An Implementation Evaluation of A Group-Based Parenting Intervention to Promote Early Childhood Development in Rural Kenya.
An Implementation Evaluation of A Group-Based Parenting Intervention to Promote Early Childhood Development in Rural Kenya.
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DOI：
10.3389/fpubh.2021.653106
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发表时间：
2021
影响因子：
5.2
通讯作者：
Alu E
中科院分区：
文献类型：
--
作者：
Luoto JE;Lopez Garcia I;Aboud FE;Singla DR;Zhu R;Otieno R;Alu E
早期儿童发展(ECD)育儿干预措施可以在资源匮乏的情况下改善儿童的发展结果，但有关其实施情况的信息远远落后于其有效性的证据，阻碍了其推广。这项研究介绍了对Msingi Bora(斯瓦希里语中的“Good Foundation”)的实施评估的结果，这是一种基于群体的反应刺激和营养教育干预措施，最近在肯尼亚西部农村的60个村庄进行了整群随机对照试验。Msingi Bora成功地改善了儿童的认知、接受性语言和社会情感结果，以及育儿实践。我们在2018年4月至2019年11月期间根据《关于报告ECD实施研究(CARE)指南的综合建议》对Msingi Bora试验进行了混合方法实施评估。我们收集了有关项目投入、产出和结果的定性和定量数据，以期检验项目实施的各个方面，如项目接受度和交付忠诚度，与观察到的项目对父母和孩子的影响有何关系。我们发现，研究地区最初对幼儿发展的熟悉程度或知识水平很低，家长、社区递送人员，甚至我们的合作伙伴非政府组织(NGO)的监督人员都是如此。作为回应，我们增加了培训和监督，并提供了一份结构化的手册，使当地的递送代理能够成功地领导会议。父母的遵从性很高，在8个月的时间里，16个两周一次的课程中有13个参加了。对于送货代理，所有衡量送货性能和保真度的指标都随着计划体验的增加而提高。年龄越大、知识更多的递送代理对父母的刺激和孩子的结果产生的影响越大，而保真度分数越高的递送代理也与改进的育儿实践有关。我们的结论是，由当地接生机构提供的基于群体的育儿干预可以改善儿童和父母的多个结果。对培训当地培训人员和交付代理的前期投资，以及对手册项目交付的定期监督，似乎是我们有据可查的成功的关键。我们的结果为在资源匮乏的农村地区推广类似干预措施提供了一条有希望的途径，为需要幼儿发展规划的家庭提供服务。该试验在ClinicalTrials.gov，NCT03548558,2018年6月7日注册。Https://clinicaltrials.gov/ct2/show/NCT03548558.
Early childhood development (ECD) parenting interventions can improve child developmental outcomes in low-resource settings, but information about their implementation lags far behind evidence of their effectiveness, hindering their generalizability. This study presents results from an implementation evaluation of Msingi Bora (“Good Foundation” in Swahili), a group-based responsive stimulation and nutrition education intervention recently tested in a cluster randomized controlled trial across 60 villages in rural western Kenya. Msingi Bora successfully improved child cognitive, receptive language, and socioemotional outcomes, as well as parenting practices. We conducted a mixed methods implementation evaluation of the Msingi Bora trial between April 2018 and November 2019 following the Consolidated Advice for Reporting ECD implementation research (CARE) guidelines. We collected qualitative and quantitative data on program inputs, outputs, and outcomes, with a view to examining how aspects of the program's implementation, such as program acceptance and delivery fidelity, related to observed program impacts on parents and children. We found that study areas had initially very low levels of familiarity or knowledge of ECD among parents, community delivery agents, and even supervisory staff from our partner non-governmental organization (NGO). We increased training and supervision in response, and provided a structured manual to enable local delivery agents to successfully lead the sessions. There was a high level of parental compliance, with median attendance of 13 out of 16 fortnightly sessions over 8 months. For delivery agents, all measures of delivery performance and fidelity increased with program experience. Older, more knowledable delivery agents were associated with larger impacts on parental stimulation and child outcomes, and delivery agents with higher fidelity scores were also related to improved parenting practices. We conclude that a group-based parenting intervention delivered by local delivery agents can improve multiple child and parent outcomes. An upfront investment in training local trainers and delivery agents, and regular supervision of delivery of a manualized program, appear key to our documented success. Our results represent a promising avenue for scaling similar interventions in low-resource rural settings to serve families in need of ECD programming. This trial is registered at ClinicalTrials.gov, NCT03548558, June 7, 2018. https://clinicaltrials.gov/ct2/show/NCT03548558.
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DOI：
10.1016/s0140-6736(16)31389-7
发表时间：
2017-01-07
期刊：
Lancet (London, England)
影响因子：
--
作者：
Black MM;Walker SP;Fernald LCH;Andersen CT;DiGirolamo AM;Lu C;McCoy DC;Fink G;Shawar YR;Shiffman J;Devercelli AE;Wodon QT;Vargas-Barón E;Grantham-McGregor S;Lancet Early Childhood Development Series Steering Committee
通讯作者：
Lancet Early Childhood Development Series Steering Committee
DOI：
10.1186/s13012-015-0242-0
发表时间：
2015-04-21
期刊：
Implementation science : IS
影响因子：
--
作者：
Nilsen P
通讯作者：
Nilsen P
DOI：
10.1016/s2214-109x(20)30469-1
发表时间：
2021-03
期刊：
The Lancet. Global health
影响因子：
--
作者：
Luoto JE;Lopez Garcia I;Aboud FE;Singla DR;Fernald LCH;Pitchik HO;Saya UY;Otieno R;Alu E
通讯作者：
Alu E
影响因子：
5.2
作者：
Cavallera, Vanessa;Tomlinson, Mark;Dua, Tarun
通讯作者：
Dua, Tarun
影响因子：
5.2
作者：
Francis T;Baker-Henningham H
通讯作者：
Baker-Henningham H