IntroductionDigital parenting interventions could be potentially cost-effective means for providing early child development services in low-income settings. This 5-month mixed-methods pilot study evaluated the feasibility of usingAfinidata, a comprehensiveFacebook Messenger-based digital parenting intervention in a remote rural setting in Latin America and explored necessary adaptations to local context.MethodsThe study was conducted in three provinces in the Cajamarca region, Peru, from February to July 2021. 180 mothers with children aged between 2 and 24 months and regular access to a smartphone were enrolled. Mothers were interviewed three times in-person. Selected mothers also participated in focus groups or in-depth qualitative interviews.ResultsDespite the rural and remote study site, 88% of local families with children between 0 and 24 months had access to internet and smartphones. Two months after baseline, 84% of mothers reported using the platform at least once, and of those, 87% rated it as useful to very useful. After 5 months, 42% of mothers were still active on the platform, with little variation between urban and rural settings. Modifications to the intervention focused on assisting mothers in navigating the platform independently and included adding a laminated booklet with general information on child development, sample activities and detailed instructions on how to self-enrol in case of lost phones.ConclusionsWe found high access to smartphones and the intervention was well received and used in very remote areas of Peru, suggesting that digital parenting interventions could be a promising path forward for supporting low-income families in remote parts of Latin America.
Introduction: Digital parenting interventions could be potentially cost-effective means for providing early child development services in low-income settings. This 5-month mixed-methods pilot study evaluated the feasibility of using Afinidata, a comprehensive FBMessenger-based digital parenting intervention in a remote rural setting in Latin America and explored necessary adaptations to local context. Methods: The study was conducted in three provinces in the Cajamarca region, Peru, from February to July 2021. 180 mothers with children aged between 2-24 months and regular access to a smartphone were enrolled. Mothers were interviewed three times in-person. Selected mothers also participated in focus groups or in-depth qualitative interviews. Results: Despite the rural and remote study site, 88% of local families with children between 0-24 months had access to internet and smartphones. Two months after baseline, 84% of mothers reported using the platform at least once, and of those, 87% rated it as useful to very useful. After 5 months, 42% of mothers were still active on the platform, with little variation between urban and rural settings. Modifications to the intervention focused on assisting mothers in navigating the platform independently and included adding a laminated booklet with general information on child development, sample activities and detailed instructions on how to self-enroll in case of lost phones. Conclusions: We found high access to smartphones and the intervention was well received and used in very remote areas of Peru, suggesting that digital parenting interventions could be a promising path forward for supporting low-income families in remote parts of Latin America.
BACKGROUND Children living in low and middle-income countries (LMIC) are at greater risk for experiencing adversities that can undermine their health and early development. Recently launched online early childhood development (ECD) programmes attempt to support children in their home environments using digital technologies. However, these programmes face several unresolved issues including access, equity, reach and scalability. Using social media messengers that are now almost universally available in LMICs can potentially address these limitations OBJECTIVE This study rigorously assesses the reach, impact, cost-effectiveness and scalability of Afini, a newly developed virtual platform designed to support parents of young children in low resource settings to improve early childhood development. The Afini platform allows caregivers to get answers to questions about child well-being, while also identifying and promoting age- and development-appropriate activities for parents to engage in with their children. METHODS This cluster-randomised controlled trial enrolled 2,471 caregivers and their 3-9 months old children across 164 study clusters in the San Marcos, Cajabamba and Cajamarca provinces of Peru. Participants were randomly assigned to one of three groups: a control group (72 community clusters, 980 caregiver-child dyads), a home visit intervention group (20 community clusters, 316 caregiver-child dyads), and an Afini intervention group (72 community clusters, 1,175 caregiver-child dyads). Families in the control group receive no focused early childhood development (ECD) intervention. The home visit group are receiving biweekly home visits by a trained field staff following the national ECD programme (Programa Nacional Cuna Más) curriculum and training guidelines. Caregivers in the Afini group are receiving ECD activities and advice through the online platform. RESULTS Enrolment started in September 2021 and concluded in March 2023. Endline assessments will take place between August 2023 to September 2024. The primary study outcomes are children's overall development at age 2.5 years, assessed through the long form of the Global Scales for Early Development (GSED). Secondary outcomes include caregiver engagement, caregiver mental health, screen time as well as caregiver-reports of children's motor, cognitive, language and socio-emotional development. CONCLUSIONS This study is one of the first in LMICs that uses e-technologies to improve ECD. Given the large number of children in LMICs currently receiving only limited external support, the evaluated platform has the potential to improve the short- and long-term wellbeing of millions of children and their parents globally. CLINICALTRIAL https://classic.clinicaltrials.gov/ct2/show/NCT05202106
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