Home Visitation or Group Meeting? Effects of Early Stimulation Programs on Child Well-Being: A Cluster Randomized Control Trial in Guatemala
*Names in bold indicate Presenter
To our knowledge, this study is the first that uses a clustered randomized controlled trial to assign communities (n=111) to three treatment arms: home visitations, group sessions, and no intervention in an indigenous setting. As such, it will advance the literature by providing evidence as to whether one early childhood stimulation modality produces better outcomes than the other does and, if so, by how much and at what cost. More than 2,000 children between 6 and 18 months of age were assessed at baseline. The interventions were also complemented with training, supervision, and mentoring of mother educators. Children received 10 months of intervention on average, and 85 percent of the original sample was re-interviewed at follow-up data collection. Attrition was mainly due to deaths and migration, but it did not show a systematic pattern. We assessed program effects on: (a) children’s nutritional status using anthropometric measures, (b) receptive and expressive language, and fine motor, using the MDAT scales of child development, (c) physical and emotional environment, using the HOME and FCI instruments, and (d) maternal depression using the Center for Epidemiologic Studies Depression Scale, Revised (CESD-R).
Intent-to-treat preliminary findings suggest that children who receive home visits are less likely to be overweight, and more likely to have a positive home environment than children who participate in group meetings or children in the control group. We also found that mothers who received home visits were less likely to be depressed than mothers in the control group. Our findings reveal a promising line of study that will be of particular interest to organizations concerned with early stimulation and its effects on child development during the crucial first two years of life. Specifically, these findings speak to policy makers of rural, indigenous and disadvantaged communities, where some parents rarely spend time reading, playing, or even talking with their infants and toddlers.