Evaluation of a Home-based Parenting Program in Rural China
Last registered on June 13, 2018

Pre-Trial

Trial Information
General Information
Title
Evaluation of a Home-based Parenting Program in Rural China
RCT ID
AEARCTR-0003052
Initial registration date
June 08, 2018
Last updated
June 13, 2018 12:09 AM EDT
Location(s)
Region
Primary Investigator
Affiliation
University of North Carolina at Chapel Hill
Other Primary Investigator(s)
PI Affiliation
Peking University
PI Affiliation
Stanford University
Additional Trial Information
Status
Completed
Start date
2014-10-01
End date
2015-05-01
Secondary IDs
Abstract
A key challenge in developing countries interested in providing early childhood development programs at scale is whether these programs can be effectively delivered through existing public service infrastructures. This study evaluates the effects of a home-based parenting program delivered by cadres in China's Family Planning Commission (FPC). We conduct a randomized trial across 131 villages in rural China comparing 66 treatment villages, where cadres made weekly visits to households with children between 18 and 30 months of age to deliver a structured stage-based curriculum designed to teach parenting skills, with 65 villages in the control group. We evaluate the impacts of the program on measures of infant cognitive, psychomotor, and socio-emotional skills as well as parental skills and investment.
External Link(s)
Registration Citation
Citation
Luo, Renfu, Scott Rozelle and Sean Sylvia. 2018. "Evaluation of a Home-based Parenting Program in Rural China." AEA RCT Registry. June 13. https://www.socialscienceregistry.org/trials/3052/history/30682
Experimental Details
Interventions
Intervention(s)
Parenting trainers, selected by the Family Planning Commission (FPC), deliver a structured curriculum through weekly home visits to households in treatment villages with children 18 to 30 months of age for a period of six months. The goal of the intervention is to train caregivers to interact with their children through stimulating and developmentally-appropriate activities.

The curriculum was developed by the research team in collaboration with the FPC and outside ECD experts in China. The curriculum is stage-based and fully scripted. Weekly age-appropriate sessions were developed targeting children from 18 months of age to 36 months of age. Each weekly session contains modules focused on two of four total developmental areas: cognition, language, socio-emotional, and (fine and gross) motor skills. Every two weeks, caregivers encounter one activity from each category. In addition to developmental activities, the curriculum also includes one weekly module on child health/nutrition. During sessions, parent trainers antroduce caregivers to the activity and assist caregivers to engage in the activity with their child. At the end of each weekly session, the materials used for that week's activities (toys and books) are left in the household to be returned at the next visit.




Intervention Start Date
2014-11-01
Intervention End Date
2015-04-01
Primary Outcomes
Primary Outcomes (end points)
The key outcomes are infant cognitive, psychomotor, and socio-emotional development. For children less than 30 months of age, cognitive and psychomotor outcomes are measured using the Bayley Scales of Infant Development, Version 1 (BSID-I). The BSID-I produced two sub-indices: the Mental Development Index (MDI), which evaluates memory, habitation, problem solving, early number concepts, generalization, classification, vocalization and language to produce a measure of cognitive development, and the Psychomotor Development Index (PDI), which evaluates gross motor skills (rolling, crawling and creeping, sitting and standing, walking, running and jumping) and fine motor skills to produce a measure of psychomotor development. For children older than 30 months of age these outcomes are assessed using the Griffith Mental Development Scales (GMDS-ER 2-8). The GMDS-ER 2-8 comprises six sub scales: locomotor, personal-social, language (receptive and expressive), hand and eye coordination, performance, practical reasoning.

An additional primary outcome is socio-emotional development as measured using the Ages and Stages Questionnaire: Social Emotional (ASQ:SE). The items in this questionnaire (which vary by age) measure a child's tendency towards a set of behaviors such as ability to calm down, accept directions, demonstrate feelings for others (empathy), communicate feelings, initiate social responses to parents and others, and respond without guidance (move to independence). Children scoring above a pre-determined threshold on the total score produced by the questionnaire are considered at risk of socio-emotional problems.
Primary Outcomes (explanation)
For BSID-I and GMDS-ER 2-8, raw scores are standardized separately by sub-index. Since raw scores are increasing in age, age-adjusted z-scores are computed using age-conditional means and standard deviations estimated by non-parametric regression.

For the ASQ:SE, the outcome is constructed as a dummy variable indicating a score of 60 or more on the assessment.
Secondary Outcomes
Secondary Outcomes (end points)
The parenting curriculum is designed to affect child development by increasing parenting skills and investment of caregivers in the development of their children. We measure parenting skills by asking the primary caregiver a series of questions on parenting knowledge and confidence. These include questions about the importance of different activities such as reading and playing with their children and caregiver confidence in engaging in these activities. Caregivers respond to these questions using a 7-point likert scale. Parental investment is measured by asking whether the main caregiver engaged in a set of child-rearing activities, such as story-telling and playing with toys, the previous day and how many children's books they have in the house.

Another secondary outcome is compliance/participation in in the program. Information on compliance -- including whether the weekly parenting sessions took place and, if not, the reason they did not take place -- as well as details of the interaction is collected on a monthly basis from caregivers and on a weekly basis from parenting trainers through telephone interviews.
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
The study randomly assigns 65 villages to a parenting intervention group and 66 villages to a control group. The randomization procedure is stratified by county, child cohort, and experimental group of an earlier nutrition trial.
Experimental Design Details
Randomization Method
The randomization was performed in office using Stata.
Randomization Unit
Clusters: Villages
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
131 villages
Sample size: planned number of observations
600 child-caregiver pairs
Sample size (or number of clusters) by treatment arms
65 in treatment group, 66 in control group
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Calculations indicated that a minimum of 123 clusters with five children per village would be required to detect a 0.2 standard deviation effect on the Bayley Mental Development Index at 80% power.
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Stanford University Institutional Review Board
IRB Approval Date
2012-10-26
IRB Approval Number
25734
Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
No
Is data collection complete?
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
Reports and Papers
Preliminary Reports
Relevant Papers