Perfecting Parenting: An evaluation of an integrated parenting program in rural China

INTERVENTION: All of the communities (villages) in the sample were randomly assigned to intervention and control using a computerized random number generator. Families assigned to the control group receive no intervention. Families in the intervention group are invited to participate in biweekly parenting training sessions delivered at home over a period of two years. During each home visit, community health workers introduce 2 age‐appropriate, interactive caregiver‐child activities targeting development in four developmental domains: cognition, language, motor, and social‐emotional development. Each activity is fully‐scripted in an ECD curriculum that is loosely based on the "Jamaica curriculum" developed by Sally Grantham‐McGregor and further developed by local child development psychologists and ECD experts. The curriculum previously underwent field testing and evaluation in rural China by our government partners at the National Health and Family Planning Commission (NHFPC) and our evaluation team. In addition to parenting training on interactive activities, caregivers receive stage‐based information on child health and nutrition during each home visit. Community health workers provide information on child nutrition and health promotion based on fully‐scripted, structured conversations developed by experts of the Capital Institute of Pediatrics (CIP) of the Chinese Academy of Medical Sciences (CAMS). No further follow‐up treatment is planned. CONDITION: Parenting attitudes, knowledge, and practice Early child development, child health, child nutrition and physical growth ; Not Applicable ; Parenting attitudes, knowledge, and practice Early child development, child health, child nutrition and physical growth PRIMARY OUTCOME: The following will be assessed at the baseline and during three rounds of follow‐up at the end of each intervention year:; 1. Children's cognitive, language, motor, and social‐emotional development, assessed using:; 1.1. Cognition, language, motor and social‐emotional scales of the third edition of the Bayley Scales of Infant and Toddler Development (Bayley‐III); 1.2. Scales for communication, gross motor, fine motor, personal‐social, problem solving, and overall development of the third edition of the Ages & Stages Questionnaire (ASQ‐3); 1.3. The Ages & Stages Questionnaire: Social‐Emotional (ASQ:SE); 2. Child health status, assessed using carer‐reported health measures included in the household questionnaire; 3. Child micronutrient status, assessed using haemoglobin values measured with fingerprick blood testing ; 4. Child weight, measured in kg using a scale; 5. Child height, measured in cm using a recumbent baby length scale for 0‐2 year olds and a child height scale for children over 2 years of age; ; SECONDARY OUTCOME: The following are assessed prior to treatment assignment (baseline) and during two rounds of follow‐up at the end of each intervention year:; 1. Caregivers' attitudes, knowledge, and behaviour with regard to early child psychosocial stimulation, health promotion, hygiene, and feeding practices, assessed using a comprehensive household questionnaire administered to the primary caregiver of the child, ; 2. Quality of the home learning environment, assessed using the Family Care Indicators (FCI) survey; 3. Caregivers' perceived social support and parental mental wellbeing, assessed using:; 3.1. Parenting and Family Adjustment Scale (PAFAS); 3.2. Depression Anxiety and Stress Scale (DASS); 3.3. Office of National Statistics (ONS) subjective wellbeing survey; INCLUSION CRITERIA: All babies aged 6‐18 months at the start of the study (and their main caregivers) who live in the sample villages