The Effectiveness and Cost-effectiveness of a Parenting Intervention Integrated with Primary Health Care on Early Childh
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The Effectiveness and Cost-effectiveness of a Parenting Intervention Integrated with Primary Health Care on Early Childhood Development: a Cluster-Randomized Controlled Trial Huifeng Shi 1 & Xuejun Li 2 & Hai Fang 3 & Jingxu Zhang 1 & Xiaoli Wang 1
# Society for Prevention Research 2020
Abstract Developing countries require interventions that can sustainably improve early childhood development (ECD) at scale because hundreds of millions of children are at risk of poor development. This study examined the effectiveness and cost-effectiveness of a parenting intervention integrated with primary health care in terms of ECD. A cluster-randomized controlled trial was conducted in 20 urban communities in China, with 82 and 86 children aged 1–2 months enrolled in the intervention and control groups, respectively, and 71 and 69 children, respectively, followed to 14 months of age. All children in both groups received routine primary health care services. Intervention caregivers received a parenting pamphlet and two parenting training sessions during well-child clinic visits; those with children with suspected developmental delay received additional parenting guidance by telephone. Compared with controls, children receiving the intervention had similar developmental outcomes, measured with the Chinese version of the Ages & Stages Questionnaires third edition (ASQ-C), at baseline, but had significantly higher communication (adjusted mean difference = 0.26; 95% CI 0.03, 0.51), fine motor (adjusted mean difference = 0.19; 95% CI 0.01, 0.37), and overall (adjusted mean difference = 0.25; 95% CI 0.10, 0.41) ASQ-C z-scores after 12 months of the intervention. The intervention cost per child was $50.87, and the costs for increasing the communication, fine motor, and overall ASQ-C scores by one SD were $195.65, $267.74, and $203.48, respectively. Our findings indicate that the integration of a parenting intervention with existing primary health care is a cost-effective way to improve ECD. Keywords Parenting intervention . Primary health care . Child development
Childhood development refers to the dynamic development of perceptual, motor, cognitive, linguistic, socio-emotional, and Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11121-020-01126-2) contains supplementary material, which is available to authorized users. * Xuejun Li [email protected] * Xiaoli Wang [email protected] 1
Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 38 Xueyuan Road, Haidian District, Beijing 100191, China
2
Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 168 Litang Road, Changping District, Beijing 102218, China
3
China Center for Health Development Studies (CCHDS), Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
self-regulation skills (Black et al. 2017). The first 3 years of life are critical in development, during which the foundations for health, development, and achievement are l
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