Rahman 2009.

Study characteristics
Methods	Study design: cluster‐RCT Duration of study: not specified Country: Pakistan Income classification: low‐income country until 2008, lower‐middle from 2009 Geographical scope: rural—Kaller Syedan, a rural subdistrict of Rawalpindi, Pakistan Healthcare setting: home of the participants in the 24 villages for intervention
Participants	1. Age: mean age 27.3 2. Gender: female 3. Socioeconomic background: family income mean—3060 Pakistani rupees 4. Educational background: years of education, mean—5.9 to 6.3 Inclusion criteria: a. all women in the 3rd trimester of pregnancy were eligible; b. married; c. in their last trimester of pregnancy that were registered with LHWs. Exclusion criteria: a. women with a complicated pregnancy; b. women with a medical condition. Note: at baseline, the intervention and control group scores for WHO Self‐Reporting Questionnaire‐20 (SRQ) were, respectively, 7.87 (4.88) and 7.13 (4.72). Stated purpose: the purpose of this study was to carry out a more robust assessment of the impact of the ‘Learning Through Play’ programme using a cluster‐randomized design.
Interventions	Name: Learning Through Play Title/name of PW and number: lady health workers (number not specified) 1. Selection: members of local community 2. Educational background: have completed secondary schools 3. Training: full‐day training workshop and refresher session of 1 hour on the second birth month stage of development by trained psychologist. They were given the manual for reference and suggesting teaching guidelines. 4. Supervision: the researchers monitored the training of LHWs and mothers to ensure that the programme was adhered to. 5. Incentives/remuneration: not specified Prevention type: selective—participants were included based upon the presence of a risk factor (last trimester of pregnancy) and presented with some level of distress as indicated by SRQ scores that were below the cut‐off for the measure. Intervention details: the ‘Learning Through Play’ programme is intended to stimulate early child development. The central feature of the program is a pictorial calendar devised for parents, depicting eight successive stages of child development, with illustrations of parent–child play and other activities that promote parental involvement, learning and attachment. A key feature of the ‘Learning Through Play’ programme is its emphasis on the quality of the mother–infant interaction and helping the mother read infant cues and develop sensitive responsiveness towards the infant through play, which can be pleasurable for both the mother and the infant. LHWs conducted half‐day workshops with groups of participants (6‐8 mothers). This was followed by fortnightly home visits where LHWs spent 15 to 20 minutes with the mothers to discuss their child’s development; the mothers were encouraged to meet in groups on their own to support each other in the use of the techniques outlined in the calendar. Control: usual care – routine follow‐up visits
Outcomes	Participants’outcomes of interest for this review Distress/PTSD symptoms – SRQ Carers’ outcomes of interest for this review Nil Economic outcomes Nil Time points: baseline, post‐intervention (1‐6 months)
Notes	Source of funding: not available Notes on validation of instruments (screening and outcomes): the outcome is widely adopted and validated across contexts. Additional information: none Handling the data: not available Prospective trial registration number: not available