PARENTING INTERVENTIONS IN THE CARIBBEAN: A PILOT STUDY
 
Poor early childhood development predicts lower educational attainment, adult income and parenting and thus perpetuates the cycle of poverty. Early childhood interventions are a critical strategy to break this cycle and promote equity. A parenting intervention project supported by the Inter-American Development Bank (IADB) is being implemented by the Child Development Research Group, The University of the West Indies in three Caribbean countries: Jamaica, Antigua and St. Lucia. The project is evaluating two approaches to early parenting intervention integrated into primary health services which may be feasible for scaled up delivery.
 
Parenting Interventions
 
Health centre intervention: A video was developed to deliver a series of child development messages for mothers with children aged two (2) to 18 months. In each clinic community, health aides have been trained to discuss the video messages with the mothers, demonstrate activities mothers can do with their children and how to make simple toys from household materials. Nurses give message cards to the mothers to remind them of the activities. Simple picture books and a puzzle are also distributed
 
Home Visiting Interventions:  Children six (6) to 18 months of age receive fortnightly visits from trained community health workers who conduct play sessions with the mother and child to improve mother-child interaction and show the mother how to promote her child’s development. This intervention is based on the Jamaica home visit program and curriculum which has been shown to have long term benefits when visits were delivered weekly. 
Training workshops are held for the nurses and community health aides and manuals for each of the interventions provided to the community health aides. A supervisor provides ongoing support to implementation of the interventions.
 
Evaluation
In Jamaica, twenty health centres were randomly assigned to one of four groups with five health centres each assigned to no intervention, health centre intervention only, home visit intervention only, and both interventions. In Antigua and St. Lucia the project includes ten health centres with five assigned to health centre intervention and five to no intervention.
The impact of the interventions on children’s development and on parenting knowledge and practices will be evaluated following the children’s 18 month clinic visit. In depth interviews with selected health centre staff and parents will be conducted to identify strengths of the program and areas which may need modification if the program is scaled up. In collaboration with the IADB, the cost-effectiveness of the interventions will also be evaluated.