Susan M Chang1, Sally M Grantham-McGregor2, Christine A Powell1, Marcos Vera-Hernández3, Florencia Lopez-Boo4, Helen Baker-Henningham5, Susan P Walker6. 1. Tropical Medicine Research Institute, The University of the West Indies, Kingston, Jamaica; 2. Institute of Child Health, and. 3. Department of Economics, University College London, London, United Kingdom; 4. Social Protection and Health Division, Inter-American Development Bank, Washington, District of Columbia; and. 5. Tropical Medicine Research Institute, The University of the West Indies, Kingston, Jamaica; School of Psychology, Bangor University, Bangor, United Kingdom. 6. Tropical Medicine Research Institute, The University of the West Indies, Kingston, Jamaica; susan.walker@uwimona.edu.jm.
Abstract
OBJECTIVE: More than 200 million children globally do not attain their developmental potential. We hypothesized that a parent training program could be integrated into primary health center visits and benefit child development. METHODS: We conducted a cluster randomized trial in the Caribbean (Jamaica, Antigua, and St Lucia). Fifteen centers were randomly assigned to the control (n = 250 mother-child pairs) and 14 to the intervention (n = 251 mother-child pairs) groups. Participants were recruited at the 6- to 8-week child health visit. The intervention used group delivery at 5 routine visits from age 3 to 18 months and comprised short films of child development messages, which were shown in the waiting area; discussion and demonstration led by community health workers; and mothers' practice of activities. Nurses distributed message cards and a few play materials. Primary outcomes were child cognition, language, and hand-eye coordination and secondary outcomes were caregiver knowledge, practices, maternal depression, and child growth, measured after the 18-month visit. RESULTS:Eight-five percent of enrolled children were tested (control = 210, intervention = 216). Loss did not differ by group. Multilevel analyses showed significant benefits for cognitive development (3.09 points; 95% confidence interval: 1.31 to 4.87 points; effect size: 0.3 SDs). There were no other child benefits. There was a significant benefit to parenting knowledge (treatment effect: 1.59; 95% confidence interval: 1.01 to 2.17; effect size: 0.4). CONCLUSIONS: An innovative parenting intervention, requiring no additional clinic staff or mothers' time, was integrated into health services, with benefits to child cognitive development and parent knowledge. This is a promising strategy that merits further evaluation at scale.
RCT Entities:
OBJECTIVE: More than 200 million children globally do not attain their developmental potential. We hypothesized that a parent training program could be integrated into primary health center visits and benefit child development. METHODS: We conducted a cluster randomized trial in the Caribbean (Jamaica, Antigua, and St Lucia). Fifteen centers were randomly assigned to the control (n = 250 mother-child pairs) and 14 to the intervention (n = 251 mother-child pairs) groups. Participants were recruited at the 6- to 8-week child health visit. The intervention used group delivery at 5 routine visits from age 3 to 18 months and comprised short films of child development messages, which were shown in the waiting area; discussion and demonstration led by community health workers; and mothers' practice of activities. Nurses distributed message cards and a few play materials. Primary outcomes were child cognition, language, and hand-eye coordination and secondary outcomes were caregiver knowledge, practices, maternal depression, and child growth, measured after the 18-month visit. RESULTS: Eight-five percent of enrolled children were tested (control = 210, intervention = 216). Loss did not differ by group. Multilevel analyses showed significant benefits for cognitive development (3.09 points; 95% confidence interval: 1.31 to 4.87 points; effect size: 0.3 SDs). There were no other child benefits. There was a significant benefit to parenting knowledge (treatment effect: 1.59; 95% confidence interval: 1.01 to 2.17; effect size: 0.4). CONCLUSIONS: An innovative parenting intervention, requiring no additional clinic staff or mothers' time, was integrated into health services, with benefits to child cognitive development and parent knowledge. This is a promising strategy that merits further evaluation at scale.
Authors: Bergen B Nelson; Rebecca N Dudovitz; Tumaini R Coker; Elizabeth S Barnert; Christopher Biely; Ning Li; Peter G Szilagyi; Kandyce Larson; Neal Halfon; Frederick J Zimmerman; Paul J Chung Journal: Pediatrics Date: 2016-07-18 Impact factor: 7.124
Authors: Justin D Smith; Gracelyn H Cruden; Lourdes M Rojas; Mark Van Ryzin; Emily Fu; Matthew M Davis; John Landsverk; C Hendricks Brown Journal: Pediatrics Date: 2020-07 Impact factor: 7.124
Authors: Linda M Richter; Bernadette Daelmans; Joan Lombardi; Jody Heymann; Florencia Lopez Boo; Jere R Behrman; Chunling Lu; Jane E Lucas; Rafael Perez-Escamilla; Tarun Dua; Zulfiqar A Bhutta; Karin Stenberg; Paul Gertler; Gary L Darmstadt Journal: Lancet Date: 2016-10-04 Impact factor: 79.321