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        Interventions to improve nutrition and nutrition related health amongst homeless mothers and their children: a systematic review
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        Interventions to improve nutrition and nutrition related health amongst homeless mothers and their children: a systematic review
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Homelessness is on the increase in the UK and at the end of 2009/10 there were approximately 51,000 households living in temporary accommodation( Reference Aldridge, Parekh and MacInnes 1 ). Tackling diet related ill health and evidencing ‘what works’ is a key priority for the coalition government, particularly in respect of poorer socio-economic groups( 2 ). Previous research has identified an emerging body of evidence on effective interventions for improving nutrition amongst low-income women( Reference Anderson 3 ). However, there is a group of women experiencing even sharper deprivation than those on low incomes, notably homeless mothers and their children( Reference Coufopoulos, Hackett, Dykes and Moran 4 ).

The aim of this study was to assess the effectiveness of interventions to improve nutrition and nutrition related health amongst homeless mothers and their children. A systematic review of the literature was undertaken following, where possible, the Centre for Reviews and Dissemination guidance for undertaking systematic reviews( 5 ). A total of 280 articles were identified by a structured search of eleven databases, a hand search of the grey literature and relevant journals and contact with experts. Two reviewers independently screened the titles and abstracts for relevance. Articles were only included if they were an empirical study focussing on a nutrition intervention for homeless pregnant women or homeless mothers and their children. Two reviewers independently extracted and scored all relevant articles for quality. Only two studies met the inclusion criteria, each of which was of low quality. For homeless mothers living in a shelter for homeless families nutrition education was successful in increasing nutrition knowledge but did not improve the diet of their young children( Reference Yousey 6 , Reference Johnson 7 ). For catering staff in homeless shelters, implementing nutrition education is compounded by wider structural factors influencing food provision such as lack of sufficient funding( Reference Yousey 6 ).

There is a lack of quality evidence surrounding effective nutrition interventions for homeless mothers and their children but this should not prevent policy work being carried out and evaluated considering the recent growth of homelessness in the UK.

1. Aldridge, H, Parekh, A, MacInnes, T et al. (2011) Monitoring poverty and social exclusion 2011. York: Joseph Rowntree Foundation.
2. Department of Health (2012) Healthy lives, healthy people: Improving outcomes and supporting transparency. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_132358
3. Anderson, AS (2007) Proc Nutr Soc 66, 2532.
4. Coufopoulos, AM & Hackett, AF (2009) Homeless mothers and their children: Two generations at nutritional risk. In Infant and Young Child Feeding: Multicultural Challenges to Implementing a Global Strategy, pp. 146162 [Dykes, F and Moran, V Hall, editors]. Chichester: Wiley-Blackwell.
5. Centre for Reviews and Dissemination (2009) CRD's guidance for undertaking reviews in health care. http://www.york.ac.uk/inst/crd/pdf/Systematic_Reviews.pdf.
6. Yousey, Y et al. (2007) Public Health Nurs 24, 249255.
7. Johnson, et al. (2009) JFBR 12, 155169.