一项以社区为基础的干预 (奥马马项目) 改善了贫困的2岁罗姆儿童的神经发育:一项准实验性观察性研究
M Fernandes1,2,3,4, O Matuskova5, R Babelova6
1Department of Paediatrics, Institute of Developmental and Regenerative Medicine, University of Oxford, Oxford, UK. michelle.fernandes@paediatrics.ox.ac.uk.
European journal of pediatrics
|January 14, 2025
概括
基于社区的早期儿童发展 (ECD) 干预显著改善了罗姆儿童的神经发育结果. 这项由受过培训的罗姆妇女提供的计划,增强了幼儿的认知,语言和精细运动技能.
科学领域:
- 儿童发展 儿童发展
- 公共卫生 公共卫生
- 少数民族健康 少数民族健康
背景情况:
- 在欧洲最大的少数民族罗姆人学龄前儿童中报告了高水平的神经障碍,营养不良和贫困.
- 最佳的早期儿童发育 (ECD) 对终身健康至关重要,早期干预有利于弱势儿童,但罗姆人社区的证据有限.
研究的目的:
- 评估基于社区的ECD干预对斯洛伐克东部罗姆人儿童神经发育结果的影响.
- 为了比较接受干预的罗姆儿童和匹配的罗姆人和非罗姆人对照之间的结果.
主要方法:
- 一项准实验性观察性研究,涉及接受社区ECD干预的罗姆儿童 (RI,n=98) 和匹配的罗姆人 (RC,n=99) 和非罗姆人对照 (NRC,n=54).
- 干预包括每周一次由受过培训的罗姆妇女在3周至20个月之间进行的家庭会议.
- 神经发育结果在2年后使用INTERGROWTH-21st神经发育评估项目 (INTER-NDA) 进行评估.
主要成果:
- 与罗姆人对照组 (RC) 相比,接受干预 (RI) 的罗姆儿童在2岁时表现出显著更高的认知,语言和精细运动分数.
- 与对照组相比,干预组的认知延迟减少了88%.
- 24个月的线性增长是所有儿童发育成绩的关键预测因素.
结论:
- 由受过培训的罗姆妇女进行的社区基础的ECD干预可以显著改善罗姆儿童的神经发育结果.
- 该干预措施在没有直接解决营养状况或贫困状况的情况下证明了有效性.
- 调查结果强调了文化敏感,社区主导的项目对弱势少数民族群体的潜力.
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