Family Strengthening Intervention for Early Childhood Development (ECD)

Study Overview
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Brief Summary
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Study activities were carried out to adapt and test a family-strengthening intervention to improve child development outcomes among families facing adversity in Rwanda.

Detailed Description
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Qualitative research from past studies was used to adapt an existing family-strengthening intervention for HIV-AIDS affected families to extremely vulnerable families with children 0-3 in order to improve early childhood development outcomes. This small scale pilot was carried out to test the feasibility and acceptability of the intervention for extremely vulnerable families with young children in Rwanda. In the first 10 families the intervention consisted of 21 modules, in the second iteration of the study with an additional 10 families, the curriculum was summarized into 15 modules. Modules were delivered by trained bachelor-level interventionists/home-visiting coaches and were delivered to families one on one in their respective homes. Modules were delivered on a weekly to biweekly basis and were flexible to the families needs and other responsibilities.

Official Title
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Adapting a Family Strengthening Intervention (FSI) to Improve Early Childhood Development (ECD) Outcomes

Conditions
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Child Development

Intervention / Treatment
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* Other: FSI ECD


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Potential participants must live in the study catchment area Caregiver(s) raising a child between 6 and 3 years old and Ubudehe 1 or 2 (Rwanda's poverty classification system) We will enroll both single and dual caregiver families to reflect population dynamics. Legal guardians may be aunts, uncles, grandparents, or foster parents Exclusion Criteria: Potential participants that do not live in the study catchment area Do not have at least one child between the ages of 0 and 3 living in their household for whom they are the primary caregiver Are not classified as Ubudehe 1 or 2 Have severe cognitive impairments which preclude their ability to speak to the research questions under study

Ages Eligible for Study
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Minimum Age: 6 Months
Maximum Age: 36 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: FSI ECD<br>Vulnerable Households (ubudehe 1 or 2) in the Government of Rwanda's poverty classification system, when categories ranged from 1 to 6; the system has since been restructured to have four categories only. Often a way to identify households for public works opportunities or other government assistance programs. For this arm, families had to be Ubudehe 1 or 2 and have a child aged 0-3 years. Households meeting these criteria in the catchment area(s) received the FSI ECD home-based parenting intervention from bachelor-level interventionists/coaches. | Other: FSI ECD<br>* The FSI ECD intervention was delivered in a structured curriculum format, covering a range of topics from health, water and sanitation, good hygiene, early stimulation, conflict resolution, to good communication. It was designed to improve vulnerable households home environment and engagement with their children in order to improve child development outcomes. The curriculum was delivered by bachelor-level trained staff with beneficiaries on an individual, one on one basis, using active coaching to promote child well being and behaviors with caregivers.<br>* Other names: Family Strengthening Intervention for ECD;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change: Ages and Stages Questionnaire | Child development | 12 months/18 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change: Hopkins Symptoms CheckList | Caregiver Mental Health | 12 months/18 months | 
| Change: MICS-5 | Water, Sanitation, and Hygeine | 12 months/18 months | 
| Change: Rwanda Comprehensive Food Security and Vulnerability Analysis and Nutrition Survey | Household Food Security | 12 months/18 months | 
| Change: Locally Derived Scale | Family Trust and Unity | 12 months/18 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ECD, parenting program, home visiting