Isanovic Sejla, Sanoe Musa, Wooten Shelbie, Frongillo Edward A, Yousafzai Aisha K, Blake Christine E, Kanyangarara Mufaro, Swan Melanie, Rodger Nicole, Murray Miriam, Larson Leila M
Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America.
Plan International, Plan International Liberia, Congo Town, Monrovia, Liberia.
PLoS One. 2024 Dec 13;19(12):e0311486. doi: 10.1371/journal.pone.0311486. eCollection 2024.
In Liberia, children are exposed to multiple forms of adversity which can negatively impact their health and development. Research is needed to examine the feasibility and benefits of integrated interventions that can be incorporated into existing health delivery programs to simultaneously address low responsive stimulation, undernutrition, and infection. This study assessed the feasibility of an integrated intervention promoting psychosocial stimulation and improved child feeding by the provision of eggs and fish. The integrated intervention was incorporated into an existing government health program. Thirty female caregiver-child dyads were randomly selected from two rural communities in Liberia. Participants received fortnightly group parenting sessions and weekly eggs and fish designated for child consumption, for four weeks. Trained community health workers delivered the intervention. Assessments were conducted before and after the intervention using quantitative surveys and qualitative interviews. At baseline, we examined the home environment, caregiver-child interactions, diet, and infection control practices. At endline, we assessed the feasibility of the intervention. Descriptive analyses were conducted with quantitative data. Qualitative data were analyzed using conventional content analysis. Baseline findings indicated uncommon responsive parenting, inadequate early learning opportunities, high food insecurity, and high child morbidity. Mixed methods indicators of feasibility, including acceptability, adoption, and fidelity were high. Qualitative data from this feasibility study informed several future modifications to the program, including engaging fathers, supplementing group sessions with home visits, and broadening facilitator eligibility. This integrated intervention is feasible and can be incorporated into existing health programs to support early child development.
在利比里亚，儿童面临多种形式的逆境，这些逆境会对他们的健康和发展产生负面影响。需要开展研究，以检验综合干预措施的可行性和益处，这些措施可纳入现有的卫生服务项目，以同时解决反应性刺激不足、营养不良和感染问题。本研究评估了通过提供鸡蛋和鱼类促进心理社会刺激并改善儿童喂养的综合干预措施的可行性。该综合干预措施被纳入现有的政府卫生项目。从利比里亚的两个农村社区中随机挑选了30对女性照顾者-儿童二元组。参与者每两周参加一次集体育儿课程，并每周获得指定供儿童食用的鸡蛋和鱼类，为期四周。经过培训的社区卫生工作者实施了该干预措施。在干预前后使用定量调查和定性访谈进行评估。在基线时，我们检查了家庭环境、照顾者与儿童的互动、饮食和感染控制措施。在终线时，我们评估了干预措施的可行性。对定量数据进行了描述性分析。使用常规内容分析法对定性数据进行了分析。基线调查结果表明，反应性育儿方式不常见、早期学习机会不足、粮食不安全程度高以及儿童发病率高。可行性的混合方法指标，包括可接受性、采用率和保真度都很高。这项可行性研究的定性数据为该项目未来的一些修改提供了参考，包括让父亲参与、通过家访补充集体课程以及扩大促进者的资格范围。这种综合干预措施是可行的，可以纳入现有的卫生项目，以支持幼儿发展。
