Early Support From Birth Onwards: ZEPPELIN

University of Applied Sciences of Special Needs Education

Status: Unknown

Conditions: Early Intervention (Education)

Treatments: Other: Parents As Teachers (PAT)

Study type: Interventional

Funder types: Other

Identifiers

NCT02882763

ZEP_0-3_FU

Details and patient eligibility

About

ZEPPELIN (Zurich Equity Prevention Project with Parents Participation and Integration) is a longitudinal, randomized controlled intervention study. The main objective is to examine the effectiveness of the early intervention program "Parents As Teachers" (PAT) in psychosocially disadvantaged families. This includes four aims:

1. Identification of children at risk at an early age, using an interdisciplinary network;
2. Investigation of the acceptability of the program by the parents;
3. Evaluation of the intervention process and efficacy during and immediately after program implementation;
4. Evaluation of the efficacy in terms of child academic performance.

Full description

The preschool years represent a critical time period, with major developmental milestones in cognitive, linguistic, motoric, and emotional areas. Families tend to manage this sensitive phase in different ways, which results in an uneven distribution of educational opportunities at school entry. However, prior evidence shows that these disparities can be reduced by means of evidence-based programs in early childhood care and education (ECCE). The main focus is on the prevention of learning and behavioral disorders; for small children, this occurs by means of strengthening parenting skills.

ZEPPELIN (Zurich Equity Prevention Project with Parents Participation and Integration) is a longitudinal, randomized controlled intervention study. The main objective is to examine the of the early intervention program "Parents As Teachers" (PAT) in psychosocially disadvantaged families. This includes four aims:

1. Identification of children at risk at an early age, using an interdisciplinary network;
2. Investigation of the acceptability of the program in parents;
3. Evaluation of the intervention process and efficacy during and immediately after program implementation;
4. Evaluation of the efficacy in terms of child academic performance.

Families were recruited in the suburbs of Zurich, Switzerland, shortly before or after giving birth. Baseline measurements were conducted at 3 months postnatal (t0), before participants were assigned to either the intervention group (IG, receiving the early intervention program PAT) or control group (CG) condition, using a stratified block randomization. Follow-up data was collected at three measurement time points around the first, second and third birthday of the children (t1, t2, t3).

Further follow-up measurements will be conducted in 2017 (t4; in the 1st year of kindergarten), 2018 (t5; in the 2nd year of kindergarten), 2019 (t6; after school transition), and in 2021 (t7; in the 3rd year of primary school). This will allow us to investigate medium-term and long-term effects of early developmental conditions.

ZEPPELIN 0-3 is the first ECCE program in Switzerland that specifically targets and recruits at risk families from birth on. Families then participate in an experimental field study including a longitudinal control group comparison. As such, ZEPPELIN fills an important gap in the current literature.

Enrollment: 213 patients

Sex: All

Ages: Under 9 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Families shortly before or after child birth
• At risk situations (presence of at least two items from the core fields described below, while protective factors attenuating these risks appear absent)

Risk factors: core fields

• Personal risks, such as neglected appearance (subjective rating based on visual impression), low level of education (no further education after compulsory school years), early parenthood (mother younger than 20 years), alcohol and drug abuse, illness, disability, violence, unwanted pregnancy
• Familial risks, such as lack of self-management and planning skills), single parents, siblings with an age difference of 18 months or less, serious partnership conflicts (close to break up)
• Social risks, such as lack of social integration and support (no or only very few relationships outside the family), antisocial environment (violence, crime, prostitution)
• Material risks, such as confined living space (less than one room per person), unemployment (one or both parents), financial problems (dependency on welfare, debts)

Exclusion criteria

• Factors that may mitigate the risks, such as familial support, stable and reliable parents, clear and transparent family structures
• Immigrants without a permanent residence permit
• Severe illness or disability of the child or of the parents which require hospitalization or long-term treatment
• Other ongoing intensive treatments or child protection procedures

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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213 participants in 2 patient groups

Parents As Teachers (PAT)

Experimental group

Description:

c.f. intervention

Treatment:

Other: Parents As Teachers (PAT)

control group condition

No Intervention group

Description:

Families in the control group condition did not receive the home visiting program PAT, but were informed about support services in their community. The use of these services was permitted for ethical reasons; however, parents were regularly asked about the nature and intensity of the retrieved services. Additionally, all parents received incentives, such as greeting cards, small birthday presents, and monetary reimbursements.