IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v239y2019ics0277953619305398.html
   My bibliography  Save this article

Using community health workers to deliver a scalable integrated parenting program in rural China: A cluster-randomized controlled trial

Author

Listed:
  • Luo, Renfu
  • Emmers, Dorien
  • Warrinnier, Nele
  • Rozelle, Scott
  • Sylvia, Sean

Abstract

Inadequate care during early childhood can lead to long-term deficits in skill development. Parenting programs are promising tools for improving parenting practices and opportunities for healthy development. We implemented a non-masked cluster-randomized controlled trial in rural China in order to assess the effectiveness of an integrated home-visitation program that includes both psychosocial stimulation and health promotion at fostering development and health outcomes of infants and toddlers in rural China. All 6-18 month-old children of two rural townships and their main caregiver were enrolled. Villages were stratified by township and randomly assigned to intervention or control. Specifically, in September 2015 we assigned 43 clusters to treatment (21 villages, 222 caregiver-child dyads) or control (22 villages, 227 caregiver-child dyads). In the intervention group, community health workers delivered education and training on how to provide young children with psychosocial stimulation and health care (henceforth psychosocial stimulation and health promotion) during bi-weekly home visits over the period of one year. The control group received no home visits. Primary outcomes include measures of child development (i.e. the Bayley Scales of Infant and Toddler Development, third edition—or Bayley-III) and health (i.e. measures of morbidity, nutrition, and growth). Secondary outcomes are measures of parenting practices. Intention-to-treat (ITT) effects show that the intervention led to an improvement of 0·24 standard deviations (SD) [95% CI 0·04 SD-0·44 SD] in cognitive development and to a reduction of 8·1 [95% CI 3·8–12·4] percentage points in the risk of diarrheal illness. In addition, we find positive effects on parenting practices mirroring these results. We conclude that an integrated psychosocial stimulation and health promotion program improves development and health outcomes of infants and toddlers (6–30 month-old children) in rural China. Because of low incremental costs of adding program components (that is, adding health promotion to psychosocial stimulation programs), integrated programs may be cost-effective.

Suggested Citation

  • Luo, Renfu & Emmers, Dorien & Warrinnier, Nele & Rozelle, Scott & Sylvia, Sean, 2019. "Using community health workers to deliver a scalable integrated parenting program in rural China: A cluster-randomized controlled trial," Social Science & Medicine, Elsevier, vol. 239(C).
    • Handle: RePEc:eee:socmed:v:239:y:2019:i:c:s0277953619305398
    DOI: 10.1016/j.socscimed.2019.112545
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953619305398
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2019.112545?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Sylvia, Sean & Luo, Renfu & Zhong, Jingdong & Dill, Sarah-Eve & Medina, Alexis & Rozelle, Scott, 2022. "Passive versus active service delivery: Comparing the effects of two parenting interventions on early cognitive development in rural China," World Development, Elsevier, vol. 149(C).
    2. Zhong, Jingdong & Kuhn, Lena & Wang, Tianyi & Liu, Chengfang & Luo, Renfu, 2020. "The interrelationships between parental migration, home environment, and early child development in rural China: A cross-sectional study," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 17(11).
    3. Bai, Yu & Emmers, Dorien & Li, Ying & Tang, Lei, 2022. "Parental locus of control and early childhood development: Evidence on parent and grandparent caregivers in rural China," China Economic Review, Elsevier, vol. 74(C).
    4. Wu, Yichao & Guo, Zhenli, 2020. "An analysis of the nutritional status of left-behind children in rural China and the impact mechanisms of child malnutrition," Children and Youth Services Review, Elsevier, vol. 119(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:239:y:2019:i:c:s0277953619305398. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.