Maawit Maladjiny: Targeting child development in Urban Aboriginal children.

Primary health care workers (Interventionists) in the treatment group will be trained to deliver the WHO/UNICEF Care for Child Development (CCD) package at each child health check in the first year of life. The CCD package promotes caregivers’ sensitivity and responsiveness using developmentally appropriate play and communication activities. The package contains a set of age-specific messages about care for child development and problem-solving. Caregivers try an age-specific play using objects readily available in the home and communication activities with their child while the primary health care worker observes, coaches, and provides feedback to enhance the quality of the interactions. Examples for infants 1 week up to 6 months include providing ways for child to see, hear, feel and move freely. Slowly move colourful things for the child to see and reach. Smiling and laughing with the child. Talking to the child. Get a conversation going by copying child’s sounds or gestures. Parents and caregivers will be encouraged to engage in activities with their child at every available opportunity. In our trial, twelve Interventionists will be employed to deliver the CCD package at universal child health checks within the first 12 months: birth-14 days, eight weeks, four months, 12 months. Depending on availability of families, each visit takes approximately 7-30 minutes and can be delivered individually or as a group. The Interventionists in the first instance will be Aboriginal Health Workers and, when not available, nurses or child health nurses who have experience working with Aboriginal families. All interventionists will receive extensive training and ongoing mentoring on how to deliver the CCD package. The training will be delivered by trained trainers (Facilitators). These facilitators (child health nurse and or midwife) will be provided face to face training by the Supervisor trainer (social psychologist and program developer). This training will be for 1 week (40hrs) and include an extra observed practice with 20 caregiver counselling interactions (up to an extra week). The trial interventionists will be trained by the Facilitators. This training will be for 3 – 4 days. Interventionists will also be observed for 10 hours following initial training. The supervisor trainer will then provide online support and observation for each interventionist and facilitator for one hour each month. A process evaluation will be developed to monitor and evaluate the intervention implementation. This will use the existing monitoring and evaluating tools developed by UNICEF and WHO developed specifically for the intervention.

Primary health care workers (CCD Workers) in the treatment group will be trained to deliver the WHO/UNICEF Care for Child Development (CCD) package at each child health check in the first year of life. The CCD package promotes caregivers’ sensitivity and responsiveness using developmentally appropriate play and communication activities. The package contains a set of age-specific messages about care for child development and problem-solving. Caregivers try an age-specific play using objects readily available in the home and communication activities with their child while the primary health care worker observes, coaches, and provides feedback to enhance the quality of the interactions. Examples for infants 1 week up to 6 months include providing ways for child to see, hear, feel and move freely. Slowly move colourful things for the child to see and reach. Smiling and laughing with the child. Talking to the child. Get a conversation going by copying child’s sounds or gestures. Parents and caregivers will be encouraged to engage in activities with their child at every available opportunity. In our trial, individuals with a background in nursing, early childhood development, childhood education or similar will be employed as CCD Workers to deliver the CCD package at the same timepoints as the universal child health checks within the first 12 months: birth-4 weeks, eight weeks, four months, 12 months. Depending on availability of families, each visit takes approximately 7-30 minutes and can be delivered individually or as a group. All CCD Workers will receive extensive training and ongoing mentoring on how to deliver the CCD package. The training will be delivered by trained trainers (Facilitators). These facilitators (child health nurse and or midwife) will be provided face to face training by the Supervisor trainer (social psychologist and program developer). CCD Workers will undergo theory and practical training for 2 days. They will also be observed for 10 hours following initial training. The supervisor trainer will then provide online support and observation for each CCD worker and facilitator for one hour each month. In addition to face-to-face contacts, educational animated videos up to 30 seconds on age-appropriate play and communication activities will be developed and provided on an invite only Instagram account that intervention families will be invited to. These videos will be released when the first infants turn 6, 9 and 18 months old. A process evaluation will be developed to monitor and evaluate the intervention implementation. This will use the existing monitoring and evaluating tools developed by UNICEF and WHO developed specifically for the intervention.