Attention Test Improvements from a Cluster Randomized Controlled Trial of Caregiver Training for HIV-Exposed/Uninfected Ugandan Preschool Children

Joseph Ikekwere, Valentine Ucheagwu, Itziar Familiar-Lopez, Alla Sikorskii, Jorem Awadu, Julius Caesar Ojuka, Deborah Givon, Cilly Shohet, Bruno Giordani, Michael J. Boivin

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    4 Scopus citations

    Abstract

    Objective: To report vigilance attention outcomes from a cluster randomized controlled trial of early childhood development caregiver training for perinatally HIV-exposed/uninfected preschool-age children in rural Uganda. The Early Childhood Vigilance Test (ECVT) provides a webcam recording of proportion of time a child views an animation periodically moving across a computer screen. Study design: Sixty mothers/caregivers received biweekly year-long training sessions of the Mediational Intervention for Sensitizing Caregivers (MISC), and 59 mothers received biweekly training about nutrition, hygiene, and health care. Children were tested for attention at baseline, 6 months, and 12 months with the ECVT, in terms of proportion of time spent viewing a 6-minute animation of animals greeting the child and moving across the computer monitor screen. Time viewing the animation were scored by trained observers using ProCoder program for webcam scoring of proportion of time the child faced the animation. Mixed-effects modeling was used to compare ECVT outcomes for the 2 intervention groups. Results: Unadjusted and adjusted (for age, sex, height, and ECVT at baseline) group differences on ECVT significantly favored the MISC arm at 6 months (P = .03; 95% CI (0.01, 0.11), effect size = 0.46) but not at 12 months. Both groups made significant gains in sustained attention across the year-long intervention (P = .021) with no significant interaction effects between time and treatment arms or sex. Conclusions: Caregiver early childhood development training enhanced attention in at-risk Ugandan children, which can be foundational to improved working memory and learning, and perhaps related to previous language benefits reported for this cohort. Trial registration: Clinicaltrials.gov: NCT00889395.

    Original languageEnglish
    Pages (from-to)226-232
    Number of pages7
    JournalJournal of Pediatrics
    Volume235
    DOIs
    StatePublished - Aug 2021

    Bibliographical note

    Publisher Copyright:
    © 2021 Elsevier Inc.

    Funding

    Supported by the National Institutes of Health (NIH) ( R34 MH082663 [PI: MJB]). The authors declare no conflicts of interest.

    FundersFunder number
    National Institutes of Health
    National Institute of Mental HealthR34MH082663

      Keywords

      • Africa
      • HIV exposed but uninfected
      • attention
      • early childhood development
      • mediational intervention to sensitize caregivers (MISC)
      • nutrition
      • webcam scoring

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