Understanding Longer-term Effects of a Father-engaged, Play-based Home Visiting Intervention to Promote Early Childhood Development and Prevent Violence in Rwanda: The Sugira Muryango Longitudinal & Spillover Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 2,932
- 试验地点
- 1
- 主要终点
- "Ages & Stages Questionnaire - 3"
研究概览
简要总结
The Early Childhood version of Sugira Muryango is a family-based, home-visiting intervention targeted at early childhood development and implemented with families living in extreme poverty in three districts of Rwanda. This version of Sugira Muryango was first tested in two small pilot studies and a large cluster randomized trial (CRT) was implemented between February 2018 and September 2019 . Pre- to post-intervention findings demonstrated that Sugira Muryango led to improvements in caregiver behaviors linked to child development and health as well as reductions in violence, which were sustained 12 months after the intervention, at which time improvements in child development were observed.
The Research Program on Children and Adversity in the Boston College School of Social Work is led by Dr. Theresa S. Betancourt and will, in partnership with the University of Rwanda, FXB-Rwanda and Laterite, conduct a longitudinal follow-up study to investigate the longer-term outcomes of the Sugira Muryango intervention in families who participated in the CRT. The four-year follow-up will examine the long-term and sustained outcomes of the intervention. In particular, the investigators will look at key indicators of long-term positive outcomes for children such as school readiness and transition to formal schooling. Given the lack of longitudinal research on intervention programs supporting ECD in sub-Saharan Africa, this study will contribute greatly to the body of knowledge on the costs and benefits of investments in ECD and guide policy makers and government leaders on making impactful investments in children, leading to long-term benefits for the population at large.
The follow-up study involves two activities:
Activity A: Pilot to assess measures performance of newly added measures and field test study protocols.
Activity B: Four-year follow-up of families who participated in the CRT of the Sugira Muryango intervention.
详细描述
The aim of the study is to assess the impacts of Sugira Muryango on treated families compared to families receiving only usual care (controls) four years after the intervention. Moreover, at this visit, the investigators will also for the first time examine potential spillover effects of Sugira Muryango onto siblings of children enrolled in the original study. The longitudinal follow-up study will assess whether and to what extent Sugira Muryango has an impact on caregivers' awareness and utilization of available services; support for children's education and playful learning; home hygiene; parenting practices, including child feeding/nutrition, stimulation and sensitive care; experiences of intimate partner violence; use of harsh discipline; mental health, including depression and alcohol use; gender attitudes; and overall wellbeing. It will also assess whether and to what extent Sugira Muryango has an impact on children's physical development; cognitive and linguistic development; temperament; enrollment in early or formal education; school readiness, including self-regulation and early literacy and numeracy; mental health, including internalizing and externalizing and depression; behavior, including conduct problems; and gender attitudes. Finally, the study will assess potential covariates such as the impact of the COVID-19 pandemic and associated lockdowns, child disability, and household size and composition.
The specific objectives are:
To assess the long-term (4 years post-intervention) impact of Sugira Muryango on caregiver behaviors, attitudes, mental health and wellbeing, especially as related to parenting and intimate partner violence.
To assess the long-term (4 years post-intervention) impact of Sugira Muryango on previously enrolled children's physical and cognitive development and health.
To assess the long-term (4 years post-intervention) impact of Sugira Muryango on previously enrolled children's behavior, mental health, school readiness and gender attitudes.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- 3 Months 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- 未提供
排除标准
- •Other than not meeting inclusion criteria, specific family exclusion criteria for the CRT were:
- •caregiver(s) having severe cognitive impairments which precluded their ability to speak to the research questions under study
- •families or caregivers being in the midst of crisis (e.g., a caregiver(s) with active suicidal attempts or psychosis). Families with ongoing crises or disabilities were excluded from the study and were referred to appropriate services.
- •These exclusion criteria remain the same for the current Longitudinal study.
- •Siblings will be excluded from sampling for the spillover study if the primary caregiver has been away from the household for six months or more.
结局指标
主要结局
"Ages & Stages Questionnaire - 3"
时间窗: Through study completion (4 years)
Caregiver report on child's development (younger siblings)
"Mullen Scale of Early Learning"
时间窗: Through study completion (4 years)
Observation of child's cognitive, motor, and linguistic development (younger siblings)
"Kaufman Assessment Battery for Children-2"
时间窗: Through study completion (4 years)
Observation of child's cognitive and linguistic development (CRT children and older siblings)
"Home Observation Measurement of the Environment" infants/toddlers survey and early childhood survey
时间窗: Through study completion (4 years)
Observation of caregiver engagement and stimulation of children (younger siblings and CRT children)
"Wechsler Preschool & Primary Scale of Intelligence"
时间窗: Through study completion (4 years)
Observation of child's cognitive and linguistic development
"International Development & Early Learning Assessment" stimulating care and play module
时间窗: Through study completion (4 years)
Caregiver report on playful parenting activities and childcare arrangement (for all children)
"Multiple Indicator Cluster Survey" child discipline module
时间窗: Through study completion (4 years)
Caregiver self-report of child discipline practices and behaviors (for all children)
Combined module based on "Multiple Indicator Cluster Survey" and "ISPCAN Child Abuse Screening Tool"
时间窗: Through study completion (4 years)
Child self-report of experiences of discipline and violence (older siblings)
DHS "Intimate Partner Violence" survey
时间窗: Through study completion (4 years)
Caregiver self-report on victimization and perpetration of intimate partner violence
"Child Behavior Checklist"
时间窗: Through study completion (4 years)
Caregiver report on child's internalizing and/or externalizing (CRT children and older siblings)
次要结局
- "Early Grade Reading Assessment"(Through study completion (4 years))
- "Parental Acceptance-Rejection Questionnaire"(Through study completion (4 years))
- "Gender Equitable Men" scale(Through study completion (4 years))
- "Service utilization" survey(Through study completion (4 years))
- "Observation of Mother-Child Interactions"(Through study completion (4 years))
- "Early Childhood Behavior Questionnaire"(Through study completion (4 years))
- "Center for Epidemiological Studies Depression Scale"(Through study completion (4 years))
- "Hopkins Symptom Checklist (25)"(Through study completion (4 years))
- "Infant Behavior Questionnaire"(Through study completion (4 years))
- DHS/Promundo "Father Engagement & Financial Decision-Making" survey(Through study completion (4 years))
- "Enrollment in early education" survey(Through study completion (4 years))
- Anthropometric measures: height in centimeters(Through study completion (4 years))
- "Preschool Self-Regulation Assessment"(Through study completion (4 years))
- Anthropometric measures: weight in kilograms(Through study completion (4 years))
- Anthropometric measures: standardized height-for-age(Through study completion (4 years))
- Anthropometric measures: middle upper arm circumference in centimeters(Through study completion (4 years))
- "The Role of Play in Children's Learning"(Through study completion (4 years))
- "Multiple Indicator Cluster Survey (5)" WASH module(Through study completion (4 years))
- World Health Organization "Infant and Young Child Feeding Practices" survey(Through study completion (4 years))
- "Child Enrollment in Formal Education" survey(Through study completion (4 years))
- Anthropometric measures: standardized height-for-weight(Through study completion (4 years))
研究者
Theresa Betancourt
Salem Professor in Global Practice
Boston College