Interaction of SQ-LNS with home environment (hypothesis 3) and other potential effect modifiers
The interaction between the intervention group and EC-HOME score was significant for self-report SDQ conduct problems (Association of SQ-LNS with self-reported SDQ conduct problems by Early Childhood Home Observation for the Measurement of the Environment (EC-HOME) scores. Among children with low EC-HOME scores (<23), the SQ-LNS group showed significantly lower conduct problems than the control group, whereas there were no significant differences between SQ-LNS and control groups amoung children with high EC-HOME scores. SDQ, strengths and difficulties questionnaire; SQ-LNS, small-quantity lipid-based nutrient supplement.Because the parent-report SDQ was the only measure administered at both 4–6 y and 9–11 y, we examined the mean SDQ total difficulties scores at both time points by the intervention group and high compared with low EC-HOME scores (split at the median = 28) (Total difficuties score on the parent-reported SDQ at age 4–6 y and 9–11 y by the intervention group and high compared with low EC-HOME scores. At the age 4–6 y, there were significantly greater effects of SQ-LNS among children with low HOME scores (less than the median). At the age 9–11 y, there were no signficiant differences between the groups. HOME, Home Observation for the Measurement of the Environment; LNS, lipid-based nutrient supplement; SDQ, strengths and difficulties questionnaire.For the exploratory effect modifiers, of the 115 interaction tests (23 outcomes by 5 exploratory effect modifiers), 14 (12%) were significant at 