Grandi Byen-supporting child growth and development through integrated, responsive parenting, nutrition and hygiene:
Patricia L Kohl1, Emmanuel A Gyimah2, Jenna Diaz3
1Brown School, Washington University in St. Louis, 1 Brookings Dr., Campus Box 1196, St. Louis, MO, 63130, USA.
Insights
The Grandi Byen study investigates an integrated intervention for child development, combining nutrition, responsive parenting, and water, sanitation, and hygiene (WASH) to improve child growth and cognitive outcomes in Haiti.
Area of Science:
- Global Health
- Developmental Pediatrics
- Public Health Interventions
Background:
- Child growth and development are impacted by complex biological, behavioral, social, and environmental factors.
- Integrated approaches addressing these interwoven factors are under-researched.
- The Grandi Byen study addresses this gap by evaluating a novel intervention.
Purpose of the Study:
- To evaluate the impact of an integrated nutrition, responsive parenting, and WASH intervention on holistic child growth and development.
- To assess the synergistic or mediating effects of the multicomponent intervention.
- To determine the feasibility of large-scale implementation.
Main Methods:
- A three-arm longitudinal randomized controlled trial involving 600 mother-infant dyads in Cap-Haitien, Haiti.
- Intervention groups: standard care, nutritional intervention (one egg/day for 6 months), and multicomponent (responsive parenting, nutrition, WASH + one egg/day for 6 months).
- Primary outcomes: child growth, cognitive, language, motor, and social-emotional development; secondary outcomes include child health indicators and responsive parenting.
Main Results:
- This section is not available in the provided abstract.
Conclusions:
- The Grandi Byen intervention, integrating nutrition, responsive parenting, and WASH, holds potential for improving child well-being globally.
- Findings may highlight synergistic effects of combined interventions for children in poverty.
- The study offers innovations for global child health strategies.
Background:
Poor child growth and development outcomes stem from complex relationships encompassing biological, behavioral, social, and environmental conditions. However, there is a dearth of research on integrated approaches targeting these interwoven factors. The Grandi Byen study seeks to fill this research gap through a three-arm longitudinal randomized controlled trial which will evaluate the impact of an integrated nutrition, responsive parenting, and WASH (water, sanitation and hygiene) intervention on holistic child growth and development.
Methods:
We will recruit 600 mother-infant dyads living in Cap-Haitien, Haiti and randomize them equally into one of the following groups: 1) standard well-baby care; 2) nutritional intervention (one egg per day for 6 months); and 3) multicomponent Grandi Byen intervention (responsive parenting, nutrition, WASH + one egg per day for 6 months). Primary outcomes include child growth as well as cognitive, language, motor, and social-emotional development. The study also assesses other indicators of child health (bone maturation, brain growth, diarrheal morbidity and allergies, dietary intake, nutrient biomarkers) along with responsive parenting as mediating factors influencing the primary outcomes. An economic evaluation will assess the feasibility of large-scale implementation of the interventions.
Discussion:
This study builds on research highlighting the importance of responsive parenting interventions on overall child health, as well as evidence demonstrating that providing an egg daily to infants during the complementary feeding period can prevent stunted growth. The multicomponent Grandi Byen intervention may provide evidence of synergistic or mediating effects of an egg intervention with instruction on psychoeducational parenting and WASH on child growth and development. Grandi Byen presents key innovations with implications for the well-being of children living in poverty globally.
Trial Registration:
NCT04785352 . Registered March 5, 2021 at https://clinicaltrials.gov/.
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