Community-based interventions to improve child nutrition knowledge, attitudes and practices: a pilot study in three nutritionally vulnerable Sri Lankan districts.

Objective: Child malnutrition remains a critical public health challenge in Sri Lanka and is exacerbated by socioeconomic disparities and gaps in community-based educational interventions. This mixed-methods study evaluated the effectiveness of a structured educational program delivered through mothers' support groups on maternal knowledge, attitudes, and practices related to child nutrition and well-being. This study was conducted across three districts (Nuwara Eliya, Trincomalee, and Puttalam), and the quasi-experimental design included pre- and postintervention surveys (n = 208) and focus group discussions with the mothers' support group members. A three-day interactive intervention covered nutrition-related topics, with knowledge, attitudes, and practices assessed via validated questionnaires and thematic analysis of qualitative data.

Results: The quantitative results revealed slight non-statistically significant improvements in knowledge (10.77 ± 2.18-11.04 ± 2.38, p = 0.064), attitudes (29.12 ± 4.06-29.70 ± 3.85, p = 0.095), and practices (19.59 ± 3.48-20.46 ± 3.09, p = 0.051). The qualitative findings were more promising, revealing enhanced awareness of balanced diets, strengthened peer networks, and improved childcare practices. Key barriers include financial constraints, logistical challenges, and initial resistance, which can be mitigated through community engagement and multisectoral collaboration. This study demonstrates the potential of mothers' support group-led interventions to foster incremental behavioral changes and social cohesion, despite its limited, statistically significant findings. Scaling such programs requires addressing structural barriers, integrating sustained reinforcement, and leveraging partnerships with local stakeholders. These findings advocate for future research on sustainable, equity-focused nutrition interventions on a much larger scale.