Baker‐Henningham 2005.

Study characteristics
Methods	Study design: cluster‐RCT Duration of study: not specified Country: Jamaica Income classification: low‐middle‐income country from 1987 to 2005 Geographical scope: urban (Kingston, St Andrew, and St Catherine) Healthcare setting: homes
Participants	1. Age: intervention group 26.0 (7.1) years, control group 25.7 (7.2) years 2. Gender: caregivers were females. 3. Socioeconomic background: (1) crowding, persons per room: 2.8 (1.3), 2.9 (1.4); (2) sanitation range 0‐12: 7.8 (2.8), 7.9 (2.6); (3) possessions, range 0‐10: 5.1 (1.9), 5.1 (1.7) 4. Educational background: % who completed high school: intervention group 43.8%, control group 37.7% Inclusion criteria—children: a. aged between 9 months and 30 months; b. weight for age currently below –1.5 z‐scores of the National Centre for Health Statistics (NCHS) references 15 and clinic records showing that they had been below –2 z‐scores in the last 3 months; c. birth weight greater than 1.8 kg; d. singleton birth; e. absence of chronic disease and/or obvious disability. Inclusion criteria—mothers: mother of children meeting the aforementioned inclusion criteria Exclusion criteria: none reported Note: at baseline, the intervention and control group scores for the Center for Epidemiological Studies Depression Scale (CES‐D) were, respectively, 5 (2.6) and 4.9 (2.2). Stated purpose: to determine the effect of early childhood stimulation with undernourished children and their mothers on maternal depression
Interventions	Name: childhood stimulation and parenting practices Title/name of PW and number: community health aides (number not specified) 1. Selection: paraprofessionals employed in government health centres 2. Educational background: not specified 3. Training: 4 weeks of pre‐service training on health and nutrition, and we provided an additional 2 weeks of training covering child development, parenting issues, and how to conduct the intervention 4. Supervision: supervisor observed each aide conducting visits once a month and visited the health centre every fortnight to discuss the programme and review the records of each visit. 5. Incentives/remuneration: not specified Prevention type: selective—participants were included based upon the presence of a risk factor (being mothers of undernourished children) and presented baseline levels of distress well below the cutoff for the measure. Intervention details: The intervention focused on improving child development by improving mothers’ knowledge and practices of child‐rearing and their parenting self‐esteem. Community health aides visited the homes weekly for half an hour and demonstrated age‐appropriate activities for the child by involving both the mother and child in play. Home‐made toys and books and materials in the home were used to keep the intervention low cost. Parenting issues, including the importance of praise, attention, and responsiveness, appropriate discipline strategies, child nutrition, and how to promote children’s play and learning were also discussed. Control: usual care
Outcomes	Participants’outcomes of interest for this review Depressive symptoms – CES‐D Carers’ outcomes of interest for this review Nil Economic outcomes Nil Time points:  baseline, post‐intervention (< 1 month)
Notes	Source of funding: Thrasher Research Fund, USA, with subsidiary grants from the British High Commission–DFID, Jamaica and the University of the West Indies Mona Campus Research and Publication Fund. The Ministry of Health Jamaica supported the Community Health Aides. This work was undertaken in collaboration with Great Ormond Street Hospital for Children NHS Trust which receives a proportion of its funding from the NHS Executive. Notes on validation of instruments (screening and outcomes): the measure CES‐D is widely validated across contexts. Additional information: none Handling the data: not applicable Prospective trial registration number: not reported