2.1. Site and Study Design
nutritional inadequacies
We conducted a cluster-randomized controlled trial in the Department of Retalhuleu from 2015 to 2017. The department is located in southwestern Guatemala and extends from the mountains to the Pacific Ocean. The area was selected due to the high prevalence of stunting (39% in children 6–72 months), suggesting nutritional inadequacies and food insecurity [A 2 × 2 factorial design was used to efficiently test the multiple micronutrient-fortified beverage and responsive caregiving interventions and their interaction [