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Impact of a child stimulation intervention on early child development in rural Peru: a cluster randomised trial using a reciprocal control design

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dc.contributor.author Hartinger, Stella Maria
dc.contributor.author Lanata, Claudio Franco
dc.contributor.author Hattendorf, Jan
dc.contributor.author Wolf, Jennyfer
dc.contributor.author Gil, Ana Isabel
dc.contributor.author Ortiz Obando, Mariela
dc.contributor.author Noblega, Magaly
dc.contributor.author Verastegui, Hector
dc.contributor.author Mausezahl, Daniel
dc.date.accessioned 2019-01-25T15:18:37Z
dc.date.available 2019-01-25T15:18:37Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/4677
dc.description.abstract OBJECTIVE: Stimulation in early childhood can alleviate adverse effects of poverty. In a community-randomised trial, we implemented 2 home-based interventions, each serving as an attention control for the other. One group received an integrated household intervention package (IHIP), whereas the other group received an early child development (ECD) intervention. The primary objective of the study was to evaluate the effect of IHIP on diarrhoea and respiratory infections, the details of which are described elsewhere. Here, we present the impact of the ECD intervention on early childhood development indicators. METHODS: In this non-blinded community-randomised trial, an ECD intervention, adapted from the Peruvian government's National Wawa Wasi ECD programme, was implemented in 25 rural Peruvian Andean communities. We enrolled 534 children aged 6-35 months, from 50 communities randomised 1:1 into ECD and IHIP communities. In ECD communities, trained fieldworkers instructed mothers every 3 weeks over the 12 months study, to stimulate and interact with their children and to use standard programme toys. IHIP communities received an improved stove and hygiene promotion. Using a nationally validated ECD evaluation instrument, all children were assessed at baseline and 12 months later for overall performance on age-specific developmental milestones which fall into 7 developmental domains. FINDINGS: At baseline, ECD-group and IHIP-group children performed similarly in all domains. After 12 months, data from 258 ECD-group and 251 IHIP-group children could be analysed. The proportion of children scoring above the mean in their specific age group was significantly higher in the ECD group in all domains (range: 12-23%-points higher than IHIP group). We observed the biggest difference in fine motor skills (62% vs 39% scores above the mean, OR: 2.6, 95% CI 1.7 to 3.9). CONCLUSIONS: The home-based ECD intervention effectively improved child development overall across domains and separately by investigated domain. Home-based strategies could be a promising component of poverty alleviation programmes seeking to improve developmental outcomes among rural Peruvian children. en_US
dc.language.iso eng
dc.publisher BMJ Publishing Group
dc.relation.ispartof urn:issn:1470-2738
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Infant en_US
dc.subject Child, Preschool en_US
dc.subject Rural Population en_US
dc.subject Research Design en_US
dc.subject Poverty Areas en_US
dc.subject Cluster Analysis en_US
dc.subject Child Development/physiology en_US
dc.subject Child health en_US
dc.subject Developing country en_US
dc.subject environmental health en_US
dc.subject Lifecourse / Childhood Circumstances en_US
dc.subject randomised trials en_US
dc.subject Diarrhea/prevention & control en_US
dc.subject Health Promotion/methods en_US
dc.subject Respiratory Tract Infections/prevention & control en_US
dc.subject Rural Health Services/organization & administration en_US
dc.title Impact of a child stimulation intervention on early child development in rural Peru: a cluster randomised trial using a reciprocal control design en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1136/jech-2015-206536
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.09
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.05

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