A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV Positive
Background/aim. In South Africa, contextual factors have been identified as barriers to outdoor, unstructured play. The human immunodeficiency virus (HIV) and resulting progressive HIV encephalopathy (PHE) is a pandemic in this area, associated with development delays that are not addressed by highl...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Occupational Therapy International |
| Online Access: | http://dx.doi.org/10.1155/2018/3652529 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850158262449602560 |
|---|---|
| author | Elelwani Ramugondo Anande Ferreira Donna Chung Reinie Cordier |
| author_facet | Elelwani Ramugondo Anande Ferreira Donna Chung Reinie Cordier |
| author_sort | Elelwani Ramugondo |
| collection | DOAJ |
| description | Background/aim. In South Africa, contextual factors have been identified as barriers to outdoor, unstructured play. The human immunodeficiency virus (HIV) and resulting progressive HIV encephalopathy (PHE) is a pandemic in this area, associated with development delays that are not addressed by highly active antiretroviral treatment (HAART). This study aimed to describe the playfulness in children with HIV and PHE on HAART living in challenging socioeconomic areas in South Africa aged 6 months to 8 years and to evaluate the feasibility and preliminary effectiveness of a play-informed, caregiver-implemented, home-based intervention (PICIHBI) for improving play. Methods. A feasibility randomized control trial allowed for comparison of PICIHBI and conventional one-on-one occupational therapy interventions. Children were filmed playing pre-, mid-, and postintervention, using the Test of Playfulness (ToP) to assess playfulness. The PICIHBI comprised of 10 monthly sessions facilitated by an occupational therapist, involving group discussions with caregivers and periods of experiential play. Results. Twenty-four children with HIV and/or PHE were randomized into one of the two intervention groups. Overall, the group (n=24) had a median score of 0 (lowest item score) on nine of 24 ToP items and only had a median score of 3 (highest score) on two items. Pre- to postintervention overall ToP scores improved marginally for the PICIHBI group (n=12) and the conventional group (n=12). Between-group differences were not significant. The PICIHBI group demonstrated a significant increase in one ToP item score at midassessment. No significant ToP item changes were found in the conventional group. Conclusion. Children with HIV were found to have the most difficulty on ToP items relating to the play elements of internal control and freedom from constraints of reality. The PICIHBI did not significantly improve children’s play and was not more effective than the conventional intervention. Considerations for feasibility and effectiveness, including barriers to attendance, are discussed. |
| format | Article |
| id | doaj-art-69ee599abd764ef2bbad8cac01cb693c |
| institution | OA Journals |
| issn | 0966-7903 1557-0703 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Occupational Therapy International |
| spelling | doaj-art-69ee599abd764ef2bbad8cac01cb693c2025-08-20T02:23:56ZengWileyOccupational Therapy International0966-79031557-07032018-01-01201810.1155/2018/36525293652529A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV PositiveElelwani Ramugondo0Anande Ferreira1Donna Chung2Reinie Cordier3Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South AfricaDepartment of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South AfricaSchool of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth 6012, AustraliaSchool of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth 6012, AustraliaBackground/aim. In South Africa, contextual factors have been identified as barriers to outdoor, unstructured play. The human immunodeficiency virus (HIV) and resulting progressive HIV encephalopathy (PHE) is a pandemic in this area, associated with development delays that are not addressed by highly active antiretroviral treatment (HAART). This study aimed to describe the playfulness in children with HIV and PHE on HAART living in challenging socioeconomic areas in South Africa aged 6 months to 8 years and to evaluate the feasibility and preliminary effectiveness of a play-informed, caregiver-implemented, home-based intervention (PICIHBI) for improving play. Methods. A feasibility randomized control trial allowed for comparison of PICIHBI and conventional one-on-one occupational therapy interventions. Children were filmed playing pre-, mid-, and postintervention, using the Test of Playfulness (ToP) to assess playfulness. The PICIHBI comprised of 10 monthly sessions facilitated by an occupational therapist, involving group discussions with caregivers and periods of experiential play. Results. Twenty-four children with HIV and/or PHE were randomized into one of the two intervention groups. Overall, the group (n=24) had a median score of 0 (lowest item score) on nine of 24 ToP items and only had a median score of 3 (highest score) on two items. Pre- to postintervention overall ToP scores improved marginally for the PICIHBI group (n=12) and the conventional group (n=12). Between-group differences were not significant. The PICIHBI group demonstrated a significant increase in one ToP item score at midassessment. No significant ToP item changes were found in the conventional group. Conclusion. Children with HIV were found to have the most difficulty on ToP items relating to the play elements of internal control and freedom from constraints of reality. The PICIHBI did not significantly improve children’s play and was not more effective than the conventional intervention. Considerations for feasibility and effectiveness, including barriers to attendance, are discussed.http://dx.doi.org/10.1155/2018/3652529 |
| spellingShingle | Elelwani Ramugondo Anande Ferreira Donna Chung Reinie Cordier A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV Positive Occupational Therapy International |
| title | A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV Positive |
| title_full | A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV Positive |
| title_fullStr | A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV Positive |
| title_full_unstemmed | A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV Positive |
| title_short | A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV Positive |
| title_sort | feasibility rct evaluating a play informed caregiver implemented home based intervention to improve the play of children who are hiv positive |
| url | http://dx.doi.org/10.1155/2018/3652529 |
| work_keys_str_mv | AT elelwaniramugondo afeasibilityrctevaluatingaplayinformedcaregiverimplementedhomebasedinterventiontoimprovetheplayofchildrenwhoarehivpositive AT anandeferreira afeasibilityrctevaluatingaplayinformedcaregiverimplementedhomebasedinterventiontoimprovetheplayofchildrenwhoarehivpositive AT donnachung afeasibilityrctevaluatingaplayinformedcaregiverimplementedhomebasedinterventiontoimprovetheplayofchildrenwhoarehivpositive AT reiniecordier afeasibilityrctevaluatingaplayinformedcaregiverimplementedhomebasedinterventiontoimprovetheplayofchildrenwhoarehivpositive AT elelwaniramugondo feasibilityrctevaluatingaplayinformedcaregiverimplementedhomebasedinterventiontoimprovetheplayofchildrenwhoarehivpositive AT anandeferreira feasibilityrctevaluatingaplayinformedcaregiverimplementedhomebasedinterventiontoimprovetheplayofchildrenwhoarehivpositive AT donnachung feasibilityrctevaluatingaplayinformedcaregiverimplementedhomebasedinterventiontoimprovetheplayofchildrenwhoarehivpositive AT reiniecordier feasibilityrctevaluatingaplayinformedcaregiverimplementedhomebasedinterventiontoimprovetheplayofchildrenwhoarehivpositive |