Stimulation Interventions and Parenting in Low- and Middle-Income Countries: A Meta-analysis
Abstract
CONTEXT: Early childhood stimulation interventions positively impact early child development (ECD) outcomes in low- and middle-income countries. However, trials have less comprehensively evaluated the effects of such parenting programs on caregivers’ skills and capacities. OBJECTIVE: We conducted a systematic review and meta-analysis to assess the effectiveness of stimulation interventions on improving parenting outcomes. DATA SOURCES: Six electronic bibliographic databases. STUDY SELECTION: Inclusion criteria included randomized controlled trials of stimulation interventions designed to improve ECD outcomes during the first 2 years of life that measured any maternal or parenting-related outcome after the start of the intervention. DATA EXTRACTION: Two independent reviewers extracted data by using a structured form. RESULTS: Fifteen studies representing 13 unique randomized controlled trials met the inclusion criteria. Pooled standardized mean differences (SMDs) based on random-effects models revealed medium-to-large benefits of stimulation interventions for improving the home caregiving environment (n = 10; SMD = 0.57; 95% confidence interval [CI], 0.37 to 0.77), mother-child interactions (n = 3; SMD = 0.44; 95% CI, 0.14 to 0.74), and maternal knowledge of ECD (n = 6; SMD = 0.91; 95% CI, 0.51 to 1.31). No significant difference was seen for maternal depressive symptoms (n = 9; SMD = −0.10; 95% CI, −0.23 to −0.03). LIMITATIONS: Limitations include heterogeneity across interventions, lack of standardized measures, and different time points of assessments across studies. CONCLUSIONS: Early childhood stimulation interventions improve several distinct aspects of maternal parenting. Improvements in parenting capacities may serve as key mechanisms by which these programs benefit ECD outcomes.
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The Jeong et al. review focused specifically on stimulation interventions, examined effects on parenting but not ECD outcomes, and was limited to LMICs.
“Yet this prior review focused specifically on stimulation interventions, examined effects on parenting but not ECD outcomes, and was also limited to LMICs.”
From Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis (2021) · cites this paper as [21]
The Jeong, Pitchik, and Yousafzai review documented significant medium-to-large benefits on parenting practices (SMD = 0.57, n = 10).
“parenting practices (SMD = 0.57, n = 10)”
From Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis (2021) · cites this paper as [21]
The Jeong, Pitchik, and Yousafzai review documented significant medium-to-large benefits on maternal knowledge (SMD = 0.91, n = 6).
“documented significant medium-to-large benefits on maternal knowledge (SMD = 0.91, n = 6)”
From Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis (2021) · cites this paper as [21]
The Jeong, Pitchik, and Yousafzai review documented significant medium-to-large benefits on mother-child interactions (SMD = 0.44, n = 3).
“mother–child interactions (SMD = 0.44, n = 3)”
From Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis (2021) · cites this paper as [21]
The Jeong, Pitchik, and Yousafzai review observed no significant effect for reducing maternal depressive symptoms (SMD = −0.10, n = 9).
“No significant effect was observed for reducing maternal depressive symptoms (SMD = −0.10, n = 9).”
From Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis (2021) · cites this paper as [21]
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Jeong, J., Franchett, E. E., Ramos de Oliveira, C. V., Rehmani, K., & Yousafzai, A. K. (2021) · PLoS Medicine · doi:10.1371/journal.pmed.1003602 · Cited by 903 · see citing works
Self-citation
- Authors
- Jeong, J., Pitchik, H. O., & Yousafzai, A. K.
- Affiliations
- Harvard University (US)
- University of California, Berkeley (US)
- Corresponding author
- Jeong, Joshua
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2018-04-01
- Volume
- 141
- Issue
- 4
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2790883626
- Cited by
- 130
- References
- 42
- Citations by year
- 2026: 17 · 2025: 11 · 2024: 17 · 2023: 19 · 2022: 16 · 2021: 29 · 2020: 14 · 2019: 4 · 2018: 3
- FWCI
- 1.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Social Sciences › Education › Early Childhood Education and Development
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- parent training, early childhood development, mother-child interaction, maternal depressive symptoms, low- and middle-income countries, early intervention
- MeSH terms
- Child, Child Development, Female, Humans, Income, Male, Mother-Child Relations, Poverty, Parenting
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