ArticleRisk management and healthcare policy2021
Effectiveness of Positive Deviance Approach to Promote Exclusive Breastfeeding Practice: A Cluster Randomized Controlled Trial.
Article in Risk management and healthcare policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Effectiveness of a positive deviance approach to improve mother's nutritional knowledge, attitude, self-efficacy, and child's nutritional status in Maji District, West Omo Zone, South West region, Ethiopia: a cluster randomized control trial.Frontiers in public health · 2023Trial
- Perceptions of Obesity and Weight-Related Behaviors Among Adults With Type 2 Diabetes in Benin.Journal of nutrition education and behavior · 2026Article
- Interventions for enhancing child survival practices among caregivers of under-five children in Sub-Saharan Africa: a scoping review.BMC public health · 2025Article
- Exploring Early Childhood Development Interventions for Building Human Capital in Sub-Saharan Africa: A Scoping Review.Child: care, health and development · 2025Article
- [Effect of positive deviation on the diagnosis and treatment of gestational syphilis, and the prevention of congenital syphilis: A cohort study].Revista colombiana de obstetricia y ginecologia · 2024Article
- How positive deviants helped in fighting the early phase of COVID-19 pandemic? A qualitative study exploring the roles of frontline health workers in Nepal.PLOS global public health · 2023Article
- Assessment of Implementation Outcome Measures for Positive Deviance Approach as a New Strategy to Promote Exclusive Breastfeeding: A Psychometric Follow-Up Study.International journal of women's health · 2022Article
- Ignoring Clustering and Nesting in Cluster Randomized Trials Renders Conclusions Unverifiable [Letter].Risk management and healthcare policy · 2022Article
- End-Users Satisfaction with Positive Deviance Approach as an Intervention to Promote Exclusive Breastfeeding in Jimma, Ethiopia: A Multi-Level Analysis.International journal of women's health · 2022Article
- Ignoring Clustering and Nesting in Cluster Randomized Trials Renders Conclusions Unverifiable [Response to Letter].Risk management and healthcare policy · 2022Article
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSuboptimal breastfeeding (BF) contributes to a significant number of infant deaths. A positive deviance approach (PDA) was not studied in Ethiopia, whether it improve exclusive breastfeeding (EBF) practice. Therefore, we determined the effectiveness of positive deviant approached intervention in increasing the proportion of EBF practice.
methodsA cluster-randomized controlled trial was employed in Jimma town from February 01 to September 30, 2018. Six randomly selected clusters (kebeles) were randomized into two arms. Then, 260 mothers who met the eligibility criteria were enrolled in either the intervention or control arm depending on where they lived. Women in the intervention group received counseling and social support in addition to the usual service to promote EBF, from women identified and trained as positive deviants in their community, while those in the control groups received the usual community-based services from urban health extension professionals. Data on primary and secondary outcome variables were collected at three points, and statistical difference was estimated using Chi-
resultsThe overall response rate at the endline was 98.8%. Exclusive BF was significantly different between the groups at mid and end points, while no difference at baseline. A higher proportion of mothers in the intervention group reported EBF compared to the control group at mid and end-line. The rate of EBF increased by 18.5% (P=0.01) in the intervention group while 0.2% in the counterparts, with a net effect of +18.2%. The probability of practicing EBF was significantly higher for the intervention group compared to the control group. At baseline, the relative risk of avoiding EBF (RR:1.112) was similar among the two groups. However, at follow-up, mothers in the intervention group were 2 times more likely to practice EBF (RR: 2.294) compared to those in the control group. CONCLUSION AND RECOMMENDATION: The PD approach is an effective intervention to promote EBF and also positively affected frequency and duration of BF. Therefore, we recommend the promotion and use of positive deviance approach as a strategy to improve EBF practice in urban settings. TRIAL REGISTRATION NUMBER: Clinical trial PACTR201805003379263, 23 May 2018.
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