Measuring the Effect of WASH Benefits Interventions on Child Development Outcomes at School Age: Follow up of an Efficacy Trial in Rural Bangladesh
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Child Development
- Sponsor
- International Centre for Diarrhoeal Disease Research, Bangladesh
- Enrollment
- 4932
- Locations
- 1
- Primary Endpoint
- Weschler Primary and Preschool Scales of Development 4th edition (WPPSI-IV)
- Last Updated
- 4 years ago
Overview
Brief Summary
The purpose of this study is to determine if the effects of individual and combined water, sanitation, hygiene, and nutrition interventions in early childhood on child development and maternal mental health persist into middle childhood. This study is a follow-up assessment of the children and mothers enrolled in the WASH-Benefits Bangladesh study.
Detailed Description
Globally, millions of children experience delays in physical health and cognitive development, due to their exposures to poverty and related issues. In low-and middle-income countries, children experience a dis-proportionally high burden of exposure to poverty and related risk factors for delayed development including of poor health and nutrition, inadequate responsive care giving, and a lack of opportunities for early learning. Water, sanitation and hygiene (WASH) interventions have the potential to positively affect the developmental trajectories of children by reducing enteric pathogen infection, improving child health, and altering parental care practices. A recent cluster-randomized controlled trial (cRCT) in Bangladesh (WASH-Benefits, or WASH-B, Clinical Trials.gov Identifier: NCT01590095), found that improvements in WASH or nutrition supported by intensive interpersonal communication, when delivered either individually or in combination, contributed to improvements in child development outcomes at 1 and 2 years of age, and mothers in all intervention groups reported lower depressive symptoms than mothers in the control households. This follow-up study, funded by the Bill \& Melinda Gates foundation, includes assessments of the children and caregivers originally enrolled in the WASH Benefits intervention 5 years following intervention completion, when the children are 5-8 year of age. The original WASH Benefits intervention enrolled pregnant women between May 31, 2012, and July 7, 2013. The goal of this follow-up study is to examine whether the improvements in child development and maternal mental health are sustained when the children are in middle childhood. Our guiding hypothesis is that interventions that showed early impact will continue to improve child and maternal outcomes at this follow-up time period. Investigators will attempt to collect follow-up data from every household originally randomized to one of the 7 arms in the WASH Benefits trial.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Enrolled in the wash-benefits Bangladesh intervention
Exclusion Criteria
- •No Exclusion criteria
Outcomes
Primary Outcomes
Weschler Primary and Preschool Scales of Development 4th edition (WPPSI-IV)
Time Frame: 5 years after intervention completion
The WPPSI-IV assessment measures cognitive development and general intellectual abilities in children 2 years 6 months to 7 years 7 months of age (2:6-7:7), and includes assessments of both performance and verbal skills.
Executive Functioning
Time Frame: 5 years after intervention completion
This executive functioning assessment consists of three sub-scales to assess executive functioning in children including verbal memory, visual and non-verbal memory, and memory capacity.
Child Socioemotional Development
Time Frame: 5 years after intervention completion
Maternal-report questionnaire designed to measure psychological adjustment in children and aims to detect any emotional or behavioural problems.
Fine Motor Development
Time Frame: 5 years after intervention completion
Manual Dexterity component of Movement Assessment Battery for Children-2 (MABC-2) is a direct assessment tool used to measure fine motor skills in children 3 to 17 years of age.
Academic achievement
Time Frame: 5 years after intervention completion
The Wide Range Assessment Test (WRAT) assessment is a written and verbal assessment of reading, writing, and math achievement.
Secondary Outcomes
- Maternal Mental Health(5 years after intervention completion)
- Home environment(5 years after intervention completion)
- School attendance(5 years after intervention completion)
- Height-for-Age Z-scores(5 years after intervention completion)
- Weight-for-Height Z-scores(5 years after intervention completion)