Food and nutrition insecurity becomes increasingly worse in areas affected by armed conflict. Children affected by conflict, or in war-torn settings, face a disproportionate burden of malnutrition and poor health outcomes. As noted by humanitarian response reviews, there is a need for a stronger evidence-based response to humanitarian crises. To achieve this, we systematically searched and evaluated existing nutrition interventions carried out in conflict settings that assessed their impact on children's nutrition status. To evaluate the impact of nutrition interventions on children's nutrition and growth status, we identified published literature through EMBASE, PubMed, and Global Health by using a combination of relevant text words and Medical Subject Heading terms. Studies for this review must have included children (aged ≤18 y), been conducted in conflict or postconflict settings, and assessed a nutrition intervention that measured ≥1 outcome for nutrition status (i.e., stunting, wasting, or underweight). Eleven studies met the inclusion and exclusion criteria for this review. Five different nutrition interventions were identified and showed modest results in decreasing the prevalence of stunting, wasting, underweight, reduction in severe or moderate acute malnutrition or both, mortality, anemia, and diarrhea. Overall, nutrition interventions in conflict settings were associated with improved children's nutrition or growth status. Emergency nutrition programs should continue to follow recent recommendations to expand coverage and access (beyond refugee camps to rural areas) and ensure that aid and nutrition interventions are distributed equitably in all conflict-affected populations.

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Rates of breastfeeding initiation and duration among women who attend the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are dramatically lower than nonparticipants. Innovative solutions are needed to improve breastfeeding rates in this population. The Lactation Advice through Texting Can Help (LATCH) study was one such approach, designed to augment and reinforce the WIC breastfeeding peer counseling process. The purpose of the present study was to examine engagement via two-way text messaging in a sample of women attending the WIC breastfeeding peer counseling program and enrolled in LATCH. The objectives were to: (1) describe text message engagement in the context of LATCH; and (2) assess the association between engagement variables and exclusive breastfeeding status. Text messaging data were first coded qualitatively by two independent researchers and engagement variables created. An analysis of engagement was conducted using descriptive statistics for normally distributed data and binary logistic regression. In the multivariable model, intensity of engagement during the first 2 weeks post partum was the single strongest predictor of exclusive breastfeeding status. LATCH is an innovative intervention designed to enhance the capacity of breastfeeding peer counselors and holds much potential for improving exclusive breastfeeding rates in this population.

These results demonstrate the utility of the HAPA model in predicting exclusive breastfeeding behavior among low-income women attending WIC. LATCH is a theoretically sound text messaging intervention that can be used to augment and reinforce the WIC breastfeeding peer counseling process.

SummaryObjectivePrior studies have suggested that weight misperception – underestimating one's actual weight – may be associated with reduced engagement in weight loss programmes, decreasing the success of initiatives to address obesity and obesity‐related diseases. The purpose of this study was to examine the factors associated with weight misperception among Eastern Caribbean adults and its influence on engagement in weight control behaviour.MethodsData from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study were analysed (adults aged 40 and older, residing in the US Virgin Islands, Puerto Rico, Barbados and Trinidad). Weight misperception is defined as participants who under‐assess their weight measured by body mass index (BMI). Multivariable logistic regression (n = 1,803 participants) was used to examine the association of weight misperception with BMI category, age, gender, education, history of non‐communicable disease and attempt to lose weight.ResultsWeight misperception was common, with 54% of overweight (BMI 25–29 kg m−2), and 23% of obese class I (BMI 30–34.9 kg m−2) participants under‐assessing their actual weight. Participants with higher levels of education, versus lower, had decreased odds of weight misperception (OR 0.5, p < 0.001). There were no significantly reduced odds of weight misperception in women versus men (OR 1.13, p = 0.367) or in individuals with history of diabetes versus none (OR 0.88, p = 0.418). Participants with weight misperception had 85% (p < 0.0001) lower odds of attempting weight loss than those with accurate weight perception.ConclusionWeight misperception is common among adults with overweight and obesity in the Eastern Caribbean and is associated with lower likelihood of attempting weight loss. Obesity interventions, targeting similar populations, should incorporate approaches for addressing weight misperception to achieve measurable success.