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Table 1 Intervention Components of NEO-MOM

From: The effectiveness of nutrition education for overweight/obese mothers with stunted children (NEO-MOM) in reducing the double burden of malnutrition in Indonesia: study protocol for a randomized controlled trial

Construct of Social Cognitive Theory Behavior mechanism impacted Session Intervention components
Provide information on health risk of maternal overweight/obesity and child stunting Mechanisms affecting belief formation/cognitive mechanisms toward maternal nutrition literacy Session 1 50-min nutrition education class on the introduction on the double burden of malnutrition, especially consequences and management of overweight/obesity and child stunting.
Outcome expectation By improving maternal nutrition literacy, mothers might expect a healthier child (their child not stunted) and improved maternal nutritional status (not overweight/obese). Session 3 50-min nutrition education class on Indonesian balanced diet and Indonesian version of MyPlate followed by healthy behavior message to improve maternal fruit and vegetable consumption, serve more animal protein to their child and increase maternal daily steps.
Environment (food access, peer support) With supportive environment, it will be easier to perform the intended healthy behavior. Session 1–6 Mothers in intervention group gathered every two weeks during nutrition education class to provide bonding and peer support. Access to food increased by distributing a grocery voucher every time mothers in the intervention group attended the nutrition education session.
Mastery experience Performing intended behavior during nutrition education class or during the hands-on activities session will improve maternal self-efficacy for performing the following behaviors:
 1. Healthy grocery shopping
 2. Food preparation
 3. Physical activity
Session 2
Session 1–6
Session 3
Session 4
50-min nutrition education class on healthy grocery shopping followed by a 30-min mock grocery shopping session.
20-min dance session
30-min making menu for children under five years old with emphasis on including animal protein (chicken liver, catfish or eggs).
30-min nutrition education class on healthy cooking methods followed by a 60-min cooking demonstration.
Goal setting Assisted planning and goal setting will make behavior change perceived as attainable by mothers. Session 1
Session 6
30-min hands-on experience on goal setting to improve physical activity (as in daily steps), maternal fruit and vegetable intake and serving animal protein to their children.
50-min Focus Group Discussion (FGD) on how to overcome barriers towards child feeding practices followed by 30 min creating a pledge and strategies for tackling stunted child and overweight/obese mother (SCOWT) from the mother’s own perspective.
Vicarious experience Watching video of how others perform responsive feeding, maternal self-efficacy for preparing more animal protein will improve. Session 5 50-min nutrition education class on child feeding practices with emphasis on responsive feeding.
Verbal Motivation Verbal motivation from a respected informal leader such as community health worker will improve maternal self-efficacy for:
 1. Healthy grocery shopping
 2. Food preparation
 3. Physical activity
Home visit
Session 6
The motivational interviewing delivered through home visit (six times throughout the study administered on alternate weeks from nutrition education class and hands-on activity sessions) will focus on providing verbal motivation for mothers to achieve their biweekly goals (consisting of improving daily steps, increasing maternal fruit and vegetable intake, and serving their child animal protein), and help with strategies to overcome barriers.
30-min of role playing and jingle/song making related to combating child stunting.