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Child DevelopmentNPECDP-UKANCT04210362

External Evaluation of the Neurological and Psycho-affective Early Childhood Development Program of the Mexican NGO Un Kilo de Ayuda

A study testing Workshops on responsive caregiving in people with Child Development, run by Amado David Quezada Sánchez at 1 site in Mexico.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Investing in early childhood development is one of the best cost-effective investments a country can make to boost long term economic growth, promote peaceful and sustainable societies, contribute to tackle poverty traps and eradicate inequality. Read more about this study

Who is it for?
Ages 1 month to 60 monthsHealthy volunteers can take part
Conditions the study is for
Child Development
What is being tested?
Workshops on responsive caregiving
Could I receive a placebo?
No, everyone receives an active treatment
How many people
764 participants
Where
1 siteMexico
Study dates
15 Jul 2019to 10 Feb 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 month to 60 months
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • Communities: Municipalities in the State of Oaxaca where the NPECDP-UKA is not currently operating.
  • Whithin selected communities:
  • children aged1 to 60 months and their caregivers who decided to enroll in the NPECDP-UKA.

Who cannot join

  • Communities: Municipalities in the State of Oaxaca with a population of children under 5 years of age below 35 habitants according to the Census of 2010

Trial locations and contacts

1 site in 1 country.

Mexico1 site
  • Un Kilo de Ayuda, A.C.

    Oaxaca City

Other trials in Mexico

About this study

Official title: External Evaluation of the Neurological and Psycho-affective Early Childhood Development Program of the Mexican Non-governmental Organization Un Kilo de Ayuda

Investing in early childhood development is one of the best cost-effective investments a country can make to boost long term economic growth, promote peaceful and sustainable societies, contribute to tackle poverty traps and eradicate inequality. It is also necessary to uphold the right of every child to survive and thrive. The single most powerful context for nurturing care is the immediate home, often mainly provided by mothers.

Although the Mexican government has implemented social programs in the past, some with nutrition and child development components, poor and isolated communities have not benefited as others easier to reach. This is particularly true for the State of Oaxaca given its orography, where higher levels of malnutrition and a higher risk of suboptimal neurodevelopment are present.

Read more

Since 1989, Un Kilo de Ayuda A.C. (UKA), a nongovernmental organization, has been involved in preventing child undernutrition in contexts of high poverty. Currently, UKA has 9 Early Childhood Development Centers distributed in 5 States of Mexico, including Oaxaca. UKA has developed the Neurological and Psycho-affective Early Childhood Development Program (NPECDP-UKA) that seeks to contribute to timely stimulation in children under 5 years of age and promote perceptual parenting practices. As part of the NPECDP-UKA, UKA redesigned their interventions to promote healthy nurturing care practices and responsive caregiving through workshops provided to caregivers and pregnant women, and with reinforcement through home visits.

It is in the interest of this study to evaluate the NPECDP-UKA through a variation of a stepped wedge cluster randomized trial. The study sample consists of participants from 80 municipalities of Oaxaca (~50% with high or very high margination status), 20 municipalities were randomly assigned to each arm. Study arms differ by design on the time of exposure to the program (0,18,24 and 30 months at the final measurement). Subjects from all study groups share the characteristic to be enrolled in the NPECDP-UKA, the group with 0 months of exposure will serve as a comparison group. This distinctive characteristic of the study requires a progressive incorporation of study groups to be able to compare development measurements between study groups at the same ages and among subjects all enrolled in the program to avoid self-selection bias. The main study hypothesis states that children exposed to the Program will have better neurodevelopment outcomes than those not exposed.

This study will provide evidence of the effect of an educational intervention for caregivers on the neurodevelopment of children under 5 years of age. Currently evidence of such interventions is very limited, especially for interventions performed by a nongovernmental organization. This is the first evaluation of this kind in Mexico.

Being tested
Workshops on responsive caregiving
Keywords
neurodevelopment, responsive caregiving, nuturing care, counseling

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Workshops on responsive caregivingBehavioural

    Caregivers will receive monthly workshops about several dimensions of nurturing care, responsive caregiving and early child development. Workshops will be reinforced through home visits.

Study groups in NCT04210362
Study groupRoleWhat they receive
Educational intervention for 30 monthsExperimentalChildren aged 31 to 60 months and their caregivers from 20 municipalities of Oaxaca will have been exposed to the Neurobehavioral and Psycho-affective Development Program for 30 months.
Receives: Behavioral: Workshops on responsive caregiving
Educational intervention for 24 monthsExperimentalChildren aged 31 to 60 months and their caregivers from 20 municipalities of Oaxaca will have been exposed to the Neurobehavioral and Psycho-affective Development Program for 24 months.
Receives: Behavioral: Workshops on responsive caregiving
Educational intervention for 12 monthsExperimentalChildren aged 31 to 60 months and their caregivers from 20 municipalities of Oaxaca will have been exposed to the Neurobehavioral and Psycho-affective Development Program for 12 months.
Receives: Behavioral: Workshops on responsive caregiving
Comparison groupNo interventionGroup comprised of children aged 31 to 60 months and their caregivers from 20 municipalities of Oaxaca, Mexico. Children and their caregivers will not be exposed to the intervention at the moment of their measurements.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Child Development Evaluation Test 2nd Edition (CDE-II)

    The CDE-II, or Evaluación del Desarrollo Infantil (EDI-II) in Spanish, was developed and validated in Mexico to screen populations for lag and for risk of delay in child development. The test has specific items for 14 age groups of children aged 1 to 60 months. Assessed developmental areas include gross motor skills, fine motor skills, language, social skills, and cognitive skills. The CDE-II is based on age-group specific items, score results are categorized into three levels: Green (normal development), Yellow (developmental lag) and Red (at risk of development delay)

    Measured: Up to 30 months

Secondary outcomes (6)
  1. Verbal McCarthy Scale of Children's Abilities (MSCA)

    The verbal MSCA has an arbitrarily chosen mean of 50 and stadard deviation of 10. Higher values indicate a higher level of the measured dimension.

    Measured: Up to 30 months

  2. Perceptual-performance McCarthy Scale of Children's Abilities (MSCA)

    The perceptual-performance MSCA has an arbitrarily chosen mean of 50 and stadard deviation of 10. Higher values indicate a higher level of the measured dimension.

    Measured: Up to 30 months

  3. Quantitative McCarthy Scale of Children's Abilities (MSCA)

    The quantitative MSCA has an arbitrarily chosen mean of 50 and stadard deviation of 10. Higher values indicate a higher level of the measured dimension.

    Measured: Up to 30 months

  4. Memory McCarthy Scale of Children's Abilities (MSCA)

    The memory MSCA has an arbitrarily chosen mean of 50 and stadard deviation of 10. Higher values indicate a higher level of the measured dimension.

    Measured: Up to 30 months

  5. Motor McCarthy Scale of Children's Abilities (MSCA)

    The motor MSCA has an arbitrarily chosen mean of 50 and stadard deviation of 10. Higher values indicate a higher level of the measured dimension.

    Measured: Up to 30 months

  6. General Cognitive Index from McCarthy Scales of Children's Abilities (MSCA)

    The General Cognitive Scale is obtained adding up the verbal, percetual-performance and quantitative MSCA and it is converted into the General Cognitive Index (GCI). The GCI has a mean set at 100 and a standard deviation of 16.

    Measured: Up to 30 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Dec 2019
  2. Study start15 Jul 2019
  3. Primary completion10 Feb 2020
  4. Study completion10 Feb 2020

Why it stopped: Due to the Covid-19 contingency, activities were suspended in March 2020. Baseline measurements were obtained for n=764 children whose caregivers enrolled in the NPECDP-UKA.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
A variation of the stepped wedge cluster randomized trial design was specified. Due to ethical and logistical considerations, the intervention in study groups under this design starts sequentially but measurements are performed at the same time period in all groups. The key difference between groups is thus the time of exposure to the intervention. Clusters were randomized into four study groups (30, 24, and 12 months of exposure, and a non-exposed group). The intervention consists of educational workshops for caregivers aimed at promoting healthy nurturing care practices and responsive caregiving. Assessment of intervention effects is performed as in a parallel design.
Masking
None (open label)
Enrolment
764 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04210362
Sponsor's protocol ID
1538/CI-896-2018/CB18-317
Acronym
NPECDP-UKA
Status last verified
Aug 2022
First submitted
14 Jul 2019
Last updated
25 Aug 2022
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Van der Gaag J, Tan J-P. The benefits of early child development programs: an economic analysis. World Bank Group; 1998

  • Heckman JJ, Moon SH, Pinto R, Savelyev P, Yavitz A. A new cost-benefit and rate of return analysis for the Perry Preschool Program: A summary. Cambridge, MA 02138: National Bureau of Economic Research; 2010. (NBER Working Paper). Report No.: 16180

  • Heckman J, Carneiro P. Human capital policy. Cambridge, MA 02138: National Bureau of Economic Research; 2003. (NBER Working Paper). Report No.: 9495

  • Delalibera BR, Ferreira PC. Early childhood education and economic growth. J Econ Dyn Control. 2019;98:82-104

  • Organization WH, Fund UNC, Group WB. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential. Ginebra 27, Suiza: World Health Organization; 2018

  • Bick J, Nelson CA. Early Adverse Experiences and the Developing Brain. Neuropsychopharmacology. 2016 Jan;41(1):177-96. doi: 10.1038/npp.2015.252. Epub 2015 Sep 3.

    PubMed 26334107
  • Shonkoff JP, Garner AS; Committee on Psychosocial Aspects of Child and Family Health; Committee on Early Childhood, Adoption, and Dependent Care; Section on Developmental and Behavioral Pediatrics. The lifelong effects of early childhood adversity and toxic stress. Pediatrics. 2012 Jan;129(1):e232-46. doi: 10.1542/peds.2011-2663. Epub 2011 Dec 26.

    PubMed 22201156
  • Force LMT. Toward Universal Learning: What Every Child Should Learn. Washington/Montreal: Brookings/UIS. 2013

  • Child C on the D. The Science of Early Childhood Development Closing the Gap Between What We Know and What We Do [Internet]. Cambridge, MA 02138; 2007. Available from: https://developingchild.harvard.edu/wp-content/uploads/2015/05/Science_Early_Childhood_Development.pdf

  • Duncan GJ, Dowsett CJ, Claessens A, Magnuson K, Huston AC, Klebanov P, Pagani LS, Feinstein L, Engel M, Brooks-Gunn J, Sexton H, Duckworth K, Japel C. School readiness and later achievement. Dev Psychol. 2007 Nov;43(6):1428-1446. doi: 10.1037/0012-1649.43.6.1428.

    PubMed 18020822
  • Blair C, Razza RP. Relating effortful control, executive function, and false belief understanding to emerging math and literacy ability in kindergarten. Child Dev. 2007 Mar-Apr;78(2):647-63. doi: 10.1111/j.1467-8624.2007.01019.x.

    PubMed 17381795
  • Shonkoff JP, Boyce WT, McEwen BS. Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention. JAMA. 2009 Jun 3;301(21):2252-9. doi: 10.1001/jama.2009.754.

    PubMed 19491187
  • Caspi A, Moffitt TE, Newman DL, Silva PA. Behavioral observations at age 3 years predict adult psychiatric disorders. Longitudinal evidence from a birth cohort. Arch Gen Psychiatry. 1996 Nov;53(11):1033-9. doi: 10.1001/archpsyc.1996.01830110071009.

    PubMed 8911226
  • Heckman JJ. Skill formation and the economics of investing in disadvantaged children. Science. 2006 Jun 30;312(5782):1900-2. doi: 10.1126/science.1128898.

    PubMed 16809525
  • Young ME. Addressing and mitigating vulnerability across the life cycle: The case for investing in early childhood. UNDP Hum Dev Rep Off. 2014

Questions about this trial

What is this clinical trial studying?

A study testing Workshops on responsive caregiving in people with Child Development, run by Amado David Quezada Sánchez at 1 site in Mexico.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 25 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Mexico. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Due to the Covid-19 contingency, activities were suspended in March 2020. Baseline measurements were obtained for n=764 children whose caregivers enrolled in the NPECDP-UKA.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Child Development Evaluation Test 2nd Edition (CDE-II) (time frame: Up to 30 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04210362, which also lists 26 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Aug 2022.

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