36 research outputs found
Evaluation of an Early Childhood Parenting Programme in Rural Bangladesh
To promote physical and mental development of children, parenting
education programmes in developing countries focus on specific
practices such as age-appropriate responsive stimulation and feeding. A
programme delivered to groups of poor mothers of children, aged less
than three years, in rural Bangla-desh was evaluated using an
intervention-control post-test design. Mothers (n=170) who had attended
a year of educational sessions and their children were compared with
those (n=159) from neighbouring villages who did not have access to
such a programme. After covariates were controlled, the parenting
mothers obtained higher scores on a test of child-rearing knowledge and
on the Home Observation for Measurement of the Environment (HOME)
inventory of stimulation. The parenting mothers did not communicate
differently with their children while doing a picture-talking task, and
children did not show benefits in nutritional status or language
comprehension. Parenting sessions offered by peer educators were
informative and participatory, yet they need to include more practice,
problem-solving, and peer-support if information is to be translated
into behaviour
Eff ects of a parenting intervention to address maternal psychological wellbeing and child development and growth in rural Uganda: a community-based, cluster-randomised trial
Background Parenting interventions have been implemented to improve the compromised developmental potential
among 39% of children younger than 5 years living in low-income and middle-income countries. Maternal wellbeing is
important for child development, especially in children younger than 3 years who are vulnerable and dependent on
their mothers for nutrition and stimulation. We assessed an integrated, community-based parenting intervention that
targeted both child development and maternal wellbeing in rural Uganda.
Methods In this community-based, cluster randomised trial, we assessed the eff ectiveness of a manualised,
parenting intervention in Lira, Uganda. We selected and randomly assigned 12 parishes (1:1) to either parenting
intervention or control (inclusion on a waitlist with a brief message on nutrition) groups using a computergenerated
list of random numbers. Within each parish, we selected two to three eligible communities that had a
parish offi ce or a primary school in which a preschool could be established, more than 75 households with children
younger than 6 years, and at least 15 socially disadvantaged families (ie, maternal education of primary school level
or lower) with at least one child younger than 36 months. Participants within communities were mother–child
dyads, where the child was 12–36 months of age at enrolment, and the mother had low maternal education. In the
parenting intervention group, participants attended 12 fortnightly peer-led group sessions focusing on child care
and maternal wellbeing. The primary outcomes were cognitive and receptive language development, as measured
with the Bayley Scales of Infant Development, 3rd edn. Secondary outcomes included self-reported maternal
depressive symptoms, using the Center for Epidemiologic Studies Depression Scale, and child growth. Theoreticallyrelevant
parenting practices, including the Home Observation for Measurement of the Environment inventory, and
mother-care variables, such as perceived spousal support, were also assessed as potential mediators. Baseline
assessments were done in January, 2013, and endline assessments were done in November, 2013, 3 months after
completion of the programme. Ethics approval was received from Mbarara and McGill universities. This trial is
registered with ClinicalTrials.gov, NCT01906606.
Findings Between December, 2012, and January, 2013, 13 communities (194 dyads) were randomly assigned to receive
intervention, and 12 communities (154 dyads) were assigned to a waitlist control. 319 dyads completed baseline
measures (171 in the intervention group and 148 in the control group), and 291 dyads completed endline measures
(160 in the intervention group and 131 in the control group). At endline, children in the intervention group had
signifi cantly higher cognitive scores (58∙90 vs 55∙65, eff ect size 0∙36, 95% CI 0∙12–0∙59) and receptive language
scores (23∙86 vs 22∙40, 0∙27, 0∙03–0∙50) than did children in the control group. Mothers in the intervention group
reported signifi cantly fewer depressive symptoms (15∙36 vs 18∙61, –0∙391, –0∙62 to –0∙16) than did mothers in the
control group. However, no diff erences were found in child growth between groups.
Interpretation The 12 session integrated parenting intervention delivered by non-professional community
members improved child development and maternal wellbeing in rural Uganda. Because this intervention was
largely managed and implemented by a local organisation, using local community members and minimal
resources, such a programme has the potential to be replicated and scaled up in other low-resource, village-based settings
Introduction of Iodised Salt Benefits Infants’ Mental Development in a Community-Based Cluster-Randomised Effectiveness Trial in Ethiopia
The effectiveness of salt iodisation in improving the mental development of young children has not been assessed. We implemented a community-based cluster-randomised effectiveness trial in sixty randomly selected districts in the Amhara region of Ethiopia. We randomly allocated each district to treatment and randomly selected one of its villages. In parallel to national salt iodisation efforts, iodised salt was brought early into the markets of the thirty intervention villages before it became widely available in the thirty control villages 4–6 months later. The primary outcome was children’s mental development scores on the Bayley Scales. This was an intention-to-treat analysis using mixed linear models adjusted for covariates and clusters. The trial was registered at ClinicalTrials.gov, NCT013496. We assessed 1835 infants aged 5–11 months at baseline. The same children (85 % of the sample) were re-assessed at 20–29 months when all villages had iodised salt. At endline, urinary iodine concentration was higher in children in the intervention group compared with those in the control group (median 228·0 v. 155·1 µg/l, P=0·001). The intervention group had higher scores compared with the control group on the Bayley composite score (raw scores:130·60 v. 128·51; standardised scores: 27·8 v. 26·9; d=0·13; 95 % CI 0·02, 0·23) and three of the four subscales: cognitive (53·27 v. 52·54, d=0·13; 95 % CI 0·03, 0·23), receptive language (20·71 v. 20·18, d=0·13; 95 % CI 0·03, 0·24) and fine motor (35·45 v. 34·94, d=0·15; 95 % CI 0·04, 0·25). The introduction of iodised salt contributes to children’s higher urinary iodine concentration and mental development
Cumulative effects of bullying and racial discrimination on adolescent health in Australia
This study examined how cumulative exposure to racial discrimination and bullying victimization influences the health of Australian adolescents (n=2802) aged 10-11 years (19.3% visible ethnic minorities (non-White, non-Indigenous); 2.6% Indigenous) using data from 3 waves (2010-2014) of the nationally representative Longitudinal Study of Australian Children (LSAC). Cumulative exposure to racial discrimination and bullying victimization had incremental negative effects on socioemotional difficulties. Higher accumulated exposure to both stressors across time was associated with increased BMI z-scores, and risk of overweight/obesity. Studies that examine exposure to single risk factors such as bullying victimization or racial discrimination at 1 time point only are likely to miss key determinants of health for adolescents from stigmatized racial/ethnic backgrounds and under-estimate their stressor burden
Cultural Perspectives on the Interactions Between Nutrition, Health, and Psychological Functioning
Food and nutrition occupy the daily thoughts of most people, particularly the 178 million children who are malnourished and have been since their first birthday. While malnutrition is directly and indirectly responsible for one-third of child deaths in developing countries, overweight has been declared the number one health problem in other countries. More food is therefore not necessarily better when talking about health. This reading presents information on the major nutrients important for health and psychological functioning, including energy, protein, vitamin A, zinc, iron, and iodine. It also discusses how cultures differ in their food preferences and their beliefs about the good and ill effects of certain foods. Finally, solutions for tackling the problem of impaired growth and development of children are examined
Evaluation of an Early Childhood Parenting Programme in Rural Bangladesh
To promote physical and mental development of children, parenting
education programmes in developing countries focus on specific
practices such as age-appropriate responsive stimulation and feeding. A
programme delivered to groups of poor mothers of children, aged less
than three years, in rural Bangla-desh was evaluated using an
intervention-control post-test design. Mothers (n=170) who had attended
a year of educational sessions and their children were compared with
those (n=159) from neighbouring villages who did not have access to
such a programme. After covariates were controlled, the parenting
mothers obtained higher scores on a test of child-rearing knowledge and
on the Home Observation for Measurement of the Environment (HOME)
inventory of stimulation. The parenting mothers did not communicate
differently with their children while doing a picture-talking task, and
children did not show benefits in nutritional status or language
comprehension. Parenting sessions offered by peer educators were
informative and participatory, yet they need to include more practice,
problem-solving, and peer-support if information is to be translated
into behaviour