Draper Catherine E, Howard Steven J, Rochat Tamsen J
Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.
South African MRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Chris Hani Baragwanath Hospital, Soweto, South Africa.
Child Care Health Dev. 2019 Nov;45(6):823-831. doi: 10.1111/cch.12714. Epub 2019 Aug 6.
The aim of this study was to assess the feasibility and acceptability of a home-based intervention-Amagugu Asakhula-to promote nurturing interactions and healthy behaviours with the caregivers of preschool children. Amagugu Asakhula means "treasures that are still growing" and focuses on children's cognitive development, physical activity, screen time, diet and sleep while also promoting the caregiver-child relationship.
This study took place in a low-income setting in Cape Town, South Africa. The 6-week intervention was implemented by community health workers (CHWs) with 20 caregivers of preschool children. CHWs provided written feedback on intervention sessions, and two focus groups were conducted, one with the CHWs involved (n = 4) and another with caregivers (n = 6), to obtain their feedback on the intervention and its implementation. Data were collated according to themes relating to implementation. In this pilot study, training and recruitment proved feasible and were facilitated by partnership with a community-based organization.
The intervention was generally implemented as intended, in terms of dose and delivery. Family support and active engagement of caregivers' preschool children in intervention activities were reported by CHWs and caregivers, and CHWs also reported mostly positive interactions with caregivers. CHWs and caregivers perceived the intervention to have benefits relating to the following: caregivers' awareness and knowledge of health behaviours, awareness of their role, changes in behaviours, and connection between the caregiver and child. The only change to the intervention suggested was the inclusion of some group sessions to promote support amongst intervention participants and sustain engagement in the intervention.
The findings of this pilot study indicate that Amagugu Asakhula was both feasible and acceptable with caregivers of preschool children in a low-income urban setting. Further research is needed to assess the extent to which this intervention has an objective and measurable effect on intended outcomes.
本研究的目的是评估一种以家庭为基础的干预措施——阿马古古·阿萨库拉（Amagugu Asakhula），以促进与学龄前儿童照料者之间的养育互动和健康行为。阿马古古·阿萨库拉意为“仍在成长的宝藏”，专注于儿童的认知发展、身体活动、屏幕使用时间、饮食和睡眠，同时也促进照料者与儿童之间的关系。
本研究在南非开普敦的一个低收入社区开展。为期6周的干预措施由社区卫生工作者（CHWs）对20名学龄前儿童的照料者实施。社区卫生工作者就干预课程提供书面反馈，并开展了两个焦点小组讨论，一个是与参与的社区卫生工作者（n = 4）进行，另一个是与照料者（n = 6）进行，以获取他们对干预措施及其实施情况的反馈。数据根据与实施相关的主题进行整理。在这项试点研究中，培训和招募被证明是可行的，并且通过与一个社区组织的合作得以顺利进行。
就剂量和实施方式而言，干预措施总体上按计划实施。社区卫生工作者和照料者报告了家庭支持以及照料者照管的学龄前儿童积极参与干预活动的情况，社区卫生工作者还报告了与照料者之间大多是积极的互动。社区卫生工作者和照料者认为该干预措施在以下方面有益：照料者对健康行为的意识和知识、对自身角色的认识、行为改变以及照料者与儿童之间的联系。所建议的对干预措施的唯一改变是增加一些小组课程，以促进干预参与者之间的支持并维持对干预措施的参与度。
这项试点研究的结果表明，在城市低收入环境中，阿马古古·阿萨库拉对学龄前儿童的照料者来说既可行又可接受。需要进一步研究来评估这种干预措施对预期结果产生客观和可衡量影响的程度。
