Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2004 Jul 10;329(7457):89.
doi: 10.1136/bmj.38132.503472.7C. Epub 2004 Jun 24.

Feasibility of integrating early stimulation into primary care for undernourished Jamaican children: cluster randomised controlled trial

Christine Powell  1 , Helen Baker-Henningham, Susan Walker, Jacqueline Gernay, Sally Grantham-McGregor
Affiliations
Clinical Trial

Feasibility of integrating early stimulation into primary care for undernourished Jamaican children: cluster randomised controlled trial

Christine Powell et al. BMJ. .

Abstract

Objectives: To assess the feasibility of integrating early psychosocial stimulation into primary care for undernourished children and to determine the effect on children's development and mothers' knowledge and practices of childrearing.

Design: Cluster randomised controlled trial.

Setting: 18 clinics in three Jamaican parishes.

Participants: 139 undernourished children aged 9 to 30 months and their mothers enrolled in intervention or control clinics.

Interventions: Weekly home visits by community health aides for one year in addition to usual duties. Parenting issues were discussed with the mothers and play activities were demonstrated with the children using homemade materials.

Main outcome measures: Children's scores on the Griffiths mental development scales and mothers' knowledge and practices of childrearing measured by questionnaires.

Results: Children from the intervention group showed significant improvements in development: developmental quotient, 7.8 points (95% confidence interval 4.5 to 11.1); hearing and speech, 10.7 (5.9 to 15.4 points); hand and eye coordination, 6.8 (3.4 to 10.1 points); and performance subscale, 11.0 (5.6 to 16.4 points). No improvements were shown on the locomotor subscale. The mothers from the intervention group showed improved knowledge and practices of childrearing. Change in children's body mass index and height independently affected change in development.

Conclusion: Integrating parenting skills and early psychosocial stimulation for undernourished children into primary care was feasible and effective in improving the children's development and mothers' knowledge and practices of childrearing.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Flow of clinics and mother-child dyads through trial
See this image and copyright information in PMC

Comment in

  • Role of poverty must be emphasised.
    Black J, Loff B, Potts H. Black J, et al. BMJ. 2004 Aug 7;329(7461):352. doi: 10.1136/bmj.329.7461.352-d. BMJ. 2004. PMID: 15297358 Free PMC article. No abstract available.

References

    1. United Nations Administrative Committee on Coordination/Subcommittee on Nutrition. Fourth report on the world nutrition situation. Geneva: ACC/SCN in collaboration with International Food Policy Research Institute, 2000.
    1. Pollitt E, Schurch B, eds. Undernutrition and behavioral development in children. J Nutr 1995;125: S2255-62.
    1. Grantham-McGregor S, Powell C, Walker S, Chang S, Fletcher P. The long term follow up of severely malnourished children who participated in an intervention program. Child Dev 1994;65: 428-39. - PubMed
    1. Walker S, Grantham-McGregor S, Powell C, Chang S. Effects of growth restriction in early childhood on growth, IQ and cognition at age 11 to 12 years and the benefits of nutritional supplementation and psychosocial stimulation. J Pediatr 2000;137: 36-41. - PubMed
    1. Unicef. The state of the world's children 2001: early childhood. New York: Unicef, 2001.

Publication types