{
  "abstract": "Objectives This paper examines the differential impact of responsive parenting and nutrition interventions on early child development in stunted versus never-stunted children at 24 months of age in rural India.Methods We conducted a secondary analysis of data from Stepping Stones—a cluster randomised controlled trial involving 21 subcentres/clusters allocated to intervention or control group. The intervention comprised home visits, group sessions and community workshops, focusing on responsive parenting and nutrition. Developmental outcomes, cognitive, motor, language and socio-emotional, were assessed at 24 months using validated tools. A mixed-effects regression model with an interaction term was used to estimate effect sizes for stunted and never-stunted children.Results Among 588 children analysed, 35.9% were stunted at 24 months, and 35 (5.95%) of them exhibited ‘early-onset persistent stunting’. The intervention improved cognitive (β=0.22), motor (β=0.23), language (β=0.17) and socio-emotional development (β=0.23) in never-stunted children compared with those who have not received intervention. For stunted children who have not received the intervention, a development score was lower for all development domains compared with never-stunted children, but not statistically significant (p>0.05). Although the effects differed between stunted and never-stunted children, the interaction effects between intervention and stunting were not statistically significant across all domains (p>0.05), indicating that the intervention’s benefits did not significantly differ by stunting status.Conclusion Integrated parenting and nutrition interventions improved developmental outcomes across all domains, regardless of the child’s stunting status. These findings support universal application of such programmes, highlighting the need to integrate them into existing child development and nutrition programmes.",
  "authors": [
    {
      "affiliations": [
        "Department of Community Medicine, Jawaharlal Nehru Medical College, Wardha",
        "Global Health Academy of Nuvance Health, Danbury, CT, USA",
        "Global Consortium Public Health Research, UK",
        "Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"
      ],
      "name": "Abhay Gaidhane"
    },
    {
      "affiliations": [
        "Centre of Early Childhood Development – Stepping Stones Project, Research and Development, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"
      ],
      "name": "Shital Telrandhe"
    },
    {
      "affiliations": [
        "Centre of Early Childhood Development - Stepping Stones Project, Research and Develoment, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"
      ],
      "name": "Penny Holding"
    },
    {
      "affiliations": [
        "Department of Physiology, Jawaharlal Nehru Medical College, Wardha",
        "Global Evidence Synthesis Initiative",
        "Division of Evidence Synthesis, School of Epidemiology & Public Health, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"
      ],
      "name": "Mahalaqua Nazli Khatib"
    },
    {
      "affiliations": [
        "Research and Development, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"
      ],
      "name": "Manoj Patil"
    },
    {
      "affiliations": [
        "Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"
      ],
      "name": "Shilpa Gaidhane"
    },
    {
      "affiliations": [
        "Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"
      ],
      "name": "Sonali G Choudhari"
    },
    {
      "affiliations": [
        "Centre of Early Childhood Development - Stepping Stones Project, Research and Development, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"
      ],
      "name": "Roshan Umate"
    },
    {
      "affiliations": [
        "Indian Institute of Public Health, Gandhinagar, Gujarat, India"
      ],
      "name": "Deepak Saxena"
    },
    {
      "affiliations": [
        "Department of Community Medicine, Jawaharlal Nehru Medical College, Wardha",
        "South Asia Infant Feeding Research Network (SAIFRN), Global Health Academy of Nuvance Health, Danbury, USA",
        "ITE Research Foundation, Wardha",
        "School of Epidemiology and Public Health",
        "Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India"
      ],
      "name": "Zahiruddin Quazi Syed"
    }
  ],
  "title": "Impact of an integrated parenting and nutrition intervention on growth and development in stunted children at 24 months: evidence from the Stepping Stones programme in rural India",
  "uid": "35ab0cca-3c37-5fc3-a96d-4eabae44d545"
}