Reimagining the Waiting Room: The Impact of Delivering Parenting Interventions Through Health Services

Integrating early childhood interventions with health and nutrition services has been recommended, however there is limited information on interventions that are effective and feasible for delivery through health services. In... [ view full abstract ]

Integrating early childhood interventions with health and nutrition services has been recommended, however there is limited information on interventions that are effective and feasible for delivery through health services. In this trial we developed and evaluated a parenting program that could be integrated into primary health center visits. The intervention used group delivery at five routine visits from age 3-18 months, and comprised: short films of child development messages, shown in the waiting area; discussion and demonstration led by community health workers; and mothers’ practice of activities. Nurses gave out and reviewed message cards with mothers, together with a few play materials. A cluster randomized trial was conducted in 3 countries in the Caribbean. Multilevel analyses comparing health center only with control in all 3 countries showed significant benefits for cognitive development from the health center intervention with effect size of 0.3 SD and benefits to parenting knowledge with effect size 0·4.  The most conservative analyses found benefit cost ratios of 5.3 for the health center intervention and 3.8 for home visits.