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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

Thesis (MSc)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Pregnant women living in South African peri-urban settlements face many challenges for
their health and the health of their infants. Current health care services face many constraints and
are not able to meet all the needs of pregnant mothers. Home-visiting programmes implemented
by community health workers can alleviate these constraints. The current RCT assessed the
effectiveness of the Philani Plus Intervention Program that addressed HIV, alcohol, maternal and
child nutrition and mental health. The effectiveness of the intervention was assessed by
measuring 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 to
determined significant social withdrawal behaviour. Data was analysed using descriptive
statistics and cross-tabulation initially, followed by analysis of variance and multilevel
modelling. Results indicated a prevalence of 46.7% of social withdrawal behaviour; however, no
significant differences between groups were found. The current prevalence was substantially
higher in comparison to the only other published study using the m-ADBB. Furthermore, the
prevalence rate was also significantly higher compared to the majority of other studies using the
original Alarm distress Baby Scale (ADBB). The high prevalence of social withdrawal
behaviour found in this study indicates an increased risk for suboptimal infant development.
Further research regarding social withdrawal behaviour and the casual mechanisms associated
with the development of such behaviour is needed. Furthermore, validation of the m-ADBB in different settings is needed. / AFRIKAANSE OPSOMMING: Swanger vroue wat in Suid-Afrikaanse buitestedelike nedersettings woon staar baie
uitdagings in die gesig met betrekking tot hul gesondheid en die gesondheid van hul babas.
Huidige gesondheidsdienste is baie beperk en is nie in staat om in al die behoeftes van swanger
moeders te voorsien nie. Huis-besoek programme wat deur gemeenskaplike gesondheidswerkers
geïmplementeer word, kan hierdie beperkings verlig. Die huidige RCT het die effektiwiteit van
die Philani Plus Intervensie Program wat MIV, alkohol, voeding en geestelike gesondheid
aanspreek, geassesseer. Die effektiwiteit van die intervensie is geassesseer deur sosiale
onttrekkingsgedrag met behulp van die gewysigde Alarm Nood Baba Skaal (m-ADBB) te meet.
‘n Totaal van 681 gevalle is lukraak in kontrole (N = 330) en intervensie groepe (N = 351)
verdeel en geëvalueer volgens die m-ADBB. 'n Afsnypunt van twee en hoër is gebruik om
beduidende sosiale onttrekkingsgedrag te bepaal. Data is aanvanklik ontleed met behulp van
beskrywende statistiek en kruis-tabulering, gevolg deur analise van variansie en multi-modelle.
Resultate toon 'n 46,7%-voorkoms van sosiale onttrekkingsgedrag, maar het egter geen
beduidende verskille tussen groepe getoon nie. Die huidige voorkoms was aansienlik hoër in
vergelyking met die enigste ander gepubliseerde studie wat gebruik gemaak het van die m-
ADBB. Verder was die voorkomssyfer ook aansienlik hoër in vergelyking met die meerderheid
van die ander studies wat gebruik gemaak het van die oorspronklike Alarm Nood Baba Skaal (ADBB). Die hoë voorkoms van sosiale onttrekkingsgedrag dui op 'n verhoogde risiko
vir suboptimale baba ontwikkeling. Verdere navorsing oor sosiale
onttrekkingsgedrag en die meganismes wat verband hou met die ontwikkeling van sulke
gedrag, is nodig. Verder word die bekragtiging van die m-ADBB in verskillende instellings benodig.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/96009
Date12 1900
CreatorsDurandt, Nicola Estelle
ContributorsTomlinson, Mark, Stellenbosch University. Faculty of Arts and Social Sciences. Department of Psychology.
PublisherStellenbosch : Stellenbosch University
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Formatxii, 210 p. : ill.
RightsStellenbosch University

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