Improving Care and Preventing Maltreatment of Orphans

NCT03594617 | Completed

• 1 other identifier: ICC-C-2018-Tanzania
• Study Type: interventional
• Target: 374
• Locations: 1 country
• Sites: 1

Brief Summary

Sub-Saharan Africa, with more than 56 million orphans worldwide, is the most affected region in terms of orphans to be cared for (UNICEF, 2014). The recently developed preventative approach Interaction Competencies with Children - for Caregivers (ICC-C; Hecker, Mkinga, Ssenyonga, \& Hermenau, 2017) trains the essential interaction skills in working with children. The focus here is on strengthening a warm, sensitive and reliable relationship between caregiver and child as well as on non-violent education strategies. In a first pilot study the feasibility of the approach icould be demonstrated (Hermenau, Kaltenbach, Mkinga, \& Hecker, 2015). The study applies a two-arm cluster-randomized controlled design. The participating institutions will be randomly divided into intervention and control bodies. The follow-up examination should take place three months after the intervention. All caregivers in facility (N = approx. 150) and 25 randomly selected children (age: 6-12) per facility (N = 200) will be included in this study.

Conditions

Maltreatment, Child

Outcome Measures

Primary Outcomes (2)

• Change in caregivers' application of harsh discipline

  The Conflict Tactics Scale Parent-Child version (CTSPC) will assess caregiver's use of violent discipline measure against children in the child care institution. All items are rated on a 7-point Likert scale from never (0) to more than 20 times (25). The focus will be particularly on the subscales physical violence (13 items, potential range: 0 to 325 with higher scores indicating more violence) and emotional violence (5 items, potential range: 0-125, with higher scores indicating more violence).

  The CTSPC will be used at T 1 (baseline, prior to intervention) and T2 (follow-up, 3-6 months after intervention)

• Change in children's exposure to harsh discipline by caregivers

  The Conflict Tactics Scale Parent-Child version (CTSPC) will assess the children's self-reported experiences of violent discipline in the child care institution. The focus will be particularly on the subscales physical violence (13 items, potential range: 0 to 325 with higher scores indicating more violence) and emotional violence (5 items, potential range: 0-125, with higher scores indicating more violence).

  CTSPC will be used at T 1 (baseline, prior to intervention) and T2 (follow-up, 3-6 months after intervention)

Secondary Outcomes (2)

• Change in student's mental health

  SDQ will be used at (baseline, prior to intervention) and T2 (follow-up, 3-6 months after intervention)

• Change in caregiver's attitudes towards harsh discipline

  The adapted version of CTSPC will be used at T 1 (baseline, prior to intervention) and T2 (follow-up, 3-6 months after intervention)

Study Arms (2)

ICC-C

EXPERIMENTAL

Intervention: Interaction Competencies with children - for Caregivers (ICC-C) 11 days with 8 hours of training for caregivers. Core training components include caregiver-child interactions, maltreatment prevention, effective discipline strategies, child-centered institutional care, identifying and supporting burdened children and implementation of the training materials into the daily working

Behavioral: Interaction Competencies with Children - for Caregiver

Control institutions

NO INTERVENTION

The control institutions do not receive any intervention.

Interventions

Interaction Competencies with Children - for Caregiver BEHAVIORAL

Interaction Competencies with Children - for Caregiver (ICC-C) aims to reduce maltreatment and to improve care quality in institutional care facilities. Following the idea of a train-the-trainer approach, ICC-C is designed to be delivered by trained local facilitators. ICC-C is based on attachment, behavioral and social learning theories. The key principles are its feasibility in low-resource contexts, participatory approach, and practical orientation. ICC-C includes sessions on (a) caregiver-child interaction, (b) maltreatment prevention, (c) effective non-violent caregiving strategies, and (d) identifying and supporting burdened children.

ICC-C

Eligibility Criteria

• Age: 6 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Legal age
• Written informed consent
• Between 6 and 12 years
• Written informed consent by head of institutional care facility \& children oral assent

You may not qualify if:

• Acute drug or alcohol intoxication
• Known psychiatric disorder
• \- Known psychiatric disorder

Sponsors & Collaborators

• University of Konstanz: lead
• Bielefeld University: collaborator
• Dar es Salaam University College of Education: collaborator

Study Sites (1)

Dar es Salaam University College of Education

Dar es Salaam, Tanzania

Location

Related Publications (2)

• Hecker T, Mkinga G, Hartmann E, Nkuba M, Hermenau K. Sustainability of effects and secondary long-term outcomes: One-year follow-up of a cluster-randomized controlled trial to prevent maltreatment in institutional care. PLOS Glob Public Health. 2022 May 20;2(5):e0000286. doi: 10.1371/journal.pgph.0000286. eCollection 2022.

  PMID: 36962306 DERIVED

• Hecker T, Mkinga G, Kirika A, Nkuba M, Preston J, Hermenau K. Preventing maltreatment in institutional care: A cluster-randomized controlled trial in East Africa. Prev Med Rep. 2021 Oct 9;24:101593. doi: 10.1016/j.pmedr.2021.101593. eCollection 2021 Dec.

  PMID: 34976652 DERIVED

MeSH Terms

Interventions

Caregivers

Intervention Hierarchy (Ancestors)

Health Personnel; Health Care Facilities Workforce and Services

Study Officials

• Tobias Hecker, PhD

  Bielefeld University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Full Professor of Clinical Psychology and Behvavioral Neuroscience

Study Record Dates

• First Submitted: July 11, 2018
• First Posted: July 20, 2018
• Study Start: August 14, 2018
• Primary Completion: July 1, 2019
• Study Completion: April 30, 2020
• Last Updated: May 8, 2020

Record last verified: 2019-09

Locations

TA (1)