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(OR10-07-26) Grandi Byen: Findings From a Randomized Controlled Trial in Haiti Examining Egg Plus Parenting Intervention Impacts on Child Growth and Nutrition

Sunday, July 26, 2026
11:42 AM - 11:54 AM ET
Location: Maryland Ballroom C
Objectives: 1) Demonstrate the reproducibility of egg-based interventions in reducing child stunting; 2) Investigate the incremental benefit of an integrated parenting intervention, Grandi Byen, compared to egg only and control groups on nutrition and growth outcomes.

Methods: Grandi Byen (GB) was a 3-arm individually randomized controlled trial (RCT) conducted in Cap Haitien, Haiti from 2021-2025, a period fraught with political and economic turmoil and widespread gang violence. Infants ages 6-8m (n=600) were recruited and enrolled into 5 rolling cohorts and randomized to: 1) control (standard well-baby care); 2) egg (one egg per day for 6 months); and 3) GB intervention (12 sessions with messaging on responsive parenting, nutrition, and WASH + one egg per day for 6m). Intervention efficacy on child anthropometry [height-for-age Z (HAZ), weight-for-age Z (WAZ), and weight-for-height Z scores] and nutrition biomarkers (plasma nutrient concentrations) was examined using difference-in-difference analyses comparing change from baseline to 6m endline timepoint. Analyses of docosahexaenoic acid (DHA), linoleic acid, α-linolenic acid, choline, betaine, and methionine were conducted on a coupled HPLC-mass spectrometer system. A generalized propensity score (GPS) approach was applied in regression modeling for main treatment effects due to detected group imbalances.

Results: There were 18% losses to follow-up. Relative to the control group, we found non-significant, positive intervention effects for WAZ and WHZ for GB and egg groups, and HAZ for GB group in GPS-weighted modeling. Two plasma biomarkers showed significant treatment effects: DHA, .38 (95% CI: .13, .64, p=.004) and IGF-1, -.34 (95% CI: -0.57, -0.11, p=.004). Choline and methionine also trended for positive intervention effects, while all others showed non-significant differences. A strong cohort effect was evident across all nutrition and growth outcomes.

Conclusions: In this Haitian context, the egg effect on stunting reduction was not replicated. Trends suggest that the integrated GB intervention may have had added benefits compared to egg alone and that both interventions may have mitigated growth deficits during this crisis period.

Funding Sources: Eunice Kennedy Shriver National Institute of Child Health and Development