Michael J. Boivin|Noeline Nakasujja|Itziar Familiar?Lopez|Sarah M. Murray|Alla Sikorskii|Jorem Awadu|Cilly Shohet|Deborah Givon|Horacio Ruiseñor-Escudero|Elizabeth E. Schut|Robert O. Opoka|Judith Bass
Effect of Caregiver Training on the Neurodevelopment of HIV-Exposed Uninfected Children and Caregiver Mental Health: A Ugandan Cluster-Randomized Controlled Trial
Michigan State University|University of Michigan–Ann Arbor|Makerere University|Michigan State University|Johns Hopkins University|Michigan State University|Michigan State University|Bar-Ilan University|Bar-Ilan University|Michigan State University|Michigan State University|Makerere University|Johns Hopkins University
abstract objective early childhood development programs typically combine healthy nutrition cognitive stimulation integrated model separately delivered 2 components clusterrandomized controlled trial evaluate comparative effectiveness promoting healthy child development caregiver mental health first study hivaffected children infected mothers methods two hundred twentyone hivexposed uninfected child 23 years old caregiver dyads 18 geographic clusters eastern uganda randomized cluster receive biweekly individualized sessions either 1 mediational intervention sensitizing caregivers misc training emphasizing cognitive stimulation 2 uganda community based association child welfare ucobac program delivered health nutrition training children evaluated baseline 6 months 1 year training conclusion 1year posttraining mullen scales early learning msel colorobject association test memory early childhood vigilance test attention behavior rating inventory executive function briefparent caldwell home observation measurement environment home completed observers gauge caregiving quality training caregiver depressionanxiety hopkins symptom checklist25 functionality list activities daily living also evaluated data collectors blinded trial arm assignment results mediational intervention sensitizing caregivers resulted significantly better quality caregiving compared ucobac midintervention adjusted mean difference adjdiff 234 95 confidence interval ci 154315 p lt 01 postintervention adjdiff 243 95 ci 161325 p lt 01 1year followup adjdiff 207 95 ci 123290 p lt 01 misc caregivers reported problems brief child 1year posttraining p lt 01 caregiving quality home significantly correlated msel composite performance 1year posttraining misc ucobac trial arms likewise physical growth significantly related child development outcomes even though differ trial arms conclusion even though misc demonstrated advantage improving caregiving quality produce better child cognitive outcomes compared health nutrition training trial registration clinicaltrialsgov identifier nct01640561