Evaluation of parenting interventions to promote child development through home visits or a health centre based approach in three Caribbean countries

ISRCTN ISRCTN43108304
DOI https://doi.org/10.1186/ISRCTN43108304
Secondary identifying numbers N/A
Submission date
06/05/2011
Registration date
06/06/2011
Last edited
21/01/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Prof Susan Walker
Scientific

Tropical Medicine Research Institute
The University of the West Indies
Mona
Kingston
7
Jamaica

Email susan.walker@uwimona.edu.jm

Study information

Study designMulticentre cluster randomised controlled study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)GP practice
Study typeQuality of life
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleHome and health centre delivery of early childhood stimulation: cluster randomised trial of the impact of interventions to improve parenting of children aged 2-18 months on child development in the Caribbean countries
Study objectivesThere is substantial evidence from efficacy trials of benefits to child development from parenting programs with home visits to improve mother-child interaction and demonstrate activities to promote development. The interventions were delivered by paraprofessionals who visited the homes weekly. Although low cost compared to programs in the USA, these interventions are often too expensive to take to scale in many countries. The challenge is to develop programs that are feasible at scale yet remain effective. We are evaluating a modified home visiting approach using fewer visits and materials and a new health centre approach using a specially designed video of child development messages to be shown at all child health visits from age 2-18 months.

We hypothesise:
1. A home visiting intervention delivered by trained community health workers every 2 weeks from age 6-18 months with the objective of helping mothers promote their child development will improve parent-child interaction, quality of stimulation in the home and child development.
2. A health centre based intervention at routine child health visits from age 2-18 months using videos of child development messages that demonstrate mother-child interactions followed by discussion and practice led by trained community health workers will improve parent-child interaction, quality of stimulation and child development.
Ethics approval(s)University Hospital of the West Indies/ University of the West Indies/ Faculty of Medical Sciences Ethics Committee aproved on 20th January 2011, Ref: ECP 18, 10/11
Health condition(s) or problem(s) studiedEarly child development
Intervention1. In Jamaica 20 Health centres will be randomly assigned to one of 4 groups:
1.1. Health Centre intervention
1.2. Home visit
1.3. Both interventions
1.4. Control
2. In Antigua and St Lucia 10 health centres in each country will be randomly assigned to Health centre intervention or control
3. Participants (mothers and infants) will be recruited at the health centre at the 6 week post natal clinic visit
4. Follow-up assessment will be at age 19-20 months
5. Health centre intervention: video will be developed, in collaboration with a team experienced in effective use of media for health education, to deliver a series of child development messages. The videos will be shown at all child health clinics which are scheduled at 3, 6, 9, 12 and 18 months of age.
7. In each clinic a community health worker will be trained to discuss the video messages with the mothers, demonstrate activities mothers can do with their children and how to make simple toys from household materials
8. Opportunities will be given for mothers to try some of the activities and they will be encouraged to make them part of their daily routine
9. Home visiting intervention: will be based on that used previously in Jamaica modified to increase the feasibility of scaling up
10. Visit frequency will be reduced from weekly to twice monthly and supervision will be by nurses rather than a child development specialist
11. Children will be visited from 6 to 18 months of age by trained community health workers and play sessions conducted to improve mother-child interaction and show mothers how to promote development
12. Separate training workshops will be held for the community health aides involved in the two types of interventions
13. A supervisor will provide ongoing support to implementation of the interventions
14. Control: centres will continue to provide the usual care at all child health visits
Intervention typeOther
Primary outcome measure1. Child Psychomotor development: Griffiths Scales of Mental Development to assess the childrens' development at age 19-20 months
2. The scales have been used frequently in Jamaica where it has good concurrent and predictive validity
3. Language development: the short version of the MacArthur Communicative Development Inventory (Short Communicative Development Inventory, CDI) will be used to measure language development based on mothers' report
Secondary outcome measures1. Child growth: weight, length and head circumference will be measures on enrolment at age 6-8 weeks and at age 19-20 months
2. Child behaviour: ratings of behaviour during the developmental test session
3. Maternal parenting knowledge, practices and depressive symptoms will be measured on enrolment and at age 19-20 months
4. Mothers’ knowledge of child development will be assessed by questionnaire
5. Stimulation in the home will be assessed with a subset of questions from the Home Observations for Measurement of the Environment (HOME)
6. Maternal depressive symptoms will be assessed using the CES depression scale
Overall study start date15/07/2011
Completion date15/12/2013

Eligibility

Participant type(s)Patient
Age groupChild
SexBoth
Target number of participantsTotal participants 600: Jamaica 400, Antigua 100, St Lucia 100
Key inclusion criteria1. Mothers and infants attending government (public) primary care health centres for child care
2. Mothers and infants will be recruited at the six week post natal clinics
Key exclusion criteria1. Infants with obvious mental or physical disabilities
2. Twins
Date of first enrolment15/07/2011
Date of final enrolment15/12/2013

Locations

Countries of recruitment

  • Antigua and Barbuda
  • Jamaica
  • Saint Lucia

Study participating centre

Tropical Medicine Research Institute
Kingston
7
Jamaica

Sponsor information

The University of the West Indies (Jamaica)
University/education

Tropical Medicine Research Institute
The University of the West Indies
Mona
Kingston
7
Jamaica

Email tmri.eru@uwimona.edu.jm
Website http://mona.uwi.edu
ROR logo "ROR" https://ror.org/03fkc8c64

Funders

Funder type

Research organisation

Inter-American Development Bank (USA) Ref: ATN/SF-12300-RG
Private sector organisation / International organizations
Alternative name(s)
Banco Interamericano de Desarrollo, Banco Interamericano de Desenvolvimento, Banque Interaméricaine de Développement, IADB, BID, IDB
Location
United States of America

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 31/10/2017 21/01/2019 Yes No
Results article results of integrating a parenting intervention with routine primary health care, 01/08/2015 21/01/2019 Yes No
Results article results of the impact, acceptability and costs of delivering parenting interventions through health services in the Caribbean, 01/11/2015 21/01/2019 Yes No

Editorial Notes

21/01/2019: Publication references added