TY - JOUR T1 - Participation in a Community-Based Women's Health Education Program and At-Risk Child Development in Rural Kenya: Developmental Screening Questionnaire Results Analysis JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 818 LP - 831 DO - 10.9745/GHSP-D-20-00349 VL - 9 IS - 4 AU - Megan S. McHenry AU - Lauren Y. Maldonado AU - Ziyi Yang AU - Gertrude Anusu AU - Evelyn Kaluhi AU - Astrid Christoffersen-Deb AU - Julia J. Songok AU - Laura J. Ruhl Y1 - 2021/12/31 UR - http://www.ghspjournal.org/content/9/4/818.abstract N2 - Key FindingsInfants in Chamas had a lower likelihood of at-risk development compared to those in the control group. Older infant age at time of screening and having natural or uncovered walls was also associated with lower odds of at-risk development.Our findings offer evidence to support that by addressing health literacy, providing community in a supportive environment, and offering a means to combat social determinants of child developmental delays, the Chamas for Change intervention may help protect children from developmental delays in this resource-limited setting in Kenya.Key ImplicationsWhen looking to revise current strategies to help protect children from developmental delay in this setting, policy makers should consider interventions that leverage existing resources to ensure their sustainability.Background:Over 43% of children living in low- and middle-income countries are at risk for developmental delays; however, access to protective interventions in these settings is limited. We evaluated the effect of maternal participation in Chamas for Change (Chamas)—a community-based women's health education program during pregnancy and postpartum—and risk of developmental delay among their children in rural Kenya.Methods:We analyzed developmental screening questionnaire (DSQ) data from a cluster randomized controlled trial in Trans Nzoia County, Kenya (ClinicalTrials.gov, NCT03187873). Intervention clusters (Chamas) participated in community health volunteer-led, group-based health lessons twice a month during pregnancy and postpartum; controls had monthly home visits (standard of care). We screened all children born during the trial who were alive at 1-year follow-up. We labeled children with any positive item on the DSQ as “at-risk development.” We analyzed data using descriptive statistics and multilevel regression models (α=.05); analyses were intention-to-treat using individual-level data.Results:Between November 2017 and March 2018, we enrolled 1,920 pregnant women to participate in the parent trial. At 1-year follow-up, we screened 1,273 (689 intervention, 584 control) children born during the trial with the DSQ. Intervention mothers had lower education levels and higher poverty likelihood scores than controls (P<.001 and P=.007, respectively). The overall rate of at-risk development was 3.5%. Children in Chamas clusters demonstrated significantly lower rates of at-risk development than controls (2.5% vs. 4.8%, P=.025). Adjusted analyses revealed lower odds for at-risk development in the intervention arm (OR=0.50; 95% confidence interval=0.27, 0.94).Conclusions:Maternal participation in a community-based women's health education program was associated with lower rates of at-risk development compared to the standard of care. Overall, rates of at-risk development were lower than expected for this population, warranting further investigation. Chamas may help protect children from developmental delay in rural Kenya and other resource-limited settings. ER -