Efficacy of infant simulator programmes to prevent teenage pregnancy: a school-based cluster randomised trial in Western Australia

Background: Infant simulator-based programmes seek to prevent teenage pregnancy. They are utilised in western and developing countries but, despite growing popularity, there is no published evidence of their long-term impact. The aim of this trial was to investigate the effect of such a programme, the Virtual Infant Parenting (VIP) Programme, on the pregnancy outcomes of birth and induced abortion. Methods: Fifty-seven of 66 eligible schools (86%) in Perth, Western Australia enrolled in the pragmatic clustered (by school) randomised trial (ISRCTN24952438) with even randomisation to the intervention and control groups. Between 2003 and 2006, the VIP programme was administered to 1,267 girls in the intervention schools, while 1,567 girls in the control schools received the standard health education curriculum. Participants were aged 13-15 years and were followed until age 20 via data linkage to hospital medical and abortion clinic records. Log binomial and Cox proportional hazards regression was used to test for differences in pregnancy rates between study groups. Findings: Compared to girls Findings: Compared to girls in the control group, a higher proportion of girls in the intervention group recorded at least one birth (7.6%, n=97; 4·3%, n=67) or at least one abortion as the first pregnancy event (8.9%, n=113; 6.4%, n=101). After adjustment for potential confounding, the intervention group had a higher overall pregnancy risk (RR = 1·36, 95% CI 1.10–1·67, p=0.003) compared to the control group. Similar results were obtained using proportional hazard models (HR = 1.35, 95% CI 1.10–1·67, p=0·016). Interpretation: The infant-simulator based VIP Programme did not achieve its aim of reducing teenage pregnancy. Girls in the intervention group were more likely to experience a birth or an induced abortion than those in the control group before turning 20 years of age. Funding: The Health Promotion Research Foundation of Western Australia (Healthway), Lotteries WA, the Western Australian Department of Education and Training and the Western Australian Department of Health

Global leadership is needed to optimize early childhood development for children with disabilities

info:eu-repo/semantics/publishedVersio

Changes in socioeconomic inequality in Indonesian children's cognitive function from 2000 to 2007: a decomposition analysis

Background: Measuring social inequalities in health is common; however, research examining inequalities in child cognitive function is more limited. We investigated household expenditure-related inequality in children’s cognitive function in Indonesia in 2000 and 2007, the contributors to inequality in both time periods, and changes in the contributors to cognitive function inequalities between the periods. Methods: Data from the 2000 and 2007 round of the Indonesian Family Life Survey (IFLS) were used. Study participants were children aged 7–14 years (n = 6179 and n = 6680 in 2000 and 2007, respectively). The relative concentration index (RCI) was used to measure the magnitude of inequality. Contribution of various contributors to inequality was estimated by decomposing the concentration index in 2000 and 2007. Oaxaca-type decomposition was used to estimate changes in contributors to inequality between 2000 and 2007. Results: Expenditure inequality decreased by 45% from an RCI = 0.29 (95% CI 0.22 to 0.36) in 2000 to 0.16 (95% CI 0.13 to 0.20) in 2007 but the burden of poorer cognitive function was higher among the disadvantaged in both years. The largest contributors to inequality in child cognitive function were inequalities in per capita expenditure, use of improved sanitation and maternal high school attendance. Changes in maternal high school participation (27%), use of improved sanitation (25%) and per capita expenditures (18%) were largely responsible for the decreasing inequality in children’s cognitive function between 2000 and 2007. Conclusions: Government policy to increase basic education coverage for women along with economic growth may have influenced gains in children’s cognitive function and reductions in inequalities in Indonesia.Amelia Maika, Murthy N. Mittinty, Sally Brinkman, Sam Harper, Elan Satriawan, John W. Lync

Study protocol for the evaluation of an Infant Simulator based program delivered in schools: a pragmatic cluster randomised controlled trial

Background: This paper presents the study protocol for a pragmatic randomised controlled trial to evaluate the impact of a school based program developed to prevent teenage pregnancy. The program includes students taking care of an Infant Simulator; despite growing popularity and an increasing global presence of such programs, there is no published evidence of their long-term impact. The aim of this trial is to evaluate the Virtual Infant Parenting (VIP) program by investigating pre-conceptual health and risk behaviours, teen pregnancy and the resultant birth outcomes, early child health and maternal health. Methods and Design: Fifty-seven schools (86% of 66 eligible secondary schools) in Perth, Australia were recruited to the clustered (by school) randomised trial, with even randomisation to the intervention and control arms. Between 2003 and 2006, the VIP program was administered to 1,267 participants in the intervention schools, while 1,567 participants in the non-intervention schools received standard curriculum. Participants were all female and aged between 13-15 years upon recruitment. Pre and post-intervention questionnaires measured short-term impact and participants are now being followed through their teenage years via data linkage to hospital medical records, abortion clinics and education records. Participants who have a live birth are interviewed by face-to-face interview. Kaplan-Meier survival analysis and proportional hazards regression will test for differences in pregnancy, birth and abortion rates during the teenage years between the study arms.Discussion: This protocol paper provides a detailed overview of the trial design as well as initial results in the form of participant flow. The authors describe the intervention and its delivery within the natural school setting and discuss the practical issues in the conduct of the trial, including recruitment. The trial is pragmatic and will directly inform those who provide Infant Simulator based programs in school settings

The role of preschool in promoting children's healthy development: Evidence from an Australian population cohort

© 2015 Elsevier Inc. A growing body of evidence suggests that engagement with quality early childhood education and care (ECEC) programs such as preschool can enhance children's early development. The Australian Early Development Census (AEDC) provides a unique opportunity to explore the relationship between ECEC and children's developmental outcomes in a full population cohort of Australian school entrants. The AEDC is a teacher-rated checklist that provides data on ECEC experiences in the year before starting school, as well as five important domains of child development at school entry: physical health and wellbeing, social competence, emotional maturity, language and cognitive skills, and communication skills and general knowledge. In 2009, the AEDC was completed for 97.5% of Australian children in their first year of formal schooling (N = 261,147; M = 5 years, 7 months of age). Logistic regression analyses revealed that attendance at preschool was associated with reduced odds (OR = 0.69, p < 0.001 to OR = 0.40, p < 0.001) of being in the vulnerable range (<10th percentile) on four of the five AEDC domains (with the exception of emotional maturity; OR = 0.89, p = 0.002), compared to other ECEC experiences, or care exclusively by parents. Subsequent analyses revealed that this effect was evident for children living in both advantaged and disadvantaged communities. Together, the results suggest that engagement with preschool programs in Australia may present a plausible, equitable, and modifiable approach to improving children's developmental outcomes

Objectively measured infant and toddler screen time: Findings from a prospective study

Objective: Screen time guidelines recommend no screens under two years due to the potential negative impacts on development. While current reports suggest many children exceed this, research relies on parent reports of their children's screen exposure. We objectively assess screen exposure during the first two years and how it differs by maternal education and gender. Methods: This Australian prospective cohort study used speech recognition technology to understand young children's screen exposure over an average day. Data collection occurred every six months when children were 6, 12, 18 and, 24 months old (n = 207). The technology provided automated counts of children's exposure to electronic noise. Audio segments were then coded as screen exposure. Prevalence of screen exposure was quantified, and differences between demographics examined. Results: At six months, children were exposed to an average of 1hr, 16 min (SD = 1hr, 36 min) of screens per day, increasing to an average of 2 h, 28 min (SD = 2 h, 4 min) by 24-months. Some children at six months were exposed to more than 3 h of screen time per day. Inequalities in exposure were evident as early as six months. Children from higher educated families were exposed to 1hr,43 min fewer screens per day, 95%CI (-2hr, 13 min, -1hr, 11 min) compared to lower educated households, with this difference remaining consistent as children age. Girls were exposed to an additional 12 min of screens 95%CI (−20 min, 44 min) per day compared to boys at six months, but this difference reduced to only 5 min by 24-months. Conclusion: Using an objective measure of screen exposure, many families exceed screen time guidelines, the extent increasing with child's age. Furthermore, substantial differences between maternal education groups emerge as young as six months old. This highlights the need for education and supports for parents around screen use in the early years, balanced within the realities of modern life