Jin Xingming, Sun Yajuan, Jiang Fan, Ma Jun, Morgan Christopher, Shen Xiaoming
Department of Paediatric Development and Behaviour, Shanghai Children's Medical Centre, Shanghai, China.
J Dev Behav Pediatr. 2007 Jun;28(3):213-8. doi: 10.1097/dbp.0b013e31802d410b.
The aim of this study was to test the efficacy and appropriateness of the World Health Organization's Care for Development (CFD) counseling materials, which form part of the Integrated Management of Childhood Illness (IMCI) strategy. The CFD materials are based on the Mother's Card, which contained age-specific messages on how caregivers can better play and communicate with a child.
We enrolled 100 families with a child of younger than 2 years of age from seven randomly selected villages in an impoverished rural county in Anhui Province, China. Two counseling sessions, using the CFD Mother's Card, were provided to 50 families randomly selected from among the study participants. All children were assessed with Gesell Developmental Schedules before counseling and after 6 months. A questionnaire on family situation and knowledge, attitudes, and practices regarding child development was also administered at the start and conclusion of the study.
At baseline assessment, both control and intervention groups were equal, with average developmental scores less than the national norms. Children in families who received counseling had significantly higher development quotient scores in cognitive, social, and linguistic domains. Questionnaire data on child rearing suggested that responsive and rich interactions and consistent caregivers correlated with higher scores. The CFD Mother's Card was found to be feasible and helpful in those families who received counseling.
There is urgent need for further work on promotion of child development in rural China. The World Health Organization's CFD approach and Mother's Card is feasible and effective and should be expanded in use, especially within the national IMCI program.
本研究旨在测试世界卫生组织的儿童发展关爱（CFD）咨询材料的有效性和适用性，这些材料是儿童疾病综合管理（IMCI）战略的一部分。CFD材料基于母亲卡片，其中包含关于照顾者如何更好地与儿童玩耍和交流的特定年龄信息。
我们从中国安徽省一个贫困农村县的七个随机选择的村庄中招募了100个有2岁以下儿童的家庭。从研究参与者中随机选择50个家庭，使用CFD母亲卡片进行两次咨询。所有儿童在咨询前和6个月后都用盖塞尔发育量表进行评估。在研究开始和结束时还发放了一份关于家庭情况以及儿童发展的知识、态度和做法的问卷。
在基线评估时，对照组和干预组情况相同，平均发育得分低于国家规范。接受咨询的家庭中的儿童在认知、社交和语言领域的发育商得分显著更高。关于育儿的问卷数据表明，积极响应和丰富的互动以及始终如一的照顾者与更高的得分相关。发现CFD母亲卡片对接受咨询的家庭是可行且有帮助的。
中国农村迫切需要进一步开展促进儿童发展的工作。世界卫生组织的CFD方法和母亲卡片是可行且有效的，应扩大使用，特别是在国家IMCI项目中。
