CASITA Intervention for Children at Risk of Delay in Carabayllo, Peru

Mass General Brigham

Status: Completed

Conditions: Community Health Workers; Child Developmental Delay; Child Development; Low Income Population

Treatments: Other: CASITA

Study type: Interventional

Funder types: Other

Identifiers

NCT03010306

2013P002554

Details and patient eligibility

About

Building on an intervention for early child development from the SPARK Center in Boston, Socios En Salud (SES) pilot tested "CASITA" a community-based package to screen and treat young children (ages 1-3 years of age) diagnosed with neurodevelopment risk and delay in Carabayllo, Lima, Peru. Ministry of Health CHWs identified children with developmental delays within the clinics and community and delivered a structured early intervention that included parent coaching and social support. In order to test the hypothesis that CASITA improves early child development, caregiver, and home environment, dyads received either nutrition supplements alone, nutrition + "CASITA" early child development sessions individually, or CASITA in a group of 10 dyads.

Enrollment: 61 patients

Sex: All

Ages: 6 to 24 months old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Age between 6 - 24 months of age;
2. Known primary caregiver (parent or legal guardian) living with child;
3. Living within the catchment area of the 6 Health Centers that comprise the study zone.
4. Screen positive for neurodevelopment delay ("at risk" or "delayed" in neurodevelopment based on Evaluation del Desarrollo Psicomotor (EEDP) assessment).
5. Be at risk by scoring <45 on the Progress Out of Poverty Index.

Exclusion criteria

1. A known medical condition that would make the child unresponsive to early intervention;
2. Family anticipates moving within the next three months.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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61 participants in 2 patient groups

Nutrition only

No Intervention group

Description:

Monthly food baskets were provided to the nutrition only group. Food baskets included basic foods to sustain a family of three over one month's time, such as rice and evaporated milk. Food baskets were valued at approximately $28 US Dollars per basket.

Nutrition + CASITA

Active Comparator group

Description:

The CASITA intervention was given by a community health worker (CHW) and involves individual and group modalities. HOME-CASITA took place at the dyad's place of residence, and the GROUP-CASITA at a local community center. All CASITA participants received 12 weekly sessions over 3 months. Interventions retain core elements of the SPARK approach: coaching parents on child development stimulation and providing social support and encouragement. Each session is as follows: 1) Child observation \& knowledge sharing about child development; 2) Practice of reciprocal attention focusing and social interaction activities; 3) Parent encouragement on behavior and developmental interactions; and 4) Parent social support through referral assistance, reassurance, and validation of parent's concerns.

Treatment:

Other: CASITA