Feasibility and acceptability of a home-based intervention to promote nurturing interactions and healthy behaviours in early childhood: The Amagugu Asakhula pilot study.

Background: The aim of this study was to assess the feasibility and acceptability of a home-based intervention-Amagugu Asakhula-to promote nurturing interactions and healthy behaviours with the caregivers of preschool children. Amagugu Asakhula means "treasures that are still growing" and focuses on children's cognitive development, physical activity, screen time, diet and sleep while also promoting the caregiver-child relationship.

Methods: This study took place in a low-income setting in Cape Town, South Africa. The 6-week intervention was implemented by community health workers (CHWs) with 20 caregivers of preschool children. CHWs provided written feedback on intervention sessions, and two focus groups were conducted, one with the CHWs involved (n = 4) and another with caregivers (n = 6), to obtain their feedback on the intervention and its implementation. Data were collated according to themes relating to implementation. In this pilot study, training and recruitment proved feasible and were facilitated by partnership with a community-based organization.

Results: The intervention was generally implemented as intended, in terms of dose and delivery. Family support and active engagement of caregivers' preschool children in intervention activities were reported by CHWs and caregivers, and CHWs also reported mostly positive interactions with caregivers. CHWs and caregivers perceived the intervention to have benefits relating to the following: caregivers' awareness and knowledge of health behaviours, awareness of their role, changes in behaviours, and connection between the caregiver and child. The only change to the intervention suggested was the inclusion of some group sessions to promote support amongst intervention participants and sustain engagement in the intervention.

Conclusions: The findings of this pilot study indicate that Amagugu Asakhula was both feasible and acceptable with caregivers of preschool children in a low-income urban setting. Further research is needed to assess the extent to which this intervention has an objective and measurable effect on intended outcomes.