The effectiveness of a community-based video-facilitated parenting intervention for child development integrated into routine maternal and child care services in India

Parenting interventions integrating nutrition, stimulation, and responsive caregiving promote child development but face challenges to scale in low-resource settings. This study describes implementation and effectiveness of Aalana Palana, a facilitated video-viewing intervention on responsive parenting, embedded in routine maternal and child care services in India. Aalana Palana was delivered by Anganwadi workers (AWWs) in Telangana, India. A quasi-experimental, non-randomized controlled design was used to evaluate its effectiveness. Intervention group were caregivers of children aged <3 years who reported seeing at least one intervention video in the three months preceding data collection; controls included caregivers who hadn't seen videos in this period. The primary outcome was child development measured using the CREDI, a caregiver report of child's development used extensively in LMICs. We analysed moderation by baseline socio-demographic characteristics and mediation of home environment on CREDI. 30 AWWs delivered Aalana Palana sessions; 361 sessions were observed by supervisors for quality assessment, reporting high fidelity. 1824 caregivers (91·5% eligible caregivers) gave consent. Aalana Palana improved overall child development (exposed: -0·58 (0·90), unexposed: -1·0 (0·92); β = 0·16, p < 0·001); improvements were observed across all CREDI domains. Home environment mediated the effect of the intervention (β = 0·027 (0·014,0·044)). Intervention effects were larger for children aged <1 year compared to older age groups. Aalana Palana is an effective strategy for scaling up parenting interventions for child development in low-resource settings. This study was funded by the UNICEF office of Andhra Pradesh, Karnataka and Telangana. Registration Number: NCT07004608.