In-person versus remote (mHealth) delivery for a responsive parenting intervention in rural Kenya: A cluster...

Area of Science:

• Global Health
• Developmental Psychology
• Public Health Interventions

Background:

• 43% of children under 5 in low- and middle-income countries (LMICs) experience developmental deficits due to poverty, malnutrition, and lack of stimulation.
• Existing early childhood development (ECD) parenting interventions are often too costly for scale-up and their impacts may diminish over time.
• There is a critical need for scalable, sustainable, and low-cost ECD parenting interventions.

Purpose of the Study:

• To experimentally compare a traditional in-person ECD parenting intervention with a hybrid model integrating mHealth and remote interactions.
• To assess the relative effectiveness, cost, and long-term sustainability of the hybrid-delivery model over two years.
• To identify the optimal delivery model for maximizing reach and sustained improvements in child development outcomes in resource-limited settings.

Main Methods:

• A cluster Randomized Controlled Trial (cRCT) involving 90 villages and approximately 1200 households in Kenya.
• Comparison of a purely in-person group-based delivery model with a hybrid model using smartphones for audiovisual content and WhatsApp for social interaction.
• Midline and endline surveys at 12 and 24 months to evaluate intention-to-treat impacts on primary outcomes and mediating pathways via Mediation Analysis.

Main Results:

• The study hypothesizes that the hybrid ECD intervention will be more cost-effective.
• It is anticipated that remote interactions may be less effective than in-person visits, posing a question about the most cost-effective program.
• The study aims to provide insights into the sustained impacts of different delivery models on parenting behaviors and ECD outcomes.

Conclusions:

• The project integrates delivery into existing Community Health Promoter (CHP) operations within Kenya's rural healthcare system.
• Utilizing low-cost technology, the study seeks to discover scalable and sustainable solutions for resource-limited settings.
• The findings will inform the development of effective and accessible ECD interventions to improve child development globally.