In-person versus remote (mHealth) delivery for a responsive parenting intervention in rural Kenya: a cluster
Italo Lopez Garcia1, Jill Luoto2, Frances Aboud3
1Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA. italolop@usc.edu.
BMC Public Health
|September 5, 2024
Summary
This study compares in-person early childhood development (ECD) parenting interventions with a hybrid model using mHealth. The goal is to find cost-effective, scalable solutions to improve child development in low-resource settings.
Area of Science:
- Global Health
- Developmental Psychology
- Health Services Research
Background:
- Poverty, malnutrition, and lack of stimulation compromise development in 43% of children under five in LMICs.
- Existing early childhood development (ECD) parenting interventions are often too costly and unsustainable for scale in low-resource settings.
- Short-term impacts of current ECD interventions tend to fade, necessitating new approaches for sustained change.
Purpose of the Study:
- To experimentally compare a traditional in-person ECD parenting intervention with a hybrid model incorporating mHealth (smartphone-based audiovisual content and WhatsApp).
- To assess the relative effectiveness, cost, and long-term sustainability of the hybrid-delivery model over two years.
- To determine the optimal delivery model for maximizing reach and sustained impacts on parenting behaviors and child development outcomes in resource-limited settings.
Main Methods:
- A cluster Randomized Controlled Trial (cRCT) involving 90 villages and approximately 1200 households in Kenya.
- Intervention delivery models include traditional in-person group sessions and a hybrid model with increasing substitution of in-person meetings with mHealth components.
- Data collection via midline (12 months) and endline (24 months) surveys to evaluate intention-to-treat impacts on primary outcomes and mediating pathways through mediation analysis.
Main Results:
- The study hypothesizes that the hybrid model will be less costly but may have inferior remote interaction effectiveness compared to in-person visits.
- Evaluation will determine the sustained two-year impacts on parenting behaviors and child development outcomes.
- Mediation analysis will explore pathways through which the interventions influence outcomes.
Conclusions:
- The study aims to identify the most cost-effective and scalable model for delivering ECD parenting interventions.
- Integrating interventions into existing healthcare systems (e.g., Community Health Promoters) and utilizing low-cost technology are key to sustainability.
- Findings will contribute to scalable, sustainable solutions for improving early childhood development in resource-limited settings.
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