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Impact of a Brief Healthcare-based Intervention to Support Early Childhood Development in India: A Pilot Randomized Controlled Trial

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Abstract

Objective

To study the impact of a brief early childhood development (ECD) intervention, Sit Down and Play (SDP), integrated within routine healthcare visits on parent and child outcomes.

Methods

Between April, 2018 and March, 2019, caregivers and their infants aged 5–6 months attending a well-baby clinic were enrolled and randomized to intervention (n=26) or control (n=26) groups. Intervention families received SDP at recruitment and two subsequent immunization visits (8 months and 10 months). Control families received usual care. ECD outcomes were assessed through in-person assessments at the age of 12 months using the Stim Q subscales to assess parenting behaviors, and the Developmental Assessment Scale for Indian Infants (DASII) for neurodevelopment.

Results

There was a significant improvement in parent-child stimulation activities and verbal interactions in the intervention group compared with the control group [6.1(1.4) vs 4.9 (1.3); P=0.002]. Infants in the intervention group had significantly higher DASII scores in multivariable analyses [108.0 (103.0–111.3) vs 102.0 (96.8–108.0); P=0.04].

Conclusion

Our findings suggest a brief healthcare intervention supports opportunities for early learning among caregivers and neurodevelopmental outcomes in their infants.

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References

  1. Black MM, Walker SP, Fernald LCH, et al. Advancing early childhood development: from science to scale 1. Lancet. 2017;389:77–90.

    Article  PubMed  Google Scholar 

  2. Grantham-McGregor S, Cheung YB, Cueto S, et al. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007;369:60–70.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Nurturing care practice guide: strengthening nurturing care through health and nutrition services, United Nations Children’s Fund, and World Health Organization, 2022. [Internet]. Accessed Feb 13, 2023. Available from: https://apps.who.int/iris/bitstream/handle/10665/365601/9789240058651-eng.pdf?sequence=l&isAllowed=y

  4. Improving early childhood development: WHO guideline. World Health Organization; 2020. Accessed May 22, 2023. Available fropm: https://www.who.int/publications/i/item/97892400020986.

  5. Pellegrini AD, Smith PK. The development of play during childhood: forms and possible functions. Child and Adolescent Mental Health. 1998;3:51–7.

    Article  Google Scholar 

  6. Kelly-Vance L, Dempsey J, Ryalls B. The effect of a parent training program on children’s play. International J Psychology. 2013,13:117–38.

    Google Scholar 

  7. Shah R, Camarena A, Park C, et al. Healthcare-based interventions to improve parenting outcomes in lMIC: a systematic review and meta-analysis. Matern Child Health J. 2022;26: 1217–30.

    Article  PubMed  Google Scholar 

  8. Shah R, DeFrino D, Kim Y, Atkins M. Sit down and play: a preventive primary care-based program to enhance parenting practices. J Child and Family Studies. 2017;26:540–7.

    Article  Google Scholar 

  9. Shah R, Gustafson E, Dhaded S, et al. Integrating an adapted, low-intensity program to promote early childhood development in routine health visits in rural India: A feasibility study. J Dev Behav Pediatr. 2020;41:281–8.

    Article  PubMed  Google Scholar 

  10. Shah R, Herekar V, Metgud D, et al. Implementing an early childhood development intervention with routine immunization visits in India: a feasibility trial. Eur J Pediatr. 2022;181:2799–808.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Julious SA. Sample size of 12 per group rule of thumb for a pilot study. Pharmaceutical Statistics. 2005;4:287–91.

    Article  Google Scholar 

  12. Bandura A. Health promotion by social cognitive means. Health Edu Beh. 2004;31:143–64.

    Article  Google Scholar 

  13. Mendelsohn AL, Cates CB, TamisLeMonda CS, Dreyer BP. StimQ cognitive home environment. Accessed May 22, 2023. Available at: https://www.videointeractionproject.org/stimq.html.

  14. Malhi P, Menon J, Bharti B, Sidhu M. Cognitive development of toddlers: does parental stimulation matter? Indian J Pediatr. 2018;85:498–503.

    Article  PubMed  Google Scholar 

  15. Dreyer BP, Mendelsohn AL, Tamis-LeMonda CS. Assessing the child’s cognitive home environment through parental report; reliability and validity. Early Development and Parenting. 1996;5:271–87

    Article  Google Scholar 

  16. Madaan P, Saini L, Sondhi V. Development assessment scale for Indian infants: A systematic review and perspective on dwindling cutoffs. Indian J Pediatr. 2021;88:918–20.

    Article  PubMed  Google Scholar 

  17. Hamadani JD, Mehrin SF, Tofail F, et al. Integrating an early childhood development programme into Bangladeshi primary health-care services: an open-label, cluster-randomised controlled trial. Lancet Global Health. 2019;7:e366–75.

    Article  PubMed  Google Scholar 

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Funding

Funding: RS: Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health; Award No. K23HD086295.

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Authors and Affiliations

  1. Pediatric Physiotherapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India

    Deepa C. Metgud & Shukra Chivate

  2. Department of Pediatric Physiotherapy, KAHER Institute of Physiotherapy, Belagavi, Karnataka, India

    Ronita Ajgaonkar

  3. Department of Medical Education, University of Illinois at Chicago, Chicago, IL, USA

    Alan Schwartz

  4. Faculty of Medicine, Department of Pediatrics, University of Southampton, Southampton, UK

    Michelle Fernandes

  5. Department of Pediatrics, College of Medicine, The University of Illinois at Chicago, Chicago, IL, USA

    Reshma Shah

  6. 840 South Wood St, MC 856, Chicago, IL, 60612, USA

    Reshma Shah

Authors
  1. Deepa C. Metgud
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  2. Ronita Ajgaonkar
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  3. Shukra Chivate
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  4. Alan Schwartz
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  5. Michelle Fernandes
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  6. Reshma Shah
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Contributions

Contributors: DM: Conceptualized the study, developed protocol for research design, supported data collection, conducted data monitoring, and assisted with writing and editing of manuscript; RA: Conducted the literature review, supported data collection, and assisted with analysis and editing of manuscript; SC: Assisted with data collection, contributed to drafting of manuscript; MF: Developed the protocol and reviewed and revised manuscript; AS: Conducted the statistical analysis, wrote statistical section, and reviewed the manuscript; RS: Conceptualized the study, assisted with data interpretation, reviewed and revised the manuscript.

Corresponding author

Correspondence to Reshma Shah.

Ethics declarations

Ethics clearance: Institutional Review Board, KLE Institute of Physiotherapy; No. 220 CTRI/2018/08/015177 dated 03/08/2018.

Competing interests: None stated.

Additional information

Note: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Metgud, D.C., Ajgaonkar, R., Chivate, S. et al. Impact of a Brief Healthcare-based Intervention to Support Early Childhood Development in India: A Pilot Randomized Controlled Trial. Indian Pediatr 60, 811–815 (2023). https://doi.org/10.1007/s13312-023-3010-2

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  • DOI: https://doi.org/10.1007/s13312-023-3010-2

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