Accepted for/Published in: JMIR Research Protocols
Date Submitted: Nov 14, 2024
Open Peer Review Period: Nov 13, 2024 - Jan 8, 2025
Date Accepted: Jun 5, 2025
(closed for review but you can still tweet)
Effects of a Dialogic Booksharing Intervention for Female Caregivers in Rural Tanzania (EDBiT): Study Protocol for a Randomized Controlled Trial
ABSTRACT
Background:
Children in less developed countries face obstacles to optimal language and cognitive development due to a variety of factors related to adverse socio-economic conditions. One of these factors is compromised caregiver-child interactions and associated pressures on parenting. Early development interventions such as Dialogic Booksharing address this variable, with evidence from both developed countries and urban areas of less developed countries for such interventions enhancing caregiver-child interaction and associated benefits to child cognitive and socio-emotional development. Yet, evidence of Dialogic Booksharing effects is lacking from poor rural communities, where the need for such early development intervention may be greatest.
Objective:
The objective of this study is to assess the effects of a Dialogic Booksharing intervention, a parenting program for female caregivers of 15-45-month-old children, implemented in rural Tanzania. We aim to assess the impact of the intervention on the following domains: child cognitive and socio-emotional skills, parenting and parental stress, and child health.
Methods:
The study is a three-arm cluster randomized controlled trial (RCT). In total, 443 female caregivers participated in the study. Clusters of caregivers were randomized to either (i) an index Dialogic Booksharing intervention group, (ii) a Playful Activities active control group, or (iii) a wait-list control group. The active control group was designed to control for any ‘attention effects‘, ensuring that observed improvement in the index group can be attributed to the Dialogic Booksharing intervention’s content. The primary outcomes are child language, parental sensitivity, and parent-child interaction. The secondary outcomes concern child attention and behavior, parenting practices, and parental stress. A combination of questionnaires and direct observations was applied. Qualitative methods were also used, primarily to capture caregivers’ experiences and subjective perspectives on intervention-induced changes.
Results:
The data collection for the EDBiT study was completed in September 2024. The study results are expected to be published by late 2025.
Conclusions:
This RCT of a Dialogic Booksharing intervention implemented in rural Tanzania adds to a growing body of international literature exploring the impact and limitations of a simple and scalable early development intervention to enhance child outcomes. Clinical Trial: ISRCTN Identifier 12613329
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