scholarly journals mHealth Supported Delivery of an Evidence-based Family Home Visiting Intervention in Sierra Leone: A Pilot Randomized Controlled Trial Study Protocol (Preprint)

2020 ◽  
Author(s):  
Alethea Desrosiers ◽  
Carolyn Schafer ◽  
Rebecca Esliker ◽  
Musu Jambai ◽  
Theresa Betancourt
Keyword(s):  
Mental Health ◽  
Emotion Regulation ◽  
Sierra Leone ◽  
Home Visiting ◽  
Early Childhood Development ◽  
Controlled Trial ◽  
Childhood Development ◽  
Evidence Based ◽  
Caregiver Mental Health ◽  
Pilot Randomized Controlled Trial

BACKGROUND Past trauma and exposure to violence has been related to poor emotion regulation and household violence, which can have persistent mental health effects across generations. The Family Strengthening Intervention for Early Childhood Development (FSI-ECD/called Sugira Muryango in Rwanda) is an evidence-based behavioral home-visiting intervention to promote caregiver mental health, positive parenting practices, and early childhood development among families facing adversity. In Sierra Leone and other LMICS, mHealth technology has the potential to improve health care delivery and health outcomes. OBJECTIVE This study aims to: (a) apply user-centered design to develop and test mHealth tools to improve supervision and fidelity monitoring of community health workers (CHWs) delivering the FSI-ECD and (b) conduct a pilot randomized controlled trial of the FSI-ECD to assess feasibility, acceptability, and preliminary effects on caregiver mental health, emotion regulation, caregiving behaviors, and family violence in high-risk families with children aged 6-36 months in comparison with control families receiving standard care. METHODS We will recruit and enroll CHWs, supervisors and families with a child aged 6-36 months from community health clinics in Sierra Leone. CHWs and supervisors will participate in one problem-analysis focus group and two user interface/user experience (UI/UX) cycles to provide feedback on mHealth tool prototypes. Families will be randomized to mHealth supported FSI-ECD or standard maternal and child health services. We will collect quantitative data on caregiver mental health, emotion regulation, caregiving behaviors, and family functioning at baseline, post-intervention and 3-month follow-up. We will use a mixed-methods approach to explore feasibility and acceptability of mHealth tools and the FSI-ECD. Mixed effects linear modeling will assess FSI-ECD effects on caregiver outcomes. Cost-effectiveness analysis will estimate costs across FSI-ECD vs standard care. RESULTS Funding for this study was received from the National Institute of Mental Health on August 17, 2020. Institutional Review Board approval was received September 4, 2020. Data collection is projected to begin December 15 2020. CONCLUSIONS This study will provide important data on the feasibility, acceptability and preliminary efficacy of mHealth-supported delivery of an evidence-based family home visiting intervention in a post-conflict, LMIC. CLINICALTRIAL Clinical trial registration: NCT04481399; registered July 22, 2020.

scholarly journals Effect of Caregiver’s Mental Health on Early Childhood Development across Different Rural Communities in China

2018 ◽  
Vol 15 (11) ◽  
pp. 2341 ◽  
Author(s):  
Siqi Zhang ◽  
Ruirui Dang ◽  
Ning Yang ◽  
Yu Bai ◽  
Lei Wang ◽  
...  
Keyword(s):  
Mental Health ◽  
Parenting Practices ◽  
Developmental Delays ◽  
Early Childhood Development ◽  
Mental Health Problems ◽  
Developmental Outcomes ◽  
Health Problems ◽  
Childhood Development ◽  
Infants And Toddlers ◽  
Caregiver Mental Health

Previous research has found that there are high rates of developmental delays among infants and toddlers in rural areas of China. Caregiver mental health problems might be one significant predictor of developmental delays among infants and toddlers, as has been found in other areas of the world. One way that the mental health of caregivers could affect early childhood development is through its effect on parenting practices. In this study, we used data from four major subpopulations of rural China to measure the correlation of caregiver mental health problems with the developmental outcomes of infants and toddlers. To do so, the study used the Bayley Scales of Infant Development III (BSID III) to examine the rates of developmental delays among 2514 rural infants/toddlers aged 6–30 months old. The results of the testing demonstrate that 48% of the sample’s infants/toddlers have cognitive delays; 52% have language delays; 53% have social-emotional delays; and 30% have motor delays. The data collection team also assessed caregiver mental health by using the Depression Anxiety Stress Scales (DASS-21) questionnaire. According to the findings, 39% of caregivers in the sample have symptoms of at least one kind of mental health problem (depression, anxiety, or stress). We also found that most caregivers do not engage in positive parenting practices, while a significant share of caregivers engage in negative parenting practices. The statistical analysis found that showing signs of mental health problems is significantly and negatively associated with infant/toddler developmental outcomes. The study also found that caregivers who show signs of mental health problems are significantly less likely to engage in interactive parenting practices. The study confirms that society needs to pay more attention to caregiver mental health problems in order to improve infant/toddler developmental outcomes in rural China and increase human capital accumulation in China as a whole.

scholarly journals Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Joy Noel Baumgartner ◽  
Mohammed Ali ◽  
John A. Gallis ◽  
Margaret Lillie ◽  
Raymond Owusu ◽  
...  
Keyword(s):  
Mental Health ◽  
Early Childhood ◽  
Emotional Development ◽  
Early Childhood Development ◽  
Controlled Trial ◽  
Childhood Development ◽  
Northern Ghana ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Cluster Randomized

Abstract Background Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children. Methods This cRCT randomized 32 women's groups – 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Surveys were administered at baseline, immediate post-intervention, and 8-month post-intervention. The primary outcome was maternal depression [Patient Health Questionnaire (PHQ-9)], and the secondary outcome was child's socio-emotional development [Ages and Stages Questionnaire: Social Emotional (ASQ:SE-2)]. Qualitative interviews with 33 stakeholders were also conducted. Results In total, 374 participants were enrolled at baseline while pregnant with the index child, 19% endorsing moderate/severe depression. Of these, 266 (71.1%) completed the 8-month post-intervention survey (~19 months post-baseline). There were no significant effects of iMBC/ECD on PHQ-9 and ASQ:SE-2 scores. However, results favored the intervention arm in most cases. iMBC participants were highly satisfied with the program but qualitative feedback from stakeholders indicated some implementation challenges. Conclusions This real-world evaluation had null findings; however, post-intervention depression levels were very low in both arms (3%). Future research should examine the potential impact of women's groups on postpartum mental health more broadly with varying content.

Do Nutrition Education Approaches With Preschoolers and Their Caregivers Influence Retention of Biofortified Orange-Fleshed Sweetpotato on Farms?: Evidence From Homa Bay County, Kenya

2021 ◽  
pp. 037957212110254
Author(s):  
Sylvester O. Ojwang ◽  
David J. Otieno ◽  
Julius J. Okello ◽  
Penina Muoki ◽  
Rose A. Nyikal
Keyword(s):  
Nutrition Education ◽  
Early Childhood Development ◽  
Controlled Trial ◽  
Text Messages ◽  
Sub Saharan Africa ◽  
Childhood Development ◽  
Control Group ◽  
Micronutrient Deficiencies ◽  
Household Level ◽  
Intention To Treat

Background: Biofortified staples have been promoted widely in sub-Saharan Africa to combat micronutrient deficiencies. Contemporary projects are increasingly using elementary schools to target households with these foods. Objective: This study assessed the effects of integrated nutrition education approaches, targeting preschoolers and their caregivers, on retention of orange-fleshed sweetpotato (OFSP) on farms in the second season after lapse of free vine dissemination initiatives. Methods: Rural farming households, with preschoolers and no prior engagement with OFSP, were targeted. A multistage sample of 431 preschooler–caregiver pairs was recruited for a cluster-randomized controlled trial. After issuing routine OFSP promotion activities, 15 village-level clusters of the pairs were randomized into 1 control group (3 villages) and 3 treatment arms (4 villages each) for the interventions. Baseline and follow-up household-level survey data were collected from the caregivers. The interventions included: (1) OFSP-branded exercise books, posters, and a poem to preschoolers only; (2) OFSP-oriented mobile phone-mediated text messages to caregivers only; and (3) both 1 and 2 provided to individual households concurrently. Interventions 1 and 2 were single-channeled, while 3 was multichanneled. We estimated the intention-to-treat (ITT) and treatment-on-the-treated (TOT) effects using a binary logit model and a special regressor method, respectively. Results: Only the multichanneled nutrition education approach had significant effects (ITT = 0.167, P = .001; TOT = .243, P = .007) on the caregivers’ likelihood to retain OFSP on their farms. Conclusions: The finding implies that multichanneled agriculture-nutrition education interventions through Early Childhood Development institutions can be effective in ensuring sustainable adoption of OFSP.

Lay-worker Delivered Home Visiting Promotes Early Childhood Development and Reduces Violence in Rwanda: A Randomized Pilot

2020 ◽  
Vol 29 (7) ◽  
pp. 1804-1817
Author(s):  
Dale A. Barnhart ◽  
Jordan Farrar ◽  
Shauna M. Murray ◽  
Robert T. Brennan ◽  
Cara M. Antonaccio ◽  
...  
Keyword(s):  
Early Childhood ◽  
Home Visiting ◽  
Early Childhood Development ◽  
Childhood Development
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