Acceptability and feasibility of a group-based intervention to improve outcomes for children at risk for developmental delays in Kenya: A piloted randomized trial

The Care for Child Development (CCD) program may improve child development outcomes in resource-limited settings, but has not yet been adapted to group-based settings to facilitate sustainable dissemination. In this study, we determined the acceptability and feasibility of a group-based CCD program, with evaluation of program outcomes for child development, home environment, and symptoms of maternal depression as secondary outcomes. We evaluated this adapted program using a 2 × 2 crossover-designed pilot study administered over 10 bi-weekly sessions. Acceptability and feasibility were assessed through focus group discussions using qualitative methods. Child development, home observations, and symptoms of maternal depression were evaluated at baseline, 6 months, and 12 months and assessed quantitatively. Twenty-six mother-child dyads participated. Overall, they perceived CCD as acceptable and feasible, and especially beneficial within its group-based format. Although there were no measured improvements in child development, improvements in stimulating home environments (mean difference 2.5, 95% C.I. [0.37, 4.72]) were found. Further scale-up of this intervention is needed to determine effectiveness.