Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jun 29, 2023
Open Peer Review Period: Jun 28, 2023 - Aug 23, 2023
Date Accepted: Oct 24, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Study Protocol: Digital support systems to improve child health and development in Peru - a randomized controlled trial (DigitalECD)
ABSTRACT
Background:
Children living in low and middle-income countries (LMIC) are at greater risk for experiencing adversities that can undermine their health and early development. Recently launched online early childhood development (ECD) programmes attempt to support children in their home environments using digital technologies. However, these programmes face several unresolved issues including access, equity, reach and scalability. Using social media messengers that are now almost universally available in LMICs can potentially address these limitations
Objective:
This study rigorously assesses the reach, impact, cost-effectiveness and scalability of Afini, a newly developed virtual platform designed to support parents of young children in low resource settings to improve early childhood development. The Afini platform allows caregivers to get answers to questions about child well-being, while also identifying and promoting age- and development-appropriate activities for parents to engage in with their children.
Methods:
This cluster-randomised controlled trial enrolled 2,471 caregivers and their 3-9 months old children across 164 study clusters in the San Marcos, Cajabamba and Cajamarca provinces of Peru. Participants were randomly assigned to one of three groups: a control group (72 community clusters, 980 caregiver-child dyads), a home visit intervention group (20 community clusters, 316 caregiver-child dyads), and an Afini intervention group (72 community clusters, 1,175 caregiver-child dyads). Families in the control group receive no focused early childhood development (ECD) intervention. The home visit group are receiving biweekly home visits by a trained field staff following the national ECD programme (Programa Nacional Cuna Más) curriculum and training guidelines. Caregivers in the Afini group are receiving ECD activities and advice through the online platform.
Results:
Enrolment started in September 2021 and concluded in March 2023. Endline assessments will take place between August 2023 to September 2024. The primary study outcomes are children's overall development at age 2.5 years, assessed through the long form of the Global Scales for Early Development (GSED). Secondary outcomes include caregiver engagement, caregiver mental health, screen time as well as caregiver-reports of children's motor, cognitive, language and socio-emotional development.
Conclusions:
This study is one of the first in LMICs that uses e-technologies to improve ECD. Given the large number of children in LMICs currently receiving only limited external support, the evaluated platform has the potential to improve the short- and long-term wellbeing of millions of children and their parents globally. Clinical Trial: https://classic.clinicaltrials.gov/ct2/show/NCT05202106
Citation
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Copyright
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