A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh
This article was published in the BMJ Global Health by BMJ Journals [© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.] and the definite version is available at: http://dx.doi.org/10.1136/bmjgh-2020-004307 The Journal's website is at: https://gh.bmj.com/co...
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2022
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| 在線閱讀: | http://hdl.handle.net/10361/17009 http://dx.doi.org/10.1136/bmjgh-2020-004307 |
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10361-170092022-06-22T21:01:50Z A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh Pitchik, Helen O Tofail, Fahmida Rahman, Mahbubur Akter, Fahmida Sultana, Jesmin Shoab, Abul Kasham Huda, Tarique Md. Nurul Jahir, Tania Amin, Md Ruhul Hossain, Md Khobair Das, Jyoti Bhushan Chung, Esther O Byrd, Kendra A Yeasmin, Farzana Kwong, Laura H Forsyth, Jenna E Mridha, Malay K Winch, Peter J Luby, Stephen P Fernald, Lia CH Brac James P. Grant School of Public Health Early child development A cluster randomised trial Multicomponent intervention Rural Bangladesh This article was published in the BMJ Global Health by BMJ Journals [© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.] and the definite version is available at: http://dx.doi.org/10.1136/bmjgh-2020-004307 The Journal's website is at: https://gh.bmj.com/content/6/3/e004307 Introduction In low- and middle-income countries, children experience multiple risks for delayed development. We evaluated a multicomponent, group-based early child development intervention including behavioural recommendations on responsive stimulation, nutrition, water, sanitation, hygiene, mental health and lead exposure prevention. Methods We conducted a 9-month, parallel, multiarm, clusterrandomised controlled trial in 31 rural villages in Kishoreganj District, Bangladesh. Villages were randomly allocated to: group sessions (‘group’); alternating groups and home visits (‘combined’); or a passive control arm. Sessions were delivered fortnightly by trained community members. The primary outcome was child stimulation (Family Care Indicators); the secondary outcome was child development (Ages and Stages Questionnaire Inventory, ASQi). Other outcomes included dietary diversity, latrine status, use of a child potty, handwashing infrastructure, caregiver mental health and knowledge of lead. Analyses were intention to treat. Data collectors were independent from implementers. Results In July–August 2017, 621 pregnant women and primary caregivers of children<15 months were enrolled (group n=160, combined n=160, control n=301). At endline, immediately following intervention completion (July–August 2018), 574 participants were assessed (group n=144, combined n=149, control n=281). Primary caregivers in both intervention arms participated in more play activities than control caregivers (age-adjusted means: group 4.22, 95% CI 3.97 to 4.47; combined 4.77, 4.60 to 4.96; control 3.24, 3.05 to 3.39), and provided a larger variety of play materials (ageadjusted means: group 3.63, 3.31 to 3.96; combined 3.81, 3.62 to 3.99; control 2.48, 2.34 to 2.59). Compared with the control arm, children in the group arm had higher total ASQi scores (adjusted mean difference in standardised scores: 0.39, 0.15 to 0.64), while in the combined arm scores were not significantly different from the control (0.25, –0.07 to 0.54). Conclusion Our findings suggest that group-based, multicomponent interventions can be effective at improving child development outcomes in rural Bangladesh, and that they have the potential to be delivered at scale. Published 2022-06-22T04:45:08Z 2022-06-22T04:45:08Z 2021 2021-03-16 Journal Article Pitchik, H. O., Tofail, F., Rahman, M., Akter, F., Sultana, J., Shoab, A. K., . . . Fernald, L. C. H. (2021). A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh. BMJ Global Health, 6(3) doi:10.1136/bmjgh-2020-004307 http://hdl.handle.net/10361/17009 http://dx.doi.org/10.1136/bmjgh-2020-004307 en_US https://gh.bmj.com/content/6/3/e004307 BMJ Global Health application/pdf BMJ Journals |
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Brac University |
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Institutional Repository |
| language |
en_US |
| topic |
Early child development A cluster randomised trial Multicomponent intervention Rural Bangladesh |
| spellingShingle |
Early child development A cluster randomised trial Multicomponent intervention Rural Bangladesh Pitchik, Helen O Tofail, Fahmida Rahman, Mahbubur Akter, Fahmida Sultana, Jesmin Shoab, Abul Kasham Huda, Tarique Md. Nurul Jahir, Tania Amin, Md Ruhul Hossain, Md Khobair Das, Jyoti Bhushan Chung, Esther O Byrd, Kendra A Yeasmin, Farzana Kwong, Laura H Forsyth, Jenna E Mridha, Malay K Winch, Peter J Luby, Stephen P Fernald, Lia CH A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh |
| description |
This article was published in the BMJ Global Health by BMJ Journals [© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.] and the definite version is available at: http://dx.doi.org/10.1136/bmjgh-2020-004307 The Journal's website is at: https://gh.bmj.com/content/6/3/e004307 |
| author2 |
Brac James P. Grant School of Public Health |
| author_facet |
Brac James P. Grant School of Public Health Pitchik, Helen O Tofail, Fahmida Rahman, Mahbubur Akter, Fahmida Sultana, Jesmin Shoab, Abul Kasham Huda, Tarique Md. Nurul Jahir, Tania Amin, Md Ruhul Hossain, Md Khobair Das, Jyoti Bhushan Chung, Esther O Byrd, Kendra A Yeasmin, Farzana Kwong, Laura H Forsyth, Jenna E Mridha, Malay K Winch, Peter J Luby, Stephen P Fernald, Lia CH |
| format |
Journal Article |
| author |
Pitchik, Helen O Tofail, Fahmida Rahman, Mahbubur Akter, Fahmida Sultana, Jesmin Shoab, Abul Kasham Huda, Tarique Md. Nurul Jahir, Tania Amin, Md Ruhul Hossain, Md Khobair Das, Jyoti Bhushan Chung, Esther O Byrd, Kendra A Yeasmin, Farzana Kwong, Laura H Forsyth, Jenna E Mridha, Malay K Winch, Peter J Luby, Stephen P Fernald, Lia CH |
| author_sort |
Pitchik, Helen O |
| title |
A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh |
| title_short |
A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh |
| title_full |
A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh |
| title_fullStr |
A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh |
| title_full_unstemmed |
A holistic approach to promoting early child development: A cluster randomised trial of a group-based, multicomponent intervention in rural Bangladesh |
| title_sort |
holistic approach to promoting early child development: a cluster randomised trial of a group-based, multicomponent intervention in rural bangladesh |
| publisher |
BMJ Journals |
| publishDate |
2022 |
| url |
http://hdl.handle.net/10361/17009 http://dx.doi.org/10.1136/bmjgh-2020-004307 |
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1814308822169157632 |