Title of article :
A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV Positive
Author/Authors :
Ramugondo, Elelwani Department of Health and Rehabilitation Sciences - Faculty of Health Sciences - University of Cape Town - Cape Town , South Africa , Ferreira , Anande Department of Health and Rehabilitation Sciences - Faculty of Health Sciences - University of Cape Town - Cape Town , South Africa , Chung, Donna School of Occupational Therapy - Social Work and Speech Pathology - Faculty of Health Sciences - Curtin University - Perth , Australia , Cordier , Reinie School of Occupational Therapy - Social Work and Speech Pathology - Faculty of Health Sciences - Curtin University - Perth , Australia
Abstract :
InSouthAfrica,contextualfactorshavebeenidentifiedasbarrierstooutdoor,unstructuredplay.Thehuman
immunodeficiencyvirus(HIV)andresultingprogressiveHIVencephalopathy(PHE)isapandemicinthisarea,associatedwith
developmentdelaysthatarenotaddressedbyhighlyactiveantiretroviraltreatment(HAART).Thisstudyaimedtodescribethe
playfulnessinchildrenwithHIVandPHEonHAARTlivinginchallengingsocioeconomicareasinSouthAfricaaged6months
to8yearsandtoevaluatethefeasibilityandpreliminaryeffectivenessofaplay-informed,caregiver-implemented,home-based
intervention(PICIHBI)forimprovingplay.Methods.AfeasibilityrandomizedcontroltrialallowedforcomparisonofPICIHBI
andconventionalone-on-oneoccupationaltherapyinterventions.Childrenwerefilmedplayingpre-,mid-,andpostintervention,
usingtheTestofPlayfulness(ToP)toassessplayfulness.ThePICIHBIcomprisedof10monthlysessionsfacilitatedbyan
occupationaltherapist,involvinggroupdiscussionswithcaregiversandperiodsofexperientialplay.Results.Twenty-four
childrenwithHIVand/orPHEwererandomizedintooneofthetwointerventiongroups.Overall,thegroup(n= 24)hada
medianscoreof0(lowestitemscore)onnineof24ToPitemsandonlyhadamedianscoreof3(highestscore)ontwoitems.
Pre-topostinterventionoverallToPscoresimprovedmarginallyforthePICIHBIgroup(n= 12)andtheconventionalgroup
(n= 12).Between-groupdifferenceswerenotsignificant.ThePICIHBIgroupdemonstratedasignificantincreaseinoneToP
itemscoreatmidassessment.NosignificantToPitemchangeswerefoundintheconventionalgroup.Conclusion.Childrenwith
HIVwerefoundtohavethemostdifficultyonToPitemsrelatingtotheplayelementsofinternalcontrolandfreedomfrom
constraintsofreality.ThePICIHBIdidnotsignificantlyimprovechildren’splayandwasnotmoreeffectivethanthe
conventionalintervention.Considerationsforfeasibilityandeffectiveness,includingbarrierstoattendance,arediscussed
Keywords :
Feasibility RCT Evaluating , Play-Informed , Caregiver-Implemented , Home-Based Intervention , Improve , Play of Children , HIV Positive , PHE , HAART
Journal title :
Occupational Therapy International
