Effects in Middle Childhood of Early Exposure to Water and Sanitation Interventions

早期接触水和卫生干预措施对童年中期的影响

• 批准号: 10228718
• 负责人: LIA C. H. FERNALD
• 金额: $ 6.71万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10228718
• 关键词: 2 year old; 8 year old; Address; Affect; Bangladesh; Caregivers; Caring; Child; Child Development; Child Health; Childhood; Chronic; Cognition; Cognitive; Collaborations; Combined Modality Therapy; Community Health Aides; Data; Data Collection; Defecation; Development; Dietary Intervention; Early Intervention; Environment; Environmental Risk Factor; Evaluation; Exclusive Breastfeeding; Exposure to; Family; Feces; Food; Funding; Goals; Grant; Growth and Development function; Hand; Handwashing; Health; Household; Human Resources; Hygiene; Impact evaluation; Individual; Intervention; Language; Latrine; Learning; Malnutrition; Measurement; Measures; Mental Health; Mothers; Outcome; Outcome Assessment; Personal Communication; Personal Satisfaction; Physiological; Policies; Poverty; Publishing; Randomized Controlled Trials; Reporting; Research; Risk Factors; Sample Size; Sanitation; Shapes; Soaps; Stress; Time; Training; Visit; Water; Work; abuse neglect; acute infection; adolescent health; arm; base; caregiving; chronic infection; cognitive development; depressive symptoms; diarrheal disease; direct application; early childhood; effectiveness testing; enteric infection; experience; follow-up; food insecurity; food preparation; group intervention; improved; innovation; international center; intervention program; low and middle-income countries; low income country; middle childhood; nutrition; physical conditioning; programs; psychologic; therapy design; therapy development; treatment arm; uptake

Project Summary/Abstract Hundreds of millions of children worldwide live in poverty, and are consequently exposed to poor water and sanitation (WASH), inadequate nutrition, and insufficient caregiving. Exposure to these risk factors then causes delays in physical and mental health, and cognitive development, which can have lifelong consequences. Water, sanitation and hygiene interventions have the potential to positively affect the developmental trajectories of children by altering parental care practices and reducing enteric pathogen infection, thereby improving the quality of the environment in which young children are living. This study uses a rigorous approach – a multi-arm randomized-controlled trial (RCT) – to test the effectiveness of an innovative program promoting water, sanitation and hygiene with combined interventions to address chronic malnutrition and poor child development in Bangladesh. The scientific premise of the proposed study is strong because the intervention had consistent short-term impacts on child development outcomes across multiple domains of development (findings published in Lancet Child and Adolescent Health, 2018), and thus there is the potential that the study will also result in effects in middle childhood. The study has a high degree of scientific rigor because we use a cluster-based, randomized controlled trial (cRCT). Furthermore, we are using data with high quality measurements of child development outcomes at three time points, as well as information on maternal well-being and intervention uptake. We obtained funding for follow-up data collection, and are now seeking funding to cover personnel to analyze the existing data. The goal of the proposed study is to identify the components of an impactful early intervention that persist into mid-childhood. Our guiding hypothesis is that interventions that showed early impact will continue to have improved child outcomes at this follow-up time period. Our goals are to examine the impact of the WASH and nutrition interventions on child development and growth in children 5-8 years of age. We hypothesize that all intervention arms will show benefits to child development and growth, but that that the arms with combined treatments will have greater effects on any of the individual arms. Another goal is to examine the effects of the WASH and nutrition interventions on intermediate outcomes of caregiver mental health and caregiving practices when children are 5-8 years of age. We hypothesize that all WASH intervention arms will show benefits to caregiver mental health and caregiving practices. This proposed research is significant because it has the potential to inform interventions, programs, and policies for the hundreds of millions of children living in low-income countries. The proposed work is innovative in its examination of longer-term effects of a program, a unique combination of interventions, and high quality outcome assessments at multiple time points. The study has a rigorous approach, allowing for causal interpretation and direct application to intervention design.

项目摘要/摘要 全球数以千计的儿童生活在贫困中，因此暴露于贫困的水中 卫生（WASH），营养不足和护理不足。接触这些风险因素，然后导致 身心健康的延迟以及认知发展可能会带来终生后果。水， 卫生和卫生干预措施有可能对 通过改变父母护理习惯并减少肠道病原体感染，从而提高质量 幼儿生活的环境。 该研究使用严格的方法 - 多臂随机控制试验（RCT） - 测试 创新计划的有效性促进水，卫生和卫生，并采取干预措施 解决孟加拉国慢性营养不良和儿童发展差。提议的科学前提 研究之所以强大，是因为干预对儿童成长结果产生一致的短期影响 跨多个发展领域（在《柳叶刀儿童和青少年健康》中发表的发现，2018年），以及 这项研究的潜力也将在童年中产生影响。这项研究很高 科学严格程度是因为我们使用基于群集的随机对照试验（CRCT）。此外，我们 正在使用具有三个时间点儿童成长结果的高质量测量数据，以及 有关母校福祉和干预吸收的信息。 我们获得了后续数据收集的资金，现在正在寻求资金来覆盖人员进行分析 现有数据。拟议的研究的目的是确定有影响力的早期干预的组成部分 这一直持续到中期。我们的指导假设是，表现出早期影响的干预措施将继续 在此后续时间期间有改善的儿童结局。我们的目标是检查清洗的影响 以及5-8岁儿童的儿童发展和成长的营养干预措施。我们假设这一点 所有干预武器都会对儿童发育和成长均能有好处，但该武器的联合 治疗对任何个体武器都会产生更大的影响。另一个目标是检查 洗涤和营养干预介绍了护理人员心理健康和照料实践中的中间结果 当孩子5-8岁时。我们假设所有洗发臂都将显示出 照料者心理健康和照料实践。 这项拟议的研究很重要，因为它有可能为干预措施，计划和 居住在低收入国家的数亿儿童的政策。拟议的工作是创新的 在检查计划的长期影响，干预措施的独特组合和高质量时 结果评估在多个时间点。该研究具有严格的方法，允许催化 解释和直接应用干预设计。