Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Aga Khan University Karachi, Sindh, Pakistan.
Trials. 2021 Aug 17;22(1):542. doi: 10.1186/s13063-021-05518-9.
The Sustainable Development Goals (SDGs) highlight the importance of investments in early childhood care and education (ECCE) and youth development. Given Pakistan's large young population, and gender and urban-rural inequalities in access to education, training, and employment, such investments offer opportunities. LEAPS is a youth-led ECCE program that trains female youth, 18-24 years, as Community Youth Leaders (CYLs) to deliver high-quality ECCE for children, 3.5-5.5 years, in rural Sindh, Pakistan.
We use a stepped wedge cluster-randomized trial to evaluate implementation of LEAPS. Ninety-nine clusters will be randomized to receive the intervention in one of three 7-month steps (33 clusters/step). The primary outcome is children's school readiness (indexed by the total score on the International Development and Early Learning Assessment (IDELA)). Secondary child outcomes are children's IDELA domain scores and executive functions. Data are collected in cross-sectional surveys of 1089 children (11 children/cluster from 99 clusters) aged 4.5-5.5 years at four timepoints (baseline and at the end of each step). Additionally, we will enroll three non-randomized youth participant open cohorts, one per step (33 CYLs: 66 comparison youth per cohort; 99:198 in total). Youth cohorts will be assessed at enrollment and every 7 months thereafter to measure secondary outcomes of youth personal and professional development, depressive symptoms, and executive functions. A non-randomized school cohort of 330 LEAPS students (10 students/cluster from 33 clusters) will also be enrolled and assessed during Step 1 after intervention rollout and at endline. The quality of the learning environment will be assessed in each LEAPS ECCE center and in a comparison center at two timepoints midway following rollout and at endline. A concurrent mixed-methods implementation evaluation will assess program fidelity and quality, and the extent to which a technical support strategy is successful in strengthening systems for program expansion. A cost evaluation will assess cost per beneficiary. Data collection for implementation and cost evaluations will occur in Step 3.
Youth-led models for ECCE offer a promising approach to support young children and youth. This study will contribute to the evidence as a means to promote sustainable human development across multiple SDG targets.
ClinicalTrials.gov NCT03764436 . Registered on December 5, 2018.
可持续发展目标（SDGs）强调了对儿童早期保育和教育（ECCE）以及青年发展进行投资的重要性。鉴于巴基斯坦庞大的青年人口，以及在获得教育、培训和就业方面存在的性别和城乡不平等，此类投资提供了机会。LEAPS 是一个由青年主导的 ECCE 项目，该项目培训 18-24 岁的女性青年作为社区青年领袖（CYL），为巴基斯坦信德省农村地区 3.5-5.5 岁的儿童提供高质量的 ECCE。
我们使用阶梯式楔形集群随机试验来评估 LEAPS 的实施情况。九十九个集群将被随机分配在三个 7 个月的步骤（每步骤 33 个集群）中接受干预。主要结果是儿童的入学准备情况（由国际发展和早期学习评估（IDELA）的总分表示）。次要儿童结果是儿童 IDELA 领域分数和执行功能。在四个时间点（基线和每个步骤结束时），通过对 99 个集群中的 1089 名 4.5-5.5 岁儿童（每个集群 11 名儿童）进行横断面调查收集数据。此外，我们将招募三个非随机青年参与者开放队列，每个队列一个（每个队列 33 名 CYL：每个队列 66 名对照青年，共 99 名）。青年队列将在入组时和此后每 7 个月进行评估，以测量青年个人和专业发展、抑郁症状和执行功能的次要结果。在干预推出后和终点线时，还将招募一个由 330 名 LEAPS 学生组成的非随机学校队列（每个队列 10 名学生，共 33 个队列）进行评估。在推出后和终点线的两个时间点，将在每个 LEAPS ECCE 中心和一个对照中心评估学习环境的质量。同时进行的混合方法实施评估将评估方案的一致性和质量，以及技术支持策略在加强方案扩大的系统方面的成功程度。成本评估将评估每位受益人的成本。实施和成本评估的数据收集将在第 3 步进行。
青年主导的 ECCE 模式为支持幼儿和青年提供了一种有前途的方法。这项研究将为促进多个可持续发展目标目标的可持续人类发展提供证据。
ClinicalTrials.gov NCT03764436。于 2018 年 12 月 5 日注册。
