Nurture Early for Optimal Nutrition (NEON) Pilot Randomised Controlled Trial: Qualitative study of community facilitators and attendees' perspective on intervention delivery.

Background Appropriate and healthy feeding practices can enhance a child's health, prevent obesity, and reduce chronic metabolic disease risks. Given the ethnic variations in feeding practices and metabolic risk, interventions must be community specific. Culturally tailored, grassroots interventions targeting infant feeding can induce behavioural changes, mitigating chronic metabolic disease risks in later life. Aim The aim of this study was to explore participant feedback and inform intervention delivery methods within marginalised communities. Methods A pilot three-arm cluster randomised controlled trial was conducted in London's Tower Hamlets and Newham boroughs, involving community participatory learning and action groups. The study recruited 186 South Asian (Indian, Bangladeshi, Pakistani, and Sri Lankan) mothers or carers of 0-2-year-old children. Attendees were invited to either face-to-face or online intervention arms, facilitated by trained multilingual community facilitators, offering culturally informed discussions on child nutrition and care practices. Qualitative feedback was collected from attendees and facilitators, with thematic analysis identifying key themes, underscoring intervention fidelity and acceptance. Results Of the initial attendees, 42 (from the remaining 153 at the study's conclusion) and 9 community facilitators offered feedback on the intervention's delivery and suggestions for enhancing community-based interventions' success. Key findings highlighted the need for a more flexible approach to boost participation and the significance of providing accessible, translated documents and resources. Conclusion Parenting interventions, particularly for new mothers, should adopt a hybrid design. This would provide attendees with the flexibility to select the delivery method, session timings, and the option to participate at any stage of the intervention. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial IRAS-ID-296259 ([ISRCTN10234623][1]) ### Funding Statement Logan Manikam and Priyanka Patil are funded via a National Institute for Health Research (NIHR) Advanced Fellowship (Ref: NIHR300020) to undertake the Pilot Feasibility Cluster Randomised Controlled Trial of the NEON programme in East London. Monica Lakhanpaul was funded by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study obtained ethical approval from UCL Research Ethics Committee [Ethics ID 17269/001], Sponsor reference number: 142600, Funding Reference: NIHR300020 and IRAS number: 296259, Ref: 21/SW/0142. Written and/or verbal informed consent was obtained from the participants prior to interviews; the participants were ensured about confidentiality and anonymity. All data was protected and made available only to the authors; data was stored in UCL on a secure university server. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors. [1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN10234623