scholarly journals Evaluating the effectiveness of a multi-component intervention on early childhood development in paediatric HIV care and treatment programmes: a randomised controlled trial

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
R. Chingono ◽  
H. Mebrahtu ◽  
Z. Mupambireyi ◽  
V. Simms ◽  
H. A. Weiss ◽  
...  
BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023539 ◽  
Author(s):  
Jane Fisher ◽  
Tuan Tran ◽  
Stanley Luchters ◽  
Thach D Tran ◽  
David B Hipgrave ◽  
...  

IntroductionOptimal early childhood development is an international priority. Risks during pregnancy and early childhood have lasting effects because growth is rapid. We will test whether a complex intervention addressing multiple modifiable risks: maternal nutrition, mental health, parenting capabilities, infant health and development and gender-based violence, is effective in reducing deficient cognitive development among children aged two in rural Vietnam.Methods and analysisThe Learning Clubs intervention is a structured programme combining perinatal stage-specific information, learning activities and social support. It comprises 20 modules, in 19 accessible, facilitated groups for women at a community centre and one home visit. Evidence-informed content is from interventions to address each risk tested in randomised controlled trials in other resource-constrained settings. Content has been translated and culturally adapted for Vietnam and acceptability and feasibility established in pilot testing.We will conduct a two-arm parallel-group cluster-randomised controlled trial, with the commune as clustering unit. An independent statistician will select 84/112 communes in Ha Nam Province and randomly assign 42 to the control arm providing usual care and 42 to the intervention arm. In total, 1008 pregnant women (12 per commune) from 84 clusters are needed to detect a difference in the primary outcome (Bayley Scales of Infant and Toddler Development Cognitive Score <1 SD below standardised norm for 2 years of age) of 15% in the control and 8% in the intervention arms, with 80% power, significance 0.05 and intracluster correlation coefficient 0.03.Ethics and disseminationMonash University Human Research Ethics Committee (Certificate Number 20160683), Melbourne, Victoria, Australia and the Institutional Review Board of the Hanoi School of Public Health (Certificate Number 017-377IDD- YTCC), Hanoi, Vietnam have approved the trial. Results will be disseminated through a comprehensive multistranded dissemination strategy including peer-reviewed publications, national and international conference presentations, seminars and technical and lay language reports.Trial registration numberACTRN12617000442303; Pre-results.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047925
Author(s):  
Andrea A Tomio ◽  
Martin Dottori ◽  
Eugenia Hesse ◽  
Fernando Torrente ◽  
Daniel Flichtentrei ◽  
...  

ObjectivesWe developed (a) a survey to investigate the knowledge of childhood health experts on public policies and behavioural insights (BI), as well as its use in Latin American and the Caribbean countries (LACs), and (b) an intervention (randomised controlled trial) to test the influence of nudges on the effect of a simulated public health programme communication.Participants and settingsA total of 2003 LACs childhood health professionals participated in the study through a Hispanic online platform.Primary and secondary outcomesWe used regression models analysing expertise-related information, individual differences and location. We extracted several outcome variables related to (a) ‘Public Policy Knowledge Index’ based on the participants’ degree of knowledge on childhood health public policies and (b) BI knowledge, perceived effectiveness and usefulness of a simulated public programme communication. We also analysed a ‘Behavioural Insights Knowledge Index’ (BIKI) based on participants’ performance in BI questions.ResultsIn general, health professionals showed low BI knowledge (knowledge of the term BI: χ2=210.29, df=1 and p<0.001; BIKI: χ2=160.5, df=1 and p<0.001), and results were modulated by different factors (age, academic formation, public policy knowledge and location). The use of BI principles for the communication of the public programme revealed higher impact and clarity ratings from professionals than control messages.ConclusionsOur findings provide relevant knowledge about BI in health professionals to inform governmental and non-governmental organisations’ decision-making processes related with childhood public policies and BI designs.


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