Summary of parenting interventions and populations included in systematic review (in order of original trial publication date)
| Primary impact paper, country | Study design (arms, n) | Sample size at enrolment | Setting | Population and child age at enrolment | Intervention dosage, total duration (contacts, n) | Original intervention description and control condition |
| Grantham-McGregor et al,19 Jamaica | 2×2 factorial individual-level RCT (among stunted children) also with a non-stunted control:
| Stimulation (stunted): 64 No stimulation (stunted): 65 | Urban | Children aged 9–24 months with height-for-age <−2 SDs, mothers with singleton pregnancy, BW >1/8 kg, housing and maternal education below predefined levels, no obvious physical or mental disabilities | Weekly home visit total duration of 24 months (96 contacts) | Stimulation: community health aides visited the homes for 1 hour/week and taught the mothers how to play with their children to promote their development. Homemade toys were left in the home at each visit, and the mothers were encouraged to play with their children daily. Supplementation: 1 kg milk-based formula/week Control: free medical care was available to all children. Children in the four stunted groups were visited every week by a community health aide, and a history of the previous week’s illnesses was recorded. |
| Walker et al,36 Jamaica | Individual-level RCT among LBW children, also with a NBW control:
| Intervention (LBW): 70 Control (LBW): 70 | Urban | Enrolled LBW, term newborns whose mothers had an education level below three secondary-evel examination passes; excluded twins, those with congenital abnormalities, receiving special care nursery, and HIV-positive mothers | Weekly home visits from birth to 2 months of age (first 8 weeks, 60 min/visit); break for 5 months, then weekly home visits again from 7 to 24 months of age (30 min/visit); total duration of 19 months (76 contacts) | The first phase during the child’s first 8 weeks of life focused on improving the mothers’ responsiveness to their infants. Community health workers encouraged mothers to converse with and sing to their infants, respond to their cues, show affection and focus their attention on the environment. The second phase of intervention began after a 5-month interval and was conducted from 7 to 24 months of age, during which the community health worker demonstrated play techniques to the mother and involved her in a play session with the child. Toys made from commonly available recyclable materials were left in the home each week. Control condition unclear, likely standard of care services for LBW |
| Cooper et al,28 South Africa | Individual-level RCT:
| Intervention: 220 Control: 229 | Periurban | Enrolled pregnant women during third trimester | Two home visits in pregnancy, 14 home visits in the first 6 months; 1 hour/home visit, total duration of 9 mo (16 contacts) | Trained community volunteer women provided mothers with psychological support to encourage maternal sensitive and responsive interactions with her infant and improve her infant attachment relationship (ie, supporting the management of infant distress and sensitising mothers to infant social cues and attachment needs). Control condition: standard of care involving fortnightly visits by a community health worker who assessed the physical and medical progress of mothers and infants, and encouraged well child visits at the local clinic |
| Yousafzai et al,24 Pakistan | 2×2 factorial cluster RCT:
| Responsive stimulation: 757 No responsive stimulation: 732 | Rural | Children aged 0–2.5 months without signs of severe impairments | Monthly home vists (30 min/session) and monthly group sessions (80 min/session), total duration of 24 months (48 contacts) | For the responsive stimulation intervention, LHWs promoted caregiver sensitivity, responsiveness and developmentally appropriate play between caregiver and child (using adapted version of care for child development). For the enhanced nutrition intervention, LHWs provided nutrition education, and all children aged 6–24 months in this group were given a multiple micronutrient powder as part of home visit. Control condition: standard-of-care services provided by LHWs, including health, hygiene and basic nutrition education |
| Attanasio et al,22 Colombia | 2×2 factorial cluster RCT:
| Stimulation: 720 No stimulation: 709 | Multiple regions, at-scale | Targeted socioeconomically vulnerable families who were beneficiaries (poorest 20% of households) of the Familias en Acción conditional cash transfer programme Enrolled children 12–24 months | Weekly home visits total duration of 18 months (72 contacts) | Parenting intervention: mother leaders demonstrated play activities using low cost or homemade toys, picture books, and form boards. These materials were left in the homes for the week after the visit and were changed weekly. The aims of the visits were to improve the quality of maternal–child interactions and to assist mothers to participate in developmentally appropriate learning activities, many centred on daily routines. Nutrition intervention: daily micronutrient sprinkles for child, which were distributed to households every 2 weeks. Control condition: existing Familias en Acción government conditional cash transfer programme |
| Chang et al,25 Jamaica, Antigua, St. Lucia | Cluster RCT:
| Intervention: 251 Control: 250 | Select regions in each country | Mother and infants at the postnatal visit to primary health clinic 6–8 weeks; excluded infants born preterm, multiple births, or those admitted to the special care nursery for >48 hours after birth | Five routine primary health clinic visit for infants at 3, 6, 9, 12 and 18 months of age, total duration of 15 months (five contacts) | Intervention integrated into routine primary health services for infants. Responsive stimulation messages were delivered through short video films played in health facility waiting area. Community health workers facilitated group discussions about the films with mother–child dyads and provided demonstrations and opportunities for mothers to practise stimulation activities. During well-baby visit, nurse reinforced short film messages about stimulation and provided mothers with message cards to take home. At ages 9 and 12 months, nurses gave the parents a picture book, and at 18 months a three-piece puzzle to take home. Control condition: usual primary care for infants at community health clinics |
| Muhoozi et al,23 Uganda | Cluster RCT:
| Intervention: 263 Control: 248 | Rural | Targeted impoverished mothers; enrolled children aged 6–8 months, excluding those with congenital malformations, physical disorder, or mental illness | Three supervised group meetings (6–8 hours each), monthly mothers group meetings+monthly home visits; total duration of 6 months (15 contacts) | Intervention focused primarily on infant complementary feeding, cooking demonstrations, and hygiene and sanitation, and additionally emphasised the importance of play for early child development. Full-day group meetings were facilitated by bachelor-level nutritionists, and monthly home visit and mothers peer group sessions were facilitated by volunteer mother. Control condition unclear |
BW, birth weight; LBW, low-birthweight; LHW, Lady Health Worker; NBW, normal-birthweight; RCT, randomised controlled trial.