Growth deficiency is a complex child health phenomenon that, if not corrected, can contribute to developmental delay, cognitive deficits, and small constitutional size. The proximal cause of growth deficiency is malnutrition, but the cause for the malnutrition varies with each child and family. Treatment for growth deficiency in multidisciplinary, tertiary-care clinics has been shown to be effective in the amelioration of growth deficiency. Home visits by lay community workers or community health nurses have also been shown to be effective in correcting growth deficiency. However, both of these modalities are expensive, and may not be available to all communities. What has not been determined is the most effective way to treat growth deficiency in a community setting, available to all communities. Community-based strategies targeting growth deficiency, especially in the Mexican-American community, are needed to prevent long-term growth deficiency and its associated sequela. As shown by the Health Status Objectives for the Nation, Mexican-American children are at particular risk for growth deficiency and concomitant problems but interventions have not focused on this population. Moreover, specialized interventions are needed for this population that are culturally appropriate. Based on preliminary studies and experience, the proposed project will test an innovative model that will reduce growth deficiency and concomitant morbidity. This study will provide an easily-accessed, culturally-appropriate intervention through community-based WIC clinics to Mexican-American children with growth deficiency. With the knowledge gained from this project, a model for the treatment of growth deficiency in a Mexican- American population can be established that can be widely disseminated in WIC clinics nationwide.
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