Judith K Bass1, Robert Opoka, Itziar Familiar, Noeline Nakasujja, Alla Sikorskii, Jorem Awadu, Deborah Givon, Cilly Shohet, Sarah M Murray, Jura Augustinavicius, Tamar Mendelson, Michael Boivin. 1. aDepartment of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA bDepartment of Pediatrics and Child Health, Makerere University, Kampala, Uganda cDepartment of Psychiatry, Michigan State University, East Lansing, Michigan, USA dDepartment of Psychiatry, Bar Ilan University, Ramat-Gan, Israel eSchool of Education, Michigan State University, East Lansing, Michigan, USA fSchool of Education, Bar Ilan University, Ramat-Gan, Israel gDepartment of Neurology and Ophthalmology, Michigan State University, East Lansing, Michigan, USA.
Abstract
OBJECTIVES:HIV infection places children at neurodevelopmental risk; for young children in poverty, risk is compounded by compromised caregiving quality. The mediational intervention for sensitizing caregivers (MISC) program trained caregivers on fostering daily interactions with young children. We hypothesized that MISC could enhance neurodevelopment of rural Ugandan HIV-infected children and improve mental health outcomes of their caregivers, which might mediate improved caregiving quality. DESIGN: A randomized trial of HIV-infected young children (ages 2-5 years) and their female caregivers; cluster randomization was to MISC or a nutrition curriculum. SETTING:A total of 18 geographic clusters in rural Uganda. STUDY PARTICIPANTS: Children and caregivers were evaluated at baseline, 6 months, 1 year, and 1-year post-training. MAIN OUTCOME MEASURES: Mullen Scales of Early Learning, the Color-Object Association Test for memory, the Early Childhood Vigilance Test of attention, and the Behavior Rating Inventory of Executive Function for the children. Caregivers completed measures of depression and anxiety symptoms and daily functioning. RESULTS:MISC had a significant impact on postintervention receptive language (adjusted mean difference = 3.13, 95% confidence interval 0.08, 6.18) that persisted at 1-year follow-up. MISC caregivers reported significantly less functional impairment postprogram (adjusted mean difference = -0.15, 95% confidence interval -0.28, -0.01). Other outcomes were NS. CONCLUSION: Both intervention conditions resulted in improvements in the study children over time. MISC showed additional impacts on child language and caregiver well-being. Future directions that include assessing the extent enhanced language development resulting from improved caregiving may better prepare impoverished children for school.
RCT Entities:
OBJECTIVES:HIV infection places children at neurodevelopmental risk; for young children in poverty, risk is compounded by compromised caregiving quality. The mediational intervention for sensitizing caregivers (MISC) program trained caregivers on fostering daily interactions with young children. We hypothesized that MISC could enhance neurodevelopment of rural Ugandan HIV-infectedchildren and improve mental health outcomes of their caregivers, which might mediate improved caregiving quality. DESIGN: A randomized trial of HIV-infected young children (ages 2-5 years) and their female caregivers; cluster randomization was to MISC or a nutrition curriculum. SETTING: A total of 18 geographic clusters in rural Uganda. STUDY PARTICIPANTS: Children and caregivers were evaluated at baseline, 6 months, 1 year, and 1-year post-training. MAIN OUTCOME MEASURES: Mullen Scales of Early Learning, the Color-Object Association Test for memory, the Early Childhood Vigilance Test of attention, and the Behavior Rating Inventory of Executive Function for the children. Caregivers completed measures of depression and anxiety symptoms and daily functioning. RESULTS: MISC had a significant impact on postintervention receptive language (adjusted mean difference = 3.13, 95% confidence interval 0.08, 6.18) that persisted at 1-year follow-up. MISC caregivers reported significantly less functional impairment postprogram (adjusted mean difference = -0.15, 95% confidence interval -0.28, -0.01). Other outcomes were NS. CONCLUSION: Both intervention conditions resulted in improvements in the study children over time. MISC showed additional impacts on child language and caregiver well-being. Future directions that include assessing the extent enhanced language development resulting from improved caregiving may better prepare impoverished children for school.
Authors: Itziar Familiar; Alla Sikorskii; Sarah Murray; Horacio Ruisenor-Escudero; Noeline Nakasujja; Clinton Korneffel; Michael Boivin; Judith Bass Journal: AIDS Behav Date: 2019-12
Authors: Michael J Boivin; Linda Barlow-Mosha; Miriam C Chernoff; Barbara Laughton; Bonnie Zimmer; Celeste Joyce; Mutsa Bwakura-Dangarembizi; Mmule Ratswana; Nasreen Abrahams; Lee Fairlie; Hermien Gous; Portia Kamthunzi; Katie McCarthy; Itziar Familiar-Lopez; Patrick Jean-Phillippe; Joan Coetzee; Avy Violari; Mark F Cotton; Paul E Palumbo Journal: AIDS Date: 2018-01-14 Impact factor: 4.177
Authors: Michael J Boivin; Noeline Nakasujja; Itziar Familiar-Lopez; Sarah M Murray; Alla Sikorskii; Jorem Awadu; Cilly Shohet; Deborah Givon; Horacio Ruiseñor-Escudero; Elizabeth E Schut; Robert O Opoka; Judith K Bass Journal: J Dev Behav Pediatr Date: 2017 Nov/Dec Impact factor: 2.225