{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:58:55Z","timestamp":1755799135033,"version":"3.44.0"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>High malnutrition among children with CP in low-income countries underscores the need for community-based nutrition strategies. This study aimed to describe the effectiveness of two caregiver-led interventions including, the positive deviance (PD) and the parent facilitator training (PFT) interventions on malnutrition among children and youth (C&amp;Y) with CP in rural Eastern Uganda. This was a 2x2 factorial quasi-randomized trial among 124 pairs of caregiver-malnourished C&amp;Y with CP aged 2\u201324 years, at the Iganga Mayuge Health and Demographic Surveillance Site (IMHDSS) in Eastern Uganda. Outcome measures included three months change in weight gain, Weight for-age-z scores and Body Mass Index for-age-z scores. Change in weight status was modelled in a multiple linear regression adjusting for baseline characteristics. Non-factorial analysis was used to determine the effect of combining both interventions on weight status. The interaction effect between PD and PFT was not statistically significant (P\u2009&gt;\u20090.05). Those who received the PD intervention significantly gained more weight by 520g (adjusted coefficient\u2009=\u20090.52, 95%CI 0.16,0.88, p\u2009=\u20090.005) and improved their BMI for age z-scores (adjusted coefficient\u2009=\u20090.65, 95% CI 0.35,0.94, P\u2009&lt;\u20090.01) than those who did not, while those who received PFT significantly improved their Weight for Age z-scores (adjusted coefficient\u2009=\u20090.42,95%CI 0.14,0.56, p\u2009=\u20090.006). Non-factorial analysis revealed a significant higher weight gain (770g) and improved BMI for age z-scores among those who received both interventions (adjusted coefficient\u2009=\u20090.77, 95%CI 0.22.1.37, p\u2009=\u20090.009). The PD alone or combined with PFT interventions improves weight status better than the PFT intervention alone. The PD and PFT caregiver-led strategies should be merged into existing community-based nutrition programs to reduce the high burden of malnutrition among C&amp;Y with CP in low-income settings.<\/jats:p>","DOI":"10.1371\/journal.pgph.0005027","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T17:31:57Z","timestamp":1755624717000},"page":"e0005027","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of the Positive deviance and parent facilitator training strategies on the nutritional status of children and youth with cerebral palsy: A quasi-randomised trial with a factorial design"],"prefix":"10.1371","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0967-1690","authenticated-orcid":true,"given":"Lukia Hamid","family":"Namaganda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Ssenkusu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asige","family":"Elizabeth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carin","family":"Andrews","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelina Kakooza","family":"Mwesige","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fred Wabwire","family":"Mangen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2069-6618","authenticated-orcid":true,"given":"Hans","family":"Forssberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"issue":"12","key":"pgph.0005027.ref001","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(17)30374-1","article-title":"Prevalence of cerebral palsy in Uganda: a population-based study","volume":"5","author":"A Kakooza-Mwesige","year":"2017","journal-title":"Lancet Glob Health"},{"issue":"12","key":"pgph.0005027.ref002","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1111\/dmcn.15346","article-title":"Global prevalence of cerebral palsy: A systematic analysis","volume":"64","author":"S McIntyre","year":"2022","journal-title":"Dev Med Child Neurol"},{"issue":"6","key":"pgph.0005027.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0001241","article-title":"Nutritional status and growth of children and adolescents with and without cerebral palsy in eastern Uganda: A longitudinal comparative analysis","volume":"3","author":"L Hamid Namaganda","year":"2023","journal-title":"PLOS Glob Public Health"},{"doi-asserted-by":"crossref","unstructured":"Jahan I, Muhit M, Hardianto D, Laryea F. 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