Child Development
Conditions
Keywords
Child Development, Home Visiting, Parenting Program, Social Protection, Public Works
Brief summary
Preliminary pilot testing of the home-based FSI-ECD intervention as delivered by community based lay workers.
Detailed description
The Family Strengthening Intervention for early childhood development was created and piloted for feasibility and acceptability in an ongoing protocol #15440 with Harvard Internal Review Board titled, Developing and Piloting a Quantitative Behavioral Assessment Battery, Estimating Prevalence of Mental Disability among HIV/AIDS-affected Youth, and Piloting an Adapted Mental Health Intervention for HIV/AIDS-Affected Children in Rwanda. Research personnel have been adapting the existing recruitment materials/sessions and 15 Module Manual (FSI-ECD) with a focus on making the manual and corresponding materials more user friendly for community based lay worker coaches. This preliminary testing will provide an opportunity to administer a planned full scale 1,000+ household cluster randomized control trial on a smaller scale in order to learn from our materials that have been adapted for community based lay workers. This will also allow us to test our supervision and training structures to make necessary adaptation ahead of the planned full scale trial. After all beneficiary households have completed the FSI-ECD intervention, each community based lay worker will complete a qualitative and quantitative exit assessment of his/her experience delivering the intervention, as well as ongoing feedback during the administration of FSI-ECD; allowing for the intervention and support structure to be strengthened for future iterations.
Interventions
OTHERFSI ECD
Households will be visited by a trained community based lay worker on a weekly to biweekly basis to deliver the 15 module curriculum covering a range of topics from nutrition, water and sanitation, hygiene, early stimulation, conflict management, to good communication. The intervention seeks to promote healthy child development via active coaching to individual beneficiary households, delivering modules on a one on one basis and engaging all family members.
Sponsors
World Bank
United States Agency for International Development (USAID)
Network of European Foundations
The ELMA Foundation
Boston College
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Months to 36 Months
Healthy volunteers
No
Inclusion criteria
* Beneficiary Inclusion Criteria: All participants must live in chosen District(s) of Rwanda. Inclusion criteria for families are: (a) being VUP-eligible, (b) having at least one children aged 6-36 months living in the home and (c) having caregiver willing to discuss and enhance their parenting practices by interacting with a home-visiting coach. Caregiver eligibility: (a) is aged 18 or older and cares for child(ren) and (b) lives in the same household as child(ren). We will enroll both single and dual caregiver families to reflect population dynamics. Legal guardians may be aunts, uncles, grandparents, or foster parents. Community Based Lay Worker
Exclusion criteria
Community based workers selected to deliver the FSI-ECD intervention must: (a) live in the sector of beneficiary households they will deliver the intervention to, (b) be Rwanda, (c) be aged 18 or older; (d) be able to write, read, and count in local language; (e) be committed to young children and family values; (f) have the required amount of time to carry out the FSI-ECD intervention with a select number of households, (e) be recommended and approved by local community and authorities.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ages Stages Questionnaire-3 | 12 months/18 months | Change in Child Communication, Fine Motor, Gross Motor, Problem Solving, and Personal Social Development |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Multiple Indicator Cluster Survey 5 | 12 months/18 months | Change in Infant and Young Child Feeding Practices |
| Rwanda Comprehensive Food Security and Vulnerability Analysis and Nutrition Survey | 12 months/18 months | Change in Assessing Household Food Security related to diversity of food and meal frequency |
| Local Derived Scale | 12 months/18 months | Change in Family Trust and Unity |
| System for Observing Family Therapy Alliances | 12 months | Interventionist Self-Report |
| Hopkins Symptoms Check List | 12 months/18 months | Change in Caregiver Mental Health |
| Malawi Development Assessment Tool (MDAT) | 12 months/18 months | Change in Child Development Observational Measure for Fine Motor, Gross Motor and Language |
| Home Observation for the Measurement of the Environment (HOME Inventory) | 12 months/18 months | Change in Home Environment |
| Observation of Mother Child Interaction (OMCI) | 12 months/18 months | Change in Caregiver-Child Relationship/Stimulation |
| Ages Stages Questionnaire Socio-Emotional | 12 months/18 months | Change in Child Socio-Emotional Development |
| Difficulties in Emotional Regulation (DERS) | 12 months/18 months | Change in Caregiver Emotional Regulation |
Countries
Rwanda
Outcome results
None listed