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. 2023 Oct 24;2023(10):CD014722. doi: 10.1002/14651858.CD014722.pub2

Rockers 2018.

Study characteristics
Methods Study design: cluster‐RCT
Duration of study: the study was conducted between 2015 and 2016.
Country: Zambia
Income classification: low‐middle‐income country in 2015‐2016
Geographical scope: rural area in the catchment areas of 5 health facilities in Choma and Pemba districts, Southern Province, Zambia
Healthcare setting: health facilities
Participants 1. Age: caregivers average 27 years; child 6‐12 months
2. Gender: caregivers were female, children both.
3. Socioeconomic background
Household wealth quintile, mean (SD)—control: 2.85 (1.42), intervention: 3.13 (1.41).
4. Educational background: fewer than half had completed primary school.
Inclusion criteria:
to be eligible for the study, a household had to have a child between 6 and 12 months of age at the time of enrolment.
Exclusion criteria:
caregivers younger than 15 years of age were excluded.
Note: At baseline, the intervention and control group scores for Self‐Reporting Questionnaire (SRQ), score > 7 were, respectively, 3.72 (2.89) and 4.57 (3.45).
Stated purpose: to evaluate the impact of a community‐based parenting group intervention on child development in Zambia
Interventions Name: community‐based parenting group intervention
Title/name of PW and number: child development agent (CDA) was a community‐based health worker; head mothers were members of the community (number not specified).
1. Selection: CDAs were selected through consultation within communities; head mothers were selected by the members of the group.
2. Educational background: CDAs had previous experience providing community‐based health services.
3. Training: “prior to the start of the study, CDAs were trained on how to support group meetings”; “CDAs trained on the curriculum 3 meeting rounds at a time every 6 weeks”; head mothers were trained by CDAs according to the planned curriculum prior to each round.
4. Supervision: not specified
5. Incentives/remuneration: not specified
Prevention type: universal – all households with a child in the selected age range were eligible for inclusion, and their baseline scores for the SRQ were well below the cut‐off for the measure.
Intervention details
Original 1‐year study—2 services: a) fortnightly home visit by a CDA who screened and referred children for infections and acute malnutrition and encouraged caregivers to use routine child health services; b) parent group meetings where they were taught a diverse curriculum that included content on cognitive stimulation and play practices, child nutrition, and cooking practices, and self‐care for good mental health. These were led by a trained “head mother”. During the year 2 study extension, the household visit component of the intervention was dropped, while facilitation of the fortnightly parenting group meetings continued. This change was motivated by the findings from the year 1 assessment, which suggested that the parenting groups were the primary driver of observed positive behaviour change.
Control: usual care
Outcomes Participants’outcomes of interest for this review
  1. Diagnosis of mental disorders – SRQ, score > 7 as proxy


Carers’outcomes of interest for this review
Nil
Economic outcomes
Nil
Time points: baseline, post‐intervention (7‐24 months)
Notes Source of funding: the first year of the study was funded through grants from Grand Challenges Canada (0349‐03) and PATH (DFI.1836‐672968‐GRT). The second year of the study was funded through a grant from the Policy Research Fund at the Department for International Development (DFID), United Kingdom (55204321). At the time of the study, author R.C.H. worked in the DFID Zambia office and was not part of the Policy Research Fund team. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Notes on validation of instruments (screening and outcomes): the WHO SRQ is a widely adopted measure that has been validated across contexts.
Additional information: none
Handling the data: not applicable
Prospective trial registration number: NCT02234726