Abstract
BackgroundImpacts of early childhood development (ECD) interventions (such as fostering attachment and responsiveness through communication, play and stimulation) are well known. Globally, there is increasing recognition of the importance of the ‘golden’ minutes, hours and days after birth for infant health and development. However, only one systematic review has examined ECD interventions implemented in the neonatal period (0–27 days), and this review only assessed interventions implemented by specialised providers. Primary care providers have many potential contacts with mothers and infants throughout the neonatal period. However, it is unclear how many research studies or programmes have examined the effectiveness of ECD interventions commencing in the neonatal period and which methods were used. To date, there has been no systematic review of the effect of ECD interventions delivered by primary care providers commencing in the neonatal period.MethodsOur overall aim is to conduct a systematic review of the effect of ECD interventions implemented by primary care providers in the neonatal period. We will assess effects by timing and number (‘dose’) of contacts with primary care providers. Subgroup assessment will include effects in disadvantaged infants such as those born with low birth weight and to mothers with mental health disorders. We will also assess effects in low- and high-income countries and by type of care provider. The primary outcome is cognitive status in children aged 0–23 months as measured using standardised scales. Secondary outcomes include other child neurodevelopment domains (speech, language, fine motor, gross motor, social, emotional, behaviour, executive functioning, adaptive functioning) in children aged 0–23 months. Effects on maternal mental health will also be assessed between 0–23 months postpartum. Databases such as MEDLINE (OVID), PsycINFO (OVID), EMBASE (OVID), CINAHL, Cochrane Library, WHO databases and reference lists of papers will be searched for relevant articles. Only randomised controlled trials will be included. A narrative synthesis for all outcomes will be reported. Meta-analyses will be performed where exposures and outcomes are sufficiently homogeneous. Guidelines for PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) will be followed.DiscussionThis review appears to be the first to be conducted in this area. The findings will be an important resource for policymakers, primary care providers and researchers who work with young infants in primary care settings.Systematic review registrationPROSPERO CRD42019122021
Highlights
Impacts of early childhood development (ECD) interventions are well known
Seven studies involving 304 participants contributed data to one metaanalysis of the impact of these tools on caregiver-infant interaction, and the results suggested a significant, medium-sized difference between intervention and control groups (SMD − 0.53, 95% confidence intervals (95%CI) − 0.90 to − 0.17), but no other outcomes were reported in the included studies or the systematic review [36]
Our overall aim is to conduct a systematic review of the effect of ECD interventions implemented by primary care providers commencing in the neonatal period
Summary
Impacts of early childhood development (ECD) interventions (such as fostering attachment and responsiveness through communication, play and stimulation) are well known. Primary care providers have many potential contacts with mothers and infants throughout the neonatal period It is unclear how many research studies or programmes have examined the effectiveness of ECD interventions commencing in the neonatal period and which methods were used. Childhood development (ECD) interventions delivered to children aged under 5 years have been clearly shown to have substantial and sustained impacts on long-term cognition and neurodevelopmental outcomes [4,5,6] ECD interventions have been shown to improve maternal mental health outcomes [7, 8]. Families and caregivers of young children receive anticipatory guidance, health promotion, health education, promotional interviewing and motivational interviewing. They receive screening, surveillance and ‘brief interventions’. Many primary care providers lack skills and confidence in developmental care for young children and few receive appropriate training, education and tools
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