Dataset Information

Promoting parent-child relationships and preventing violence via home-visiting: a pre-post cluster randomised trial among Rwandan families linked to social protection programmes.

ABSTRACT: BACKGROUND:Sugira Muryango is a father-engaged early child development and violence-prevention home-visiting programme delivered by trained lay workers. This cluster-randomised trial evaluates whether families living in extreme poverty (Ubudehe 1, the poorest category in the Government of Rwanda's wealth ranking) who receive Sugira Muryango in combination with a government-provided social protection programme demonstrate greater responsive, positive caregiving, nutrition, care seeking, hygiene, and father involvement compared with control families receiving usual care (UC). METHODS:Using detailed maps, we grouped closely spaced villages into 284 geographic clusters stratified by the type of social protection programmes operating in the village clusters; 198 clusters met all enrolment criteria. Sugira Muryango was delivered to n =?541 families in 100 treatment clusters with children aged 6-36?months living in extreme poverty. We assessed changes in outcomes in intervention and n =?508 UC control families using structured surveys and observation. Analyses were intent to treat using mixed models to accommodate clustering. RESULTS:Families receiving Sugira Muryango improved on core outcomes of parent-child relationships assessed using the Home Observation for Measurement of the Environment (Cohen's d =?0.87, 95% CI: 0.74, 0.99) and the Observation of Mother-Child Interaction (Cohen's d =?0.29, 95% CI: 0.17, 0.41). We also saw reductions in harsh discipline on items from the UNICEF MICS (OR?=?0.30: 95% CI: 0.19, 0.47) and in violent victimisation of female caregivers by their partners (OR?=?0.49, 95% CI: 0.24, 1.00) compared with UC. Moreover, children in families receiving SM had a 0.45 higher increase in food groups consumed in the past 24?h (Cohen's d =?0.35, 95% CI: 0.22, 0.47), increased care seeking for diarrhoea (OR?=?4.43, 95% CI: 1.95, 10.10) and fever (OR?=?3.28, 95% CI: 1.82, 5.89), and improved hygiene behaviours such as proper treatment of water (OR?=?3.39, 95% CI: 2.16, 5.30) compared with UC. Finally, Sugira Muryango was associated with decreased caregiver depression and anxiety (OR?=?0.58, 95% CI: 0.38, 0.88). CONCLUSIONS:Sugira Muryango led to improvements in caregiver behaviours linked to child development and health as well as reductions in violence. TRIAL REGISTRATION:ClinicalTrials.gov number NCT02510313.

SUBMITTER: Betancourt TS

PROVIDER: S-EPMC7201751 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Promoting parent-child relationships and preventing violence via home-visiting: a pre-post cluster randomised trial among Rwandan families linked to social protection programmes.

Betancourt Theresa S TS Jensen Sarah K G SKG Barnhart Dale A DA Brennan Robert T RT Murray Shauna M SM Yousafzai Aisha K AK Farrar Jordan J Godfroid Kalisa K Bazubagira Stephanie M SM Rawlings Laura B LB Wilson Briana B Sezibera Vincent V Kamurase Alex A

BMC public health 20200506 1

<h4>Background</h4>Sugira Muryango is a father-engaged early child development and violence-prevention home-visiting programme delivered by trained lay workers. This cluster-randomised trial evaluates whether families living in extreme poverty (Ubudehe 1, the poorest category in the Government of Rwanda's wealth ranking) who receive Sugira Muryango in combination with a government-provided social protection programme demonstrate greater responsive, positive caregiving, nutrition, care seeking, h ...[more]

PMID: 32375840

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Project description:ImportanceAntisocial behavior and adult criminality often have origins in childhood and are best addressed early in the child's life using evidence-based parenting programs. However, families with additional risk factors do not always make sufficient changes while attending such programs; these families may benefit from additional support.ObjectiveTo evaluate the efficacy of adding a 10-session, structured home parent support (HPS) intervention to enhance outcomes for high-risk families attending the Incredible Years Parent (IYP) program.Design, setting, and participantsA randomized clinical superiority trial of 126 parents of children aged 3 to 7 years with conduct problems compared the IYP program plus HPS with treatment as usual of the IYP program alone. Child behavior measures were collected before and after treatment and at the 6-month follow-up. Recruitment from 19 IYP groups began February 13, 2013, and follow-up data collection was completed June 4, 2015. All data were analyzed using an intention-to-treat design with last observation carried forward. Statistical analysis took place from May 20, 2015, to March 31, 2016.InterventionParents were randomly assigned to receive IYP program plus HPS or IYP alone.Main outcomes and measuresThe primary outcome measure was the posttreatment change in Eyberg Child Behavior Inventory Total Problem Scale (ECBI-P) score. Secondary outcomes included maintenance of change on the ECBI-P score, ECBI Intensity Scale score, and Social Competence Scale score at the 6-month follow-up; percentage of child behavior scores in the clinical range after treatment; retention; and attendance.ResultsA total of 126 parents (112 women and 14 men; mean [SD] age, 34.7 [8.4] years) were included; 63 parents were randomly assigned to each intervention group. Analysis of variance using intention to treat showed no significant difference between groups after treatment (P = .62). At follow-up, there was a medium effect (d = 0.63) showing a significant benefit from IYP plus HPS of 3.6 (95% CI, 0.8-6.5) on the ECBI-P score (F1,124 = 6.3; P = .01). Families receiving the IYP plus HPS intervention had significantly fewer children with child behavior scores in the clinical range after treatment (9 of 51 [17.6%]) compared with families receiving the IYP program alone (18 of 45 [40.0%]), and this status was maintained at follow-up. The HPS intervention had better retention than the IYP program (dropout, 7 [5.6%] vs 16 [12.7%]) as well as better attendance.Conclusions and relevanceIn this trial, the IYP plus HPS intervention significantly improved outcomes for the most vulnerable families at 6 months. This study demonstrated that the HPS intervention is an effective addition to the IYP program to improve engagement and implementation of IYP program strategies and enhance child behavior outcomes for the most vulnerable families.Trial registrationhttp://anzctr.org.au Identifier: ACTRN12612000878875.

Project description:BackgroundStudies investigating dietary resemblance between parents and their children have gained mixed results, and the resemblance seems to vary across nutrients, foods, dietary-assessment tools used, and parent-child pairs. We investigated parent-child dietary resemblance using a novel approach in applying statistical analysis, which allowed the comparison of 'whole-diet' between parents and their children. Additionally, we sought to establish whether sociodemographic factors or family meals were associated with dietary resemblance and whether parent-child dietary resemblance was dependent on the parent providing food consumption data on behalf of the child (father or mother, "the respondent").MethodsThe DAGIS study investigated health behaviors among Finnish preschoolers using a cross-sectional design. One parent filled in a food frequency questionnaire (FFQ) measuring the child's food consumption outside preschool hours during the last week. In addition, we instructed both parents or legal guardians, should the child have two, to fill in a similar FFQ regarding their own food use. Parents also reported their educational level, the number of children living in the same household, and the number of family meals. As a measure of dietary resemblance between a parent and a child, we computed Spearman correlations ranging mostly from no resemblance (0) to complete resemblance (+ 1) between parent-child pairs over the 'whole-diet' (excluding preschool hours). These resemblance measures were further investigated using linear mixed models.ResultsWe obtained 665 father-child and 798 mother-child resemblance measures. Mother-child resemblance was on average 0.57 and stronger than father-child resemblance (0.50, p < 0.0001), which was explained by a parent-respondent interaction: the diet of the child resembled more the diet of the parent who provided food consumption data for the child. In univariate models, father- and mother-reported number of family meals were positively associated with father-child and mother-child resemblances. Mother-reported number of family meals was positively associated with mother-child resemblance in a full model.ConclusionsThe diet of the child seems to resemble more the diet of the parent responsible for the reporting of food consumption. Studies should report who provided the food consumption data for the child and take this into account in analyses, since reporter-bias can influence the results.

Dataset Information

Promoting parent-child relationships and preventing violence via home-visiting: a pre-post cluster randomised trial among Rwandan families linked to social protection programmes.

Publications

Promoting parent-child relationships and preventing violence via home-visiting: a pre-post cluster randomised trial among Rwandan families linked to social protection programmes.

Similar Datasets

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