Effects of a Dialogic Book-sharing Intervention for Female Caregivers in Rural Tanzania (EDBiT): Protocol for a Randomized Controlled Trial
Bibliographic record
Abstract
BACKGROUND: Children in low- and middle-income countries face obstacles to optimal language and cognitive development due to a variety of factors related to adverse socioeconomic conditions. One of these factors is compromised caregiver-child interactions and associated pressures on parenting. Early development interventions, such as dialogic book-sharing (DBS), address this variable, with evidence from both high-income countries and urban areas of low- and middle-income countries showing that such interventions enhance caregiver-child interaction and the associated benefits for child cognitive and socioemotional development. Yet, evidence for DBS effects is lacking from poor rural communities where the need for such early development intervention may be greatest. OBJECTIVE: The objective of this study is to assess the effects of a DBS intervention, a parenting program for female caregivers of children aged between 15 and 45 months, implemented in rural Tanzania. We aim to assess the impact of the intervention on the following domains: child cognitive and socioemotional skills, parenting and parental stress, and child health. METHODS: The study is a 3-arm cluster randomized controlled trial. In total, 443 female caregivers participated in the study. Clusters of caregivers were randomized to either (1) an index DBS intervention group, (2) a playful activity active control group, or (3) a waitlist control group. The active control group was designed to control for any attention effects, ensuring that observed improvement in the index group can be attributed to the DBS intervention's content. The primary outcomes were child language, parental sensitivity, and parent-child interaction. The secondary outcomes concerned child attention and behavior, parenting practices, and parental stress. A combination of questionnaires and direct observations was applied. Qualitative methods were also used, primarily to capture caregivers' experiences and subjective perspectives on intervention-induced changes. RESULTS: Data collection for the study was completed in September 2024. The study results are expected to be published by late 2025. CONCLUSIONS: This randomized controlled trial of a DBS intervention implemented in rural Tanzania adds to a growing body of international literature exploring the impact and limitations of a simple and scalable early development intervention to enhance child outcomes. TRIAL REGISTRATION: International Standard Registered Clinical/Social Study Number (ISRCTN) ISRCTN12613329; https://www.isrctn.com/ISRCTN12613329. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/68758.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.034 | 0.028 |
| Meta-epidemiology (narrow) | 0.006 | 0.003 |
| Meta-epidemiology (broad) | 0.012 | 0.005 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.008 | 0.008 |
| Insufficient payload (model declined to judge) | 0.069 | 0.009 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".