Outcome of a home-visiting intervention to improve social withdrawal assessed with the m-ADBB in six-month old infants in Khayelitsha, Cape Town : a cluster randomised controlled trial

[摘要] ENGLISH ABSTRACT: Pregnant women living in South African peri-urban settlements face many challenges fortheir health and the health of their infants. Current health care services face many constraints andare not able to meet all the needs of pregnant mothers. Home-visiting programmes implementedby community health workers can alleviate these constraints. The current RCT assessed theeffectiveness of the Philani Plus Intervention Program that addressed HIV, alcohol, maternal andchild nutrition and mental health. The effectiveness of the intervention was assessed bymeasuring infant social withdrawal behaviour using the modified Alarm Distress Baby Scale (m-ADBB). A total of 681 cases were randomised into control (N=330) and intervention groups(N=351) and assessed using the m-ADBB. A cut-off score of two and above was used todetermined significant social withdrawal behaviour. Data was analysed using descriptivestatistics and cross-tabulation initially, followed by analysis of variance and multilevelmodelling. Results indicated a prevalence of 46.7% of social withdrawal behaviour; however, nosignificant differences between groups were found. The current prevalence was substantiallyhigher in comparison to the only other published study using the m-ADBB. Furthermore, theprevalence rate was also significantly higher compared to the majority of other studies using theoriginal Alarm distress Baby Scale (ADBB). The high prevalence of social withdrawalbehaviour found in this study indicates an increased risk for suboptimal infant development.Further research regarding social withdrawal behaviour and the casual mechanisms associatedwith the development of such behaviour is needed. Furthermore, validation of the m-ADBB in different settings is needed.

[发布机构] Stellenbosch University