NCT02059863

Brief Summary

A large number of children in developing countries lack access to known effective interventions. Almost 9 million die each year before reaching their fifth birthday, and over 200 million children who survive fail to achieve their full growth or developmental potential, trapping them in a cycle of continuing disadvantage. The goal of "SPRING", Sustainable Programme Incorporating Nutrition and Games, is to develop an innovative approach to close this access gap, in two of the worst affected countries India and Pakistan, using community based agents. Extensive formative research will be carried out to help ensure that the content and approach of the "SPRING" intervention is feasible, acceptable and appropriately targeted. Findings will be reviewed at an intervention development workshop with local and international stakeholders and experts, and the agreed intervention piloted with a few community based agents and their supervisors. Cluster randomised controlled trials will be carried out in each setting to evaluate the impact of "SPRING" on child growth, development and survival. The programme will include process and economic evaluations to provide information on the total cost of the intervention and its cost effectiveness, as well as development of a framework with lessons learned for implementing "SPRING" in other settings.

Trial Health

47
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
12,000

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Mar 2014

Longer than P75 for not_applicable

Geographic Reach
2 countries

2 active sites

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 10, 2014

Completed
1 day until next milestone

First Posted

Study publicly available on registry

February 11, 2014

Completed
18 days until next milestone

Study Start

First participant enrolled

March 1, 2014

Completed
3.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2017

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2017

Completed
Last Updated

August 24, 2017

Status Verified

August 1, 2017

Enrollment Period

3.6 years

First QC Date

February 10, 2014

Last Update Submit

August 23, 2017

Conditions

Keywords

cluster randomised triallow and middle income countriescommunity based interventioncomplex intervention

Outcome Measures

Primary Outcomes (4)

  • infant mortality

    the % of newborns who die during the first year of life

    the first year of life

  • stunting

    % children stunted, with stunting defined as below -2 standard deviations of height for age using the WHO growth standards

    18-24 months

  • child development

    a range of psychometric outcome measures covering several domains including cognition, motor, language, and psychosocial development plus maternal-child interaction and quality of the home environment.

    18-24 months of age

  • maternal psychosocial distress/depression

    assessed using the 9 item Patient Health Questionnaire

    6-12 months postpartum

Secondary Outcomes (4)

  • % adopting key promoted behaviours

    from pregnancy up to age 2

  • wasting

    18-24 months of age

  • underweight

    18-24 months of age

  • age-specific infant mortality

    during the first year of life

Study Arms (2)

SPRING intervention clusters

EXPERIMENTAL

SPRING package: Home visits by community based agents carried out from pregnancy to 2 years of age to encourage key behaviours to promote child growth, survival and development together with regular supervision PLUS access to routine maternal and child health services

Behavioral: SPRING

Control clusters

NO INTERVENTION

access to routine maternal and child health services

Interventions

SPRINGBEHAVIORAL

SPRING package: Home visits by community based agents carried out from pregnancy to 2 years of age to encourage key behaviours to promote child growth, survival and development together with regular supervision

Also known as: Pakistan: Roshan Kal, India: Kilkaari (to be confirmed)
SPRING intervention clusters

Eligibility Criteria

Age1 Day - 24 Months
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • All liveborn babies whose mothers reside within the trial evaluation zones

You may not qualify if:

  • major congenital malformation
  • maternal death in neonatal period

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Sangath: Haryana field site

Porvorim, Goa, 403501, India

RECRUITING

Human Development Research Foundation: Rawalpindi field site

Islamabad, Punjab Province, 44000, Pakistan

NOT YET RECRUITING

Related Publications (2)

  • Zafar S, Sikander S, Haq Z, Hill Z, Lingam R, Skordis-Worrall J, Hafeez A, Kirkwood B, Rahman A. Integrating maternal psychosocial well-being into a child-development intervention: the five-pillars approach. Ann N Y Acad Sci. 2014 Jan;1308:107-117. doi: 10.1111/nyas.12339.

    PMID: 24571213BACKGROUND
  • Lingam R, Gupta P, Zafar S, Hill Z, Yousafzai A, Iyengar S, Sikander S, Haq ZU, Mehta S, Skordis-Worrel J, Rahman A, Kirkwood B. Understanding care and feeding practices: building blocks for a sustainable intervention in India and Pakistan. Ann N Y Acad Sci. 2014 Jan;1308:204-217. doi: 10.1111/nyas.12326. Epub 2014 Jan 6.

    PMID: 24392960BACKGROUND

MeSH Terms

Conditions

Growth DisordersDepression, PostpartumDeath

Condition Hierarchy (Ancestors)

Pathologic ProcessesPathological Conditions, Signs and SymptomsPuerperal DisordersPregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesDepressive DisorderMood DisordersMental Disorders

Study Officials

  • Betty Kirkwood, MSc, FMedSci

    London School of Hygiene and Tropical Medicine

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 10, 2014

First Posted

February 11, 2014

Study Start

March 1, 2014

Primary Completion

October 1, 2017

Study Completion

October 1, 2017

Last Updated

August 24, 2017

Record last verified: 2017-08

Locations