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Table 1 Intervention session content

From: Improving early childhood care and development, HIV-testing, treatment and support, and nutrition in Mokhotlong, Lesotho: study protocol for a cluster randomized controlled trial

 

Nutrition and health (all ages)

ECCD for children aged 12–30 months

ECCD for children aged 31–60 months

Session 1

Introduce the importance of child health and growth for future development

Introduce concept of picture book-sharing as an activity that improves caregiver-child relationship and facilitates school readiness

Introduce concept of picture book-sharing as an activity that improves caregiver-child relationship and facilitates school readiness

Present child development as a holistic concept (physical, mental and social health)

Facilitate baby’s handling of the book

Encourage child’s active participation in book-sharing

Session 2

Importance of growth monitoring

Support caregivers to follow cues from baby

Encourage pointing and naming to help child learn new words

Basic nutrition education

Encourage baby’s active participation in book-sharing

Engaging the child in a conversation about the picture book (using “where,” “who,” “what,” “why” questions)

Identifying locally available nutritious food options

Demonstrate how to follow baby’s interest (indexed by simple looking, patting or banging the picture)

Active linking of book content to the child’s world

Measuring weight, height and MUAC

Using lively voice to keep baby interested and to help baby learn

Responding to the child in a supportive and nonjudgmental manner

Individual feedback session with caregivers to discuss child’s growth status and make referrals if necessary

  

Session 3

Key messages and recommendations for appropriate infant and young child feeding

Using pointing and naming of pictures to help baby learn new words

Talking about feelings with the child: using book-sharing as an opportunity to talk about different emotions

Hygiene, sanitation, and safe food preparation

Repeating words to help baby remember new words

Helping child understand the meaning of emotion words

Early recognition of illness and help-seeking

Emphasizing the importance of positive responses

Linking emotions being shown in the book to the child’s own emotions

 

Finding opportunities to praise baby

 

Session 4

Information about HIV prevention and modes of HIV infection

Prompting baby to point to words that he/she knows (“where is the…” or “can you find the…”)

Talking about intentions: helping child to think about reasons why characters in the book are doing what they are doing (questions such as “why do you think they are doing that?” or “what are they trying to do here?”)

Importance of early identification of HIV (video followed by group discussion)

Prompting baby to name objects in the book that he/she knows how to say by asking “what’s this?”

Session 5

Emphasizing the importance of early identification of HIV through testing for caregivers and children

Active linking of book content to the baby’s world (making links between objects in the book and objects in the baby’s visual field)

Perspective taking: using what is happening in the book to help the child see that different people can think and feel different things

Information on benefits of HIV treatment (video followed by group discussion)

Session 6

Exploring fears and concerns (for family testing)

Talking about feelings with the child: using book-sharing as an opportunity to talk about different emotions

Numeracy and comparisons: using the book to help child become comfortable with numbers and practice counting

Discuss barriers to testing and disclosure

Helping child understand the meaning of emotion words

Using books to get children to make comparisons in relation to numbers, size or order (most/least; big/small; first/last)

Identify strategies and systems of support to overcome barriers

Linking emotions being shown in the book to the child’s own emotions

 

Session 7

Summary of key messages from past 6 sessions

Summary of main book-sharing principles from past 6 sessions using video examples of caregivers

Summary of main book-sharing principles from past 6 sessions using video examples of caregivers

Sessions 8 & 9

Promote attendance of community health events

Review of main principles using more video examples of caregivers

Review of main principles using more video examples of caregivers

Identify strategies for continued recognition of illness and help-seeking

Identify strategies to encourage continued book-sharing

Identify strategies to encourage continued book-sharing

  1. ECCD Early Childhood Care and Development, MUAC mid upper arm circumference