Scaling up home-visiting to promote early childhood development and prevent violence in Rwanda: a hybrid type-2 effectiveness-implementation trial

被引:0
作者
Black, Candace J. [1 ]
Placencio-Castro, Matias [1 ]
Phend, Gabriela [1 ]
Havugimana, Jean Marie Vianney [2 ]
Umulisa, Grace [2 ]
Uwamahoro, Pacifique [2 ]
Nyirahabimana, Marie Gaudence [2 ]
Bond, Laura [1 ]
Hernandez, Kayla [1 ]
Jensen, Sarah K. G. [3 ,4 ]
Kajani, Ursula [5 ]
Murray, Shauna M. [1 ]
Rawlings, Laura B. [6 ]
Sezibera, Vincent [7 ]
Betancourt, Theresa S. [1 ]
机构
[1] Boston Coll, Sch Social Work, 140 Commonwealth Ave, Chestnut Hill, MA 02467 USA
[2] FXB Rwanda, Kigali, Rwanda
[3] Boston Childrens Hosp, Boston, MA USA
[4] Harvard Med Sch, Boston, MA USA
[5] Emory Univ, Carter Ctr, Atlanta, GA USA
[6] World Bank, Washington, DC USA
[7] Univ Rwanda, Coll Med & Hlth Sci, Kigali, Rwanda
关键词
Implementation science; implementation strategy; Hybrid Type-2 Trial; early child development; global health; violence prevention; father engagement; poverty; social protection; home-visiting; FOLLOW-UP; STIMULATION; CHILDREN; INTERVENTIONS; PROGRAMS; SUPPLEMENTATION; INSTRUMENT; COGNITION; BENEFITS; GROWTH;
D O I
10.1111/jcpp.14160
中图分类号
B844 [发展心理学(人类心理学)];
学科分类号
040202 ;
摘要
Background: Children in impoverished families-especially those affected by violence-face risks to healthy development. In the years of strong economic recovery since the 1994 Genocide Against the Tutsi, the Rwandan Government has invested in early child development, social and child protection and violence prevention, but few strategies for scaling evidence-based interventions (EBIs) in these areas have been studied. Methods: We present a Hybrid Type-2 Implementation-Effectiveness study of the PLAY Collaborative implementation strategy to engage government and other stakeholders in scaling Sugira Muryango (SM, "Strong Family") to families eligible for social protection in three rural districts. SM promotes nurturing care of children under three while reducing family violence. We assessed delivery quality (fidelity, competence) and perceptions of the PLAY Collaborative (e.g, feasibility, leadership, organisation, sustainability). An embedded trial of 538 households (778 caregivers, 555 children) tested SM effectiveness when delivered by child protection volunteers. Results: Child protection volunteers delivered SM with high fidelity and competence that improved with time and routine supervision. The PLAY Collaborative was rated moderately to highly across implementation outcomes. The embedded trial revealed improvements in children's stimulation at home (d = 0.20, 95% CI: 0.04-0.36) as caregivers involved them more in daily activities (d = 0.37, 95% CI: 0.18-0.57) and provided more learning materials (d = 0.37, 95% CI: 0.16-0.59). SM families increased stimulating care (e.g. singing, playing; d = 0.26, 95% CI: 0.07-0.46); involved fathers more in caregiving (IRR = 1.18, 95% CI: 1.03-1.37); reduced harsh discipline (OR = 0.34, 95% CI: 0.14-0.82); and increased dietary diversity (d = 0.25, 95% CI: 0.04-0.45). SM caregivers reported improved mental health (d = -0.13, 95% CI: -0.26 to -0.01). SM households increased safe water storage (OR = 3.14, 95% CI: 1.64-6.03) and water treatment (OR = 3.56, 95% CI: 1.80-7.05) practices. Conclusions: The PLAY Collaborative successfully overcame implementation barriers and maintained effectiveness across most outcomes while scaling delivery to N = 8,745 families, highlighting the value of systematically investigating implementation strategies while scaling an EBI as integrated into existing social and child protection systems.
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页数:16
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  • [41] The Role of Home-Visiting Programs in Preventing Child Abuse and Neglect
    Howard, Kimberly S.
    Brooks-Gunn, Jeanne
    [J]. FUTURE OF CHILDREN, 2009, 19 (02) : 119 - 146
  • [42] Interagency Collaborative Team model for capacity building to scale-up evidence-based practice
    Hurlburt, Michael
    Aarons, Gregory A.
    Fettes, Danielle
    Willging, Cathleen
    Gunderson, Lara
    Chaffin, Mark J.
    [J]. CHILDREN AND YOUTH SERVICES REVIEW, 2014, 39 : 160 - 168
  • [43] Institute for Health Metrics and Evaluation, 2022, COVID19
  • [44] Family Violence Reduction Within a Parenting Intervention in Rwanda: A Mixed-Methods Study
    Jensen, Sarah K. G.
    Murray, Shauna M.
    Placencio-Castro, Matias
    Kajani, Ursula
    Amponsah, Deborah
    Sezibera, Vincent
    Betancourt, Theresa S.
    [J]. PEDIATRICS, 2023, 151
  • [45] Effect of a home-visiting parenting program to promote early childhood development and prevent violence: a cluster-randomized trial in Rwanda
    Jensen, Sarah K. G.
    Placencio-Castro, Matias
    Murray, Shauna M.
    Brennan, Robert T.
    Goshev, Simo
    Farrar, Jordan
    Yousafzai, Aisha
    Rawlings, Laura B.
    Wilson, Briana
    Habyarimana, Emmanuel
    Sezibera, Vincent
    Betancourt, Theresa S.
    [J]. BMJ GLOBAL HEALTH, 2021, 6 (01):
  • [46] Short-term, medium-term and long-term effects of early parenting interventions in low- and middle-income countries: a systematic review
    Jeong, Joshua
    Pitchik, Helen O.
    Fink, Guenther
    [J]. BMJ GLOBAL HEALTH, 2021, 6 (03):
  • [47] Improving Parenting Practices for Early Child Development: Experimental Evidence from Rwanda
    Justino, Patricia
    Leone, Marinella
    Rolla, Pierfrancesco
    Abimpaye, Monique
    Dusabe, Caroline
    Uwamahoro, Marie D.
    Germond, Richard
    [J]. JOURNAL OF THE EUROPEAN ECONOMIC ASSOCIATION, 2023, 21 (04) : 1510 - 1550
  • [48] 8-Year Follow-up of a Maternal Education Trial in a Low-Resource Setting
    Kakwangire, Paul
    Muhoozi, Grace
    Ngari, Moses
    Matovu, Nicholas
    Westerberg, Ane Cecilie
    Iversen, Per Ole
    Atukunda, Prudence
    [J]. PEDIATRICS, 2024, 153 (04)
  • [49] The Future of Parenting Programs: II Implementation
    Lansford, Jennifer E.
    Betancourt, Theresa S.
    Boller, Kimberly
    Popp, Jill
    Altafim, Elisa Rachel Pisani
    Attanasio, Orazio
    Raghavan, Chemba
    [J]. PARENTING-SCIENCE AND PRACTICE, 2022, 22 (03): : 235 - 257
  • [50] Love and peace across generations: Biobehavioral systems and global partnerships
    Leckman, James F.
    Ponguta, Liliana Angelica
    Pavarini, Gabriela
    Hein, Sascha D.
    Mccarthy, Michael F.
    Staiti, Haifa
    Hanoz-Penney, Suna
    Rubinstein, Joanna
    Pruett, Kyle D.
    Yazgan, M. Yanki
    Fallon, N. Shemrah
    Hartl, Franz J.
    Ziv, Margalit
    Salah, Rima
    Britto, Pia Rebello
    Fitzpatrick, Siobhan
    Panter-Brick, Catherine
    [J]. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY, 2021, 8