Luoto 2020.
| Study characteristics | |
| Methods |
Study design: cluster‐RCT Duration of study: the study was conducted in 2018‐2021. Country: Kenya Income classification: lower‐middle‐income country Geographical scope: rural—subcounties of East Rachuonyo, South Rachuonyo, and Sabatia in western Kenya Healthcare setting: group sessions took place in local community centres or churches; these were paired with home visits for one of the intervention arms. |
| Participants | 1. Age: mother's age around 27‐29 2. Gender: both 3. Socioeconomic background: these predominantly rural areas are characterized by high rates of poverty, child mortality, and stunting (31 to 34%). 4. Educational background: around 8.8 years of education for mothers, and 9.4 to 9.7 for fathers Inclusion criteria Mothers or other female primary caregivers: a. aged 15 years or older; b. with a child aged 6–24 months without signs of severe mental or physical impairment; c. if married or in established relationships, fathers or male caregivers aged 18 years or older were also eligible to participate. Exclusion criteria: child with signs of severe mental or physical impairment. Note: at baseline, the intervention (1 and 2) and control group scores for Center for Epidemiologic Studies Depression Scale (CES‐D) were, respectively, 10.3 (6.1); 9.8 (7.1); and 10.2 (7.1). Stated purpose: to test the effectiveness of two group‐based delivery models for an integrated ECD responsive stimulation and nutrition education intervention using Kenya’s network of community health volunteers. |
| Interventions |
Name: group‐based parenting interventions Title/name of PW and number: community health volunteer (CHV) (40) 1. Selection: part‐time volunteers and members of their communities tasked with improving community health and linking individuals to primary health‐care services 2. Educational background: mean 11 years of education and mean 9 years of CHV experience 3. Training: training of sessions 1 to 8 took place at the start of the programme; training of sessions 9 to 16 took place at midline. CHVs received a manual in their language of delivery and in English. Trainings included both classroom time to review each session as well as supervised practice with mothers and children. Monthly 1‐day refresher trainings were also performed in each subcounty to ensure CHVs were prepared ahead of each session. Knowledge was tested with a paper‐and‐pencil test at the end of each training. Research team and later NGO staff were following a train‐the‐trainers model. 4. Supervision: CHVs were rated on skills such as facilitating discussion, coaching parents, answering questions, as well as overall session quality and engagement. CHVs were provided with supervisor feedback immediately after each session. Trained members of local NGO involved in intervention implementation. 5. Incentives/remuneration: the research project paid CHVs a monthly stipend for their duties, according to local policy. Prevention type: indicated – programme tailored for all mother‐child dyads in the selected communities: mothers presented with some level of distress as indicated by the CES‐D scores. Intervention details Msingi Bora (Good Foundation) — group sessions only: the Msingi Bora curriculum focused on five key practices: responsive play, responsive communication, hygiene, nutrition, and love and respect in the family. The sessions emphasized parents learning new practices with their child, spouse, and peers through demonstration and coached practice, group‐based problem‐solving, and peer support. Sessions took place in local community centres or churches. Every fourth session served as a review session, for which households receiving the group‐only intervention continued with group meetings. In half of the villages, fathers were invited to participate in the intervention. They were invited to all 16 sessions, 12 of which were for both mothers and fathers and 4 of which were separate sessions by sex, including the first 2, as a way to try to encourage their participation, practising respectful communication, father involvement in child‐care, and emotional support between spouses. Similar topics were covered in the four corresponding mother‐child sessions so that the curriculum was identical across mothers, regardless of the intervention group. Msingi Bora (Good Foundation) – group sessions + home visits: households receiving the mixed‐delivery intervention received individual home visits. Community health volunteers in mixed‐delivery villages visited each participant household during the same week that a group review session was held in group‐only villages. During these home visits, the community health volunteers delivered review messages identical to those in the group reviews, but the focus was tailored to that family. The same fathers involvement procedures were carried out in this group too. Control: usual care – households in villages assigned to the comparison group did not receive any interventions other than information about child feeding during the baseline survey. |
| Outcomes |
Participants’outcomes of interest for this review
Note: we included data from the Msingi Bora (Good Foundation) group sessions only from intervention and control groups. Carers’ outcomes of interest for this review Nil Economic outcomes Nil Time points: baseline, post‐intervention (< 1 month) |
| Notes |
Source of funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health Notes on validation of instruments (screening and outcomes): no specifications given for the scales included in the review; nevertheless, the used tools have been widely validated across contexts. Additional information: none Handling the data: not applicable Prospective trial registration number: NCT03548558 |