Experimental Evaluation of Semillas de Apego
Condition: Child Development; Attachment Disorder; Exposure to Violent Event; Parenting
Study type: Interventional

Summary: 
      The current trial focuses on the effectiveness evaluation of Semillas de Apego in Tumaco, a
      municipality in Colombia heavily affected by violence and poverty. Over a time-span of 23
      months, the researchers will follow the implementation of Semillas de Apego with 40 groups of
      16 participants each, all of them mothers or primary caregivers of children 2 to 5. This will
      allow the researchers to reach a total of 640 participants and their children. The impact
      evaluation will be based on a cluster- randomized control trial in which the researchers will
      assign 1280 eligible subjects, nested within 18 child development centers, to either an
      intervention arm or a control group. The former group will participate in 15 group-led
      session over the period of 3 months; the latter will continue to have access to the regular
      early childhood programs offered through the centers to which children are affiliated. Data
      will be collected at baseline and two follow-ups: 1 and 12 months after the implementation
      has concluded. The researchers hypothesize that the program will have a positive and
      sequential impact on the following dimensions: (i) primary caregiver's mental health, (ii)
      child rearing practices, (iii) quality of child-parent emotional bond, (iv) children's mental
      health, and (v) children's cognitive and socioemotional development.
    

Detailed description: 
      Over half a million children between 0 and 5 years of age in Colombia have been affected by a
      civil conflict that has spanned over six decades. Exposure to violence during early
      childhood, or being born to a household that has been formerly victimized, may have
      devastating consequences on early childhood cognitive and socio-emotional development. In
      doing so, violence can compromise the right to lead healthy and productive lives for
      thousands of children in Colombia.

      First, violence leaves a legacy of poverty and psychological trauma (Ibañez & Moya, 2010;
      Moya, 2018). Children who experienced violence during early childhood lag in cognitive,
      social, and emotional development, while exposure to violence increases the probability of
      child neglect (Harker, Moya, & Riveros, 2015; Cuartas, Harker, & Moya, 2015). Protecting
      children from effects of violence, toxic stress, and deficits in family care is therefore one
      of the key challenges as Colombia transitions into a post-conflict stage and for the
      construction of a more equal and peaceful society. More generally, identifying cost effective
      ways to protect children and children from the effects of violence, toxic stress, and
      deficits in maternal care is a key challenge in contexts of violence and humanitarian crises.

      Recent evidence exploring the effect of interventions to promote positive child-development
      suggest a promising path through the attention to their caregivers (Singla Kumbakumba, &
      Aboud, 2015; Rahman et al., 2013). Building from this evidence, in this trial the researchers
      will evaluate the effectiveness of a group-based psychosocial program (Semillas de Apego) for
      victimized caregivers with children 2 to 5 in Colombia, a country devastated by violence. The
      program promotes healthy child-parent attachments as a pathway for a proper development among
      children exposed to violence. By fostering caregivers' mental health and their capacity to
      become a source of emotional protection, the intervention helps children reach their full
      potential amid such traumatic circumstances. Delivered in a 15-week curriculum, Semillas de
      Apego first provides tools so that victimized caregivers can start processing their own
      trauma. Then, the program focuses on allowing a proper understanding of the child's
      development trajectories and how they affected by the experience of adversities (such as
      violence exposure). Finally, the curriculum works towards fostering positive child-rearing
      practices. Taken together, Semillas de Apego's curriculum aims to foster the healthy
      child-parent attachments that promote appropriate affect regulation and healthy emotional
      development in the midst of adverse circumstances.

      The current trial focuses on the effectiveness evaluation of Semillas de Apego in Tumaco, a
      municipality in Colombia heavily affected by violence and poverty. Over a time-span of 23
      months, the researchers will follow the implementation of Semillas de Apego with 40 groups of
      16 participants each, all of them mothers or primary caregivers of children 2 to 5. This will
      allow the researchers to reach a total of 640 participants and their children. The impact
      evaluation will be based on a cluster- randomized control trial in which 1280 eligible
      subjects, nested within 18 child development centers, will be assigned to either an
      intervention arm or a control group. The former group will participate in 15 group-led
      session over the period of 3 months; the latter will continue to have access to the regular
      early childhood programs offered through the centers to which children are affiliated. Data
      will be collected at baseline and two follow-ups: 1 and 12 months after the implementation
      has concluded. The researchers hypothesize that the program will have a positive and
      sequential impact on the following dimensions: (i) primary caregiver's mental health, (ii)
      child rearing practices, (iii) quality of child-parent emotional bond, (iv) children's mental
      health, and (v) children's cognitive and socioemotional development.
    

Intervention name(s): Semillas de Apego
Intervention type(s): Behavioral
Intervention description(s): Group-based Primary Caregiver Intervention: Group-based psychosocial program for victimized mothers (or alternative primary caregivers) with children 2 to 5, that aims at promoting healthy child-parent attachments as a pathway for a proper development among children exposed to violence.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: early childhood development; social and emotional development; secure parenting relationships