Effect of play-based family-centered psychomotor/psychosocial stimulation on the development of severely acutely malnourished children under six in a low-income setting: a randomized controlled trial

Abessa, Teklu Gemechu; Worku, Berhanu Nigussie; Wondafrash, Mekitie; Girma, Tsinuel; Valy, Johan; Lemmens, Johan; Bruckers, Liesbeth; Kolsteren, Patrick; Granitzer, Marita

doi:10.1186/s12887-019-1696-z

Table 4 Average increase ^a [95% CI] in developmental performance, linear growth and nutritional status from baseline to discharge, and from discharge to end-line and baseline to end-line, and effect size for significant intervention effect

From: Effect of play-based family-centered psychomotor/psychosocial stimulation on the development of severely acutely malnourished children under six in a low-income setting: a randomized controlled trial

Developmental outcomes
Outcomes	Increase from baseline to discharge ^b			Increase from discharge to end-line ^b			Increase from baseline to end-line ^c
Outcomes	Control group	Intervention effect	Effect size	Control group	Intervention effect	Effect size	Control group	Intervention effect	Effect size
Fine Motor	0.73^‡ [0.28, 1.16] p < 0.001	0.31^‡ [− 0.29, 0.94] p = 0.299	0.07	1.73^‡ [1.1, 2.4] p < 0.001	0.85^‡ [0.1, 1.6] p = 0.023	0.15^†	2.50^† [1.9, 3.1] p = 0.001 0.38^¥ [0.28, 0.47] p < 0.001	1.09^† [0.5, 1.7] p = 0.001 0.13^¥ [0.01, 0.24] p = 0.033	0.22 ^Ÿ
Gross Motor	0.36 ^‡ [0.01, 0.7] p = 0.044 0.40^† [0.07, 0.74] p = 0.019	0.98^‡ [0.5, 1.5] p = 0.001 0.88^† [0.40, 1.37] p < 0.001	0.26	3.9^‡ [3.3, 4.5] p < 0.001	−0.6^‡ [−1.5, 0.3] p = 0.222	− 0.20	4.3^‡ [3.6, 4.9] p < 0.001 0.63^¥ [0.54, 0.73] p < 0.001	0.4^‡ [− 0.50, 1.3] p = 0.376–0.004^¥ [− 0.14, 0.13] p = 0.948	0.06
Language	0.5^‡ [0.1, 1.0] p = 0.022	0.01 [− 0.7, 0.7] p = 0.966	0.45	3.3 ^‡ [2.5, 4.0] p < 0.001	0.5^‡ [− 0.5, 1.5] p = 0.326	0.07	3.8^‡ [3.0, 4.5] p < 0.001 0.55^¥ [0.44, 66] p < 0.001	0.5^‡ [− 0.5, 1.5] p = 0.329 0.07^¥ [− 0.07, 0.21] p = 0.341	0.07
Personal Social	0.7 ^‡ [0.3, 1.0] p = 0.001	−0.06^‡ [− 0.6, 0.4] p = 0.812	−0.02	2.6^‡ [2.0, 3.2] p < 0.001	0.12^‡ [−0.7, 0.9] p = 0.762	− 0.03	3.2 ^‡ [2.6, 3.8] p < 0.001 0.46^¥ [0.37, 0.55] p < 0.001	0.06^‡ [− 0.7, 0.8] p = 0.865 0.01^¥ [− 0.11, 0.13] p = 0.887	0.011
Social-emotional Behavior	−12.8^‡ [− 17.0, −8.5] p = 0.001	1.7^‡ [−4.3, 7.7] p = 0.583	0.04	−1.8^‡ [−7.6, 3.9] p = 0.256	− 4.3^‡ [− 12.4, 3.8] p = 0.295	− 0.09	− 14.6^‡ [− 20, −9.0] p < 0.001 1.78^¥ [− 2.63, − 0.94] p < 0.001	−2.64^‡ [− 9.2, 3.9] p = 0.426–0.36^¥ [− 1.50, 0.78] p = 0.541	−0.09
Linear growth and nutritional outcomes
Outcomes	Increase from baseline to discharge ^b			Increase from discharge to end-line ^b			Increase from baseline to end-line ^c
Outcomes	Control group	Intervention effect	Effect size	Control group	Intervention effect	Effect size	Control group	Intervention effect	Effect size
HAZ	−0.05 ^‡ [− 0.2, 0.1] p = 0.419	− 0.05^‡ [− 0.1, 0.1] p = 0.633	−0.03	0.2^‡ [0.01,0.4] p = 0.039	0.03^‡ [−0.2, 0.3] p = 0.790	0.03	0.2 ^‡ [−0.1,0.4] p = 0.138 0.03^¥ [− 0.01, 0.07 p = 0.104	−0.004^‡ [− 0.3, 0.3] p = 0.978–0.01^¥ [− 0.05, 0.04] p = 0.753	−0.002
MUACZ	0.3^‡ [0.1, 0.4] p = 0.002 0.34^† [0.24, 0.44] p < 0.001	0.2^‡ [− 0.04, 0.35] P = 0.123 0.15^‡ [− 0.04, 0.35] p = 0.123	0.12	1.9^‡ [1.6, 2.2] p < 0.001	− 0.2^‡ [− 0.5,0.2] p = 0.430	0.00	2.1^‡ [1.8, 2.4] p < 0.001 0.34^¥ [0.29, 0.39] p < 0.001	0.002^‡ [− 0.4, 0.4] p = 0.999–0.02^¥ [− 0.09, 0.05] p = 0.596	- < 0.001
WAZ	0.2^‡ [0.03, 0.30] p = 0.022	0.1^‡ [− 0.1, 0.3] p = 0.260	0.08	1.1^‡ [0.9, 1.3] p < 0.001	− 0.3^‡ [− 0.7,0.1] p = 0.155	−0.20	1.3^‡ [1.0, 1.5] p = 0.001 1.30.19^¥ [0.15, 0.23] p < 0.001	− 0.2^‡ [− 0.7, 0.2] p = 0.372–0.06^¥ [− 0.13, 0.01] p = 0.112	−0.02
WHZ or BAZ	0.5^‡ [0.2, 0.8] p < 0.001	0.04^‡ [−0.2, 0.3] p = 0.791	0.02	1.5^‡ [1.1, 1.8] p < 0.001	−0.2^‡ [− 0.6, 0.2] p = 0.321	− 0.04	2.0^‡ [1.7, 2.3] p < 0.001 0.29^¥ [0.24, 0.34] p < 0.001	−0.2^‡ [− 0.5, 0.2] p = 0.352–0.06^¥ [− 0.123, 001] p = 0.054	−0.06

In full model, parameter estimates are based on all significant and non-significant terms
In reduced model, parameter estimates are based on a parsimonious model that includes statistically significant terms and only essential non-significant model terms
BAZ body-mass-index-for-age z score, GEE Generalized Estimating Equations, HAZ height/length-for-age z score, MUACZ mid-upper-arm-circumference z score, WAZ weight-for-age z score, WHZ weight-for-height/length z score
^aThe increase for the control group during the follow-up time and the intervention effect (additional increase for the intervention group). When there is no intervention effect, the average increase of the control group and intervention group are equal
^bA GEE model using time as a factor variable. As a factor variable (parameters marked with “^{‡, †}”, time indicates the follow-up phases (hospital-based, home-based or a combination of both)
^cA GEE model using time both as factor variable and as a continuous variable (parameters marked by “^¥” . As a continuous variable, time indicates a mean change in the outcome variable when the duration of follow-up increases by 1 day)
^‡ Obtained from a full model comprising time as factor variables (y = Time2 + Time3+ Time2*Treatment +Time3*Treatment, where Time1 = 0)
^† Obtained from a reduced model comprising time as factor variables
^¥ Obtained from a full model comprising time as a continuous variable (y = Time + Treatment+ Time*Treatment)

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ISSN: 1471-2431

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