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Promoting Early Language Development Through Parent-child Book Reading in Costa Rica

NCT ID: NCT04978766

Last Updated: 2023-12-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

184 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-08-13

Study Completion Date

2022-09-10

Brief Summary

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The purpose of this study is to analyze the effect of an interactive parent-child book reading intervention. The intervention includes two components: the provision of five children's books to parent-child dyads and information about how to practice interactive book reading. The investigators expect to find an effect of this intervention on a) infants' expressive vocabulary, b) reading activity, c) parental expectations and knowledge about language development and d) parental use of interactive book reading strategies.

Detailed Description

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The foundations of optimal health, growth and development are forged early in life, when income-related gaps in learning opportunities already exist in Costa Rica. It is therefore important for the government to mitigate the effects of these gaps through programs targeting the development of academic, behavioral, socioemotional and economic abilities. Key to the success of such programs is to consider physical health, nutrition, responsive care and early learning. Multiple government-led initiatives in Costa Rica had been carried out in order to provide adequate programs for infants and young children. Evidence of these efforts are observed in the low rates attained in infant mortality, malnutrition and anemia, as well as the high coverage of the current immunization program. However, policies targeting early learning in children under 36 months of age are incipient and government initiatives in this regard are relatively recent.

The purpose of this study is to promote early language development, a central component of early learning. Our goal is to implement and evaluate a low-cost intervention targeting parents of infants who benefit from the existing immunization program of the public health services offered by the Caja Costarricense del Seguro Social (Costa Rican Social Security Fund).

The investigators will use an experimental design to randomly assign 15- to 17-month-old infants and their caregivers to one of two groups: a control group or an experimental group. In the experimental group, caregivers will receive a package including five children's books and 36 text messages with information on how to practice interactive book reading with their children. This information will be delivered over a period of 12 weeks. The control group will not receive any treatment during the implementation of the intervention.

In order to measure the efficacy of the intervention, the investigators will evaluate a) infants' expressive vocabulary, b) parent-child reading activity, c) parental expectations and knowledge about language development and d) parental use of interactive book reading strategies at baseline (15-17 months of age) and at posttest (18-20 months of age) in the control and the experimental group. After posttest, the control group will receive the complete intervention.

The investigators expect to find an effect of the interactive book reading intervention on a) infants' expressive vocabulary, b) reading activity, c) parental expectations and knowledge about language development and d) parental use of interactive book reading strategies.

Conditions

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Language Development

Keywords

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Book reading Infancy Interactive reading Vocabulary development Parenting

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

All participants will take baseline measures. After baseline, each participant will be randomly assigned to the control or the experimental group. At posttest, all measures taken at baseline will be evaluated again in all participants.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

SINGLE

Outcome Assessors
An external collaborator will create the allocation sequence for each of the two participating health centers (stratified randomization). Two independent research assistants will prepare the allocation in sequentially numbered, opaque, sealed and stapled envelopes. Aluminium foil inside each envelope will be used to render the envelope impermeable to intense light. This will allow the allocation sequence to be concealed from the researcher assessing participants at baseline. Once baseline assessment is completed, the next consecutively numbered envelope will be opened to reveal the participant's allocation.

Treatment for the experimental group will be provided by two different researchers who will not participate in outcome assessment.

A different researcher (outcome assessor), blind to the allocation sequence, to the participant's allocation and to the participant's baseline scores, will complete the participants' assessments during posttest.

Study Groups

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Interactive Book Reading Group

Participants in this arm will take baseline measures, will receive the intervention and will take posttest measures.

Group Type EXPERIMENTAL

Interactive Book Reading

Intervention Type BEHAVIORAL

The intervention is a package including five children's books and information on how to practice interactive book reading. Information includes 36 audiovisual products delivered via text messaging over a 12-week period. Products include:

1. An introductory video about interactive book reading, along with a written list of recommendations on how to practice interactive book reading.
2. Two videos of child development experts explaining the benefits of interactive reading.
3. Thirty written text messages strengthening content provided in the videos.
4. Three audio messages guiding the progress of the intervention.

Based on Abraham and Michie's (2008) taxonomy of behavior change techniques, one audiovisual product prompts specific goal settings, 13 provide instruction, one provides information on consequences, 10 prompt practice, three use follow-up prompts, one prompts self-monitoring of behavior, one models or demonstrates the behavior and six prompt barrier identification.

Control Group

Participants in this arm will take baseline and posttest measures. For ethical purposes, they will receive the intervention after posttest measures are taken.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Interactive Book Reading

The intervention is a package including five children's books and information on how to practice interactive book reading. Information includes 36 audiovisual products delivered via text messaging over a 12-week period. Products include:

1. An introductory video about interactive book reading, along with a written list of recommendations on how to practice interactive book reading.
2. Two videos of child development experts explaining the benefits of interactive reading.
3. Thirty written text messages strengthening content provided in the videos.
4. Three audio messages guiding the progress of the intervention.

Based on Abraham and Michie's (2008) taxonomy of behavior change techniques, one audiovisual product prompts specific goal settings, 13 provide instruction, one provides information on consequences, 10 prompt practice, three use follow-up prompts, one prompts self-monitoring of behavior, one models or demonstrates the behavior and six prompt barrier identification.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Age limits: 15 months to 17 months.
* Sex: All.
* Infant was born full term (≥ 37 weeks).
* Infant is raised in a monolingual Spanish-speaking home.


* Mother knows how to read and write.
* Mother has access to cell phone with internet.

Exclusion Criteria

* Neither caregivers nor infants must have any significant known physical, mental or learning disability.
Minimum Eligible Age

15 Months

Maximum Eligible Age

17 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Caja Costarricense de Seguro Social

OTHER_GOV

Sponsor Role collaborator

Universidad de Costa Rica

OTHER

Sponsor Role lead

Responsible Party

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Ana María Carmiol

Professor of Psychology at Instituto de Investigaciones Psicológicas

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ana M. Carmiol, PhD

Role: PRINCIPAL_INVESTIGATOR

Universidad de Costa Rica

Locations

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Área de Salud (CCSS), Santo Domingo de Heredia

Santo Domingo, Heredia Province, Costa Rica

Site Status

Área de Salud (CCSS), Desamparados 2

Desamparados, Provincia de San José, Costa Rica

Site Status

Countries

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Costa Rica

References

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Jackson-Maldonado, D., Marchman, V. A., & Fernald, L. C. (2013). Short-form versions of the Spanish MacArthur-Bates Communicative Development Inventories. Applied Psycholinguistics, 34(4), 837-868.

Reference Type BACKGROUND

Mol, S. E., Bus, A. G., De Jong, M. T., & Smeets, D. J. (2008). Added value of dialogic parent-child book readings: A meta-analysis. Early education and development, 19(1), 7-26.

Reference Type BACKGROUND

Muhinyi, A., & Rowe, M. L. (2019). Shared reading with preverbal infants and later language development. Journal of Applied Developmental Psychology, 64, 101053. https://doi.org/10.1016/j.appdev.2019.101053

Reference Type BACKGROUND

Suskind, D. L., Leung, C. Y., Webber, R. J., Hundertmark, A. C., Leffel, K. R., Suskind, E., Hernandez, M. W., & Graf, E. (2018). Development of the survey of parent/provider expectations and knowledge (SPEAK). First Language, 38(3), 312-331.

Reference Type BACKGROUND

Ministerio de Salud, Instituto Nacional de Estadística y Censos, & Fondo de las Naciones Unidas para la Infancia. (2018). Encuesta de mujeres, niñez y adolescencia (EMNA).

Reference Type BACKGROUND

Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008 May;27(3):379-87. doi: 10.1037/0278-6133.27.3.379.

Reference Type RESULT
PMID: 18624603 (View on PubMed)

Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, McCoy DC, Fink G, Shawar YR, Shiffman J, Devercelli AE, Wodon QT, Vargas-Baron E, Grantham-McGregor S; Lancet Early Childhood Development Series Steering Committee. Early childhood development coming of age: science through the life course. Lancet. 2017 Jan 7;389(10064):77-90. doi: 10.1016/S0140-6736(16)31389-7. Epub 2016 Oct 4.

Reference Type RESULT
PMID: 27717614 (View on PubMed)

Cusick SE, Georgieff MK. The Role of Nutrition in Brain Development: The Golden Opportunity of the "First 1000 Days". J Pediatr. 2016 Aug;175:16-21. doi: 10.1016/j.jpeds.2016.05.013. Epub 2016 Jun 3. No abstract available.

Reference Type RESULT
PMID: 27266965 (View on PubMed)

Dreyer, B. P., Mendelsohn, A. L., & Tamis-LeMonda, C. S. (1996). Assessing the child's cognitive home environment through parental report; reliability and validity. Early Development and Parenting: An International Journal of Research and Practice, 5(4), 271-287.

Reference Type RESULT

Instituto Nacional de Estadística y Censos. (2018). Mortalidad Infantil y Evolución Reciente 2018 I Semestre. Datos Preliminares. Volumen 1, Año 14.

Reference Type RESULT

Other Identifiers

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R019-SABI-00235

Identifier Type: OTHER

Identifier Source: secondary_id

723-B9-343

Identifier Type: -

Identifier Source: org_study_id