• First Submitted That Met QC Criteria: December 21, 2016
• First Posted (Estimated): December 26, 2016

Study Record Updates

• Last Update Posted (Actual): February 20, 2024
• Last Update Submitted That Met QC Criteria: February 17, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: Pregnancy; Randomized controlled trial; Physical activity; Diet; Growth; Infant; Education; Breastfeeding; Complementary feeding; Screen; Body mass index; Social disadvantage; Food vouchers
• Other Study ID Numbers: 2014-A00849-38; n°CPP 03/010/2014 (Other Identifier: Comité de Protection des Personnes Nord-Ouest 1)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No