Early Childhood Development in HIV-Exposed Children
Conditions
Keywords
HIV-exposed, Early Childhood Development, Cameroon
Brief summary
There is substantial evidence that early childhood development (ECD) programming can improve child health and development outcomes. An important component of ECD programming is supporting positive parenting and early stimulation practices. While many parents could benefit from such programming, mothers that are HIV-infected may particularly benefit given the higher risks of poorer child development among HIV-exposed children. Catholic Relief Services (CRS) in Cameroon is implementing the Key Interventions to Develop Systems and Services (KIDSS) ECD program for HIV-exposed children. This impact evaluation will ascertain to what extent the KIDSS home-based component of the ECD model affects attainment of age-appropriate developmental milestones (measured by the Ages and Stages Questionnaire 3 (ASQ-3)) in HIV-exposed children in Cameroon. The study design is a cluster-randomized controlled trial with a cohort of 200 mother/child dyads across 10 study clinics. HIV+ mothers will be recruited during pregnancy and their children will be followed up until 18 months of age. The intervention group will receive regular home-based ECD services focused on positive parenting and early stimulation. The control group will not have any exposure to ECD services, though they may receive home-based services focused on HIV care and treatment, hygiene, and nutrition. Randomization occurs at the clinic (cluster) level.
Interventions
BEHAVIORALHome-based ECD services
Health facilities will be randomized to intervention and control groups. The clients at clinics assigned to the intervention group will receive Home-based Early Childhood Development (ECD+) program. The clients at clinics assigned to the control group will not receive the Early Childhood Development (ECD) program.
Sponsors
Catholic Relief Services
Duke University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
This study utilizes a cluster-randomized trial (CRT) design in order to evaluate the impact of the KIDSS ECD program delivered by Catholic Relief Services, specifically the home visiting component, on child development outcomes and utilization of HIV testing services. The main reason for including randomization is to reduce the risk of selection bias. The unit of inference for this CRT is at the individual level but the unit of randomization is the health facility (cluster) level due to issues of program feasibility.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* HIV-positive * Pregnant and currently in 3rd trimester * Must reside in Nkoldongo district or Djoungolo district * Willing to be followed up for up to 21 months (pregnancy + postpartum periods) * Agrees to voluntary participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Attainment of age-appropriate developmental milestones | ASQ-3 score assessed 18 months after birth. | Child Development Outcomes, measured by ASQ-3 (18-month survey) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Attainment of age-appropriate developmental milestones | ASQ-SE score assessed at 18 months after birth. | Child Development Outcomes, measured by ASQ-Social Emotional (SE) |
Countries
Cameroon
Outcome results
None listed