The Project is a curriculum-based caregiver education intervention that aims to improve early childhood psychosocial development and maternal well-being through caregiver training classes by trainers. There are two curricula implemented in this intervention.
The parenting training curriculum was loosely based on the Reach Up and Learn curriculum and adapted by the research team in collaboration with early childhood development experts in China. Weekly stage-based, age-appropriate sessions were developed targeting children 6-36 months of age. Each weekly session contains modules focusing on two of four developmental modules: cognition, language, motor, and social-emotional skill development. At the end of each session, caregivers are encouraged to take toys and books home and to practice the activities at home daily. To maximize adherence, parenting trainers will conduct home visits to households that cannot visit the Center Centers. Parenting trainers will invite caregivers to attend one-on-one parenting training sessions at the child centers in the villages. To maximize adherence, parenting trainers will conduct home visits to households that cannot visit the Child Centers.
The mental health curriculum is adapted from the World Health Organization Thinking Healthy Programme, an evidence-based psychosocial intervention providing psychoeducation and coaching based on principles of cognitive behavioral therapy. Structured forms of talk therapy are used to disrupt and alter the cycle of unhealthy thinking (cognitions), leading to unhelpful emotions which can result in undesirable actions (behaviors). In a safe environment, caregivers are encouraged to voice their problems, share their experiences of childrearing, and receive social support, therefore improving their relationship with their children and with the people around them. Although the WHO-designed curriculum only covers the first ten months after childbirth, the outcome of other research has extended and implemented the curriculum for caregivers of children up to 3 years of age. In this study, we will adapt the curriculum to be culturally appropriate to rural households in rural China. For example, we will adjust the language in the sessions to make it more accessible to older and less-educated grandmother caregivers, who are typically responsible for taking care of left-behind children in rural areas. The caregiver mental health curriculum will be delivered in group-based workshops every two weeks at private and undisturbed locations in the villages.