Effectiveness of a health promotion intervention to address determinants of child neglect in a disadvantaged community in Sri Lanka

Abstract

Background Child neglect is a form of child maltreatment and it is a neglected area of research. As similar to other forms of maltreatment, neglect also results in negative health outcomes for children. Child neglect is concentrated in disadvantaged communities. The community-centered health promotion approach empowers communities to identify and address determinants of perceived health issues. This study aimed to implement a health promotion intervention to enable a disadvantaged community to address determinants of child neglect and evaluate the effectiveness of the intervention. Methods A quasi-experimental study design was used. Two disadvantaged communities in Anuradhapura District, Sri Lanka with similar socio-demographic characteristics were purposively selected as the experimental and control study settings. The mothers who have at least one child in the age range 5–18 years were included in the sample. The sample included 42 mothers from the experimental group and 44 mothers from the control group. The elder children of mothers in the experimental group were selected to be the agents of change. A health promotion intervention was implemented only with the experimental setting. The steps of the intervention included; (1) identifying prevention of child neglect as a goal, (2) understanding the determinants, (3) analyzing determinants and identifying actions and (4) implementing and modifying the actions. The total study duration was 1 year, with the intervention taking an average of 6 months. Data were collected at both pre and post-intervention phases from mothers and children through interviewer-administered questionnaires. Results Mothers of the experimental group improved their knowledge on child neglect significantly in comparison to the control group (p < 0.05). In the post-intervention phase, there were significant differences in attitudes related to child neglect between experimental and control groups (p < 0.05). Following the health promotion intervention, mothers of the experimental group had significantly improved their practices related to the safety, education, nutrition of children, relationships with the child and social support for child caring (p < 0.05) when compared with the control group. Conclusions The health promotion intervention was effective in addressing the selected determinants of child neglect in a disadvantaged community. Children could act as active agents of change to deliver the interventions to their mothers (perpetrators).

Health Education Intervention Programs in Early Childhood Education: A Systematic Review

“…Some of the programs combine the issue of health education with the perspective of sustainability [49,50,86,87]. There is an increased effort to involve parents [56,88,89] and a special focus on specific target groups (various acute and chronic diseases, conditions related to atypical development, disadvantaged families) [39,40,[90][91][92][93].…”

A health promotion intervention to address youth violence among students in a technical college in Sri Lanka guided by the participatory action research approach: a study protocol

“…Both spiral PAR stages and steps of the community-centred health promotion model [52] which go up and down based on effectiveness make the process very flexible. Communitycentred health promotion model [52] has been adopted in several studies to address different health problems such as low birth weight [55,58], child neglect [59,60] and alcohol consumption [61] in Sri Lanka but not along with the PAR approach. Youth violence is a global public health issue [6] and it is a problem in Sri Lanka as well [12].…”

“…The community-centred health promotion model introduced by Samarasinghe and colleagues in 2011 [52] which has been used in Sri Lankan context with success [55,[58][59][60] will be adopted for the present study. Figure 1 shows the logical framework of the health promotion intervention for the present study.…”