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Interventions targeting early child development (ECD) during the first 2\u00a0years of life can improve neurodevelopmental outcomes in vulnerable children; however, evidence from Roma preschoolers is scarce. In a quasi-experimental observational study, we compared neurodevelopmental outcomes at age 2\u00a0years, measured on the INTERGROWTH-21st Project Neurodevelopmental Assessment (INTER-NDA), between Roma children receiving a community-based ECD intervention (RI, <jats:italic>n<\/jats:italic>\u2009=\u200998), and age- and sex-matched Roma and non-Roma children (RC, <jats:italic>n<\/jats:italic>\u2009=\u200999 and NRC, <jats:italic>n<\/jats:italic>\u2009=\u200954, respectively) who did not receive the intervention in Eastern Slovakia. The intervention was delivered between 3\u00a0weeks and 20\u00a0months in weekly home-based sessions by trained Roma women from matched settlements to RIs. Compared with RC, RI had higher 2-year cognitive (<jats:italic>B<\/jats:italic>\u2009=\u20090.15; 95% CI, 0.04, 0.25), language (<jats:italic>B<\/jats:italic>\u2009=\u20090.25; 95% CI, 0.11, 0.38) and fine motor (<jats:italic>B<\/jats:italic>\u2009=\u20090.08; 95% CI, 0.01, 0.16) scores. After adjustment for covariates, cognitive delay decreased by 88% in RI compared with RC (aOR, 0.12; 95% CI, 0.03, 0.53). Linear growth at 24\u00a0months was a key predictor of developmental scores for both groups (range, <jats:italic>B<\/jats:italic>\u2009=\u20090.04\u20130.14; 95% CI, 0.01, 0.07 and 0.09, 0.20).<\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>: Our results highlight that, without directly intervening on nutritional and poverty status, a community-based ECD intervention, delivered by trained Roma women to Roma children, can significantly improve neurodevelopmental outcomes at age 2\u00a0years.<\/jats:p>\n          <jats:p>\n            <jats:table-wrap>\n              <jats:table>\n                <jats:tbody>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:bold>What is Known:<\/jats:bold>\u2022 <jats:italic>The Roma are Europe\u2019s largest ethnic minority. High rates of neurodisability, malnutrition and poverty are reported in Roma preschoolers.<\/jats:italic>\u2022 <jats:italic>Optimal early child development (ECD) is foundational to lifecourse health and wellbeing. Early interventions improve ECD outcomes in vulnerable children; however, evidence from Roma communities is limited.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                  <jats:tr>\n                    <jats:td align=\"left\">\n                      <jats:bold>What is New:<\/jats:bold>\u2022 <jats:italic>The Omama project is a community-based ECD intervention, delivered by trained Roma women to Roma children aged 3\u00a0weeks to 20\u00a0months living in impoverished settlements in Eastern Slovakia.<\/jats:italic>\u2022 <jats:italic>Roma children receiving the intervention had (i) higher cognitive, language and fine motor scores and (ii) lower rates of cognitive delay compared with controls.<\/jats:italic>\n                    <\/jats:td>\n                  <\/jats:tr>\n                <\/jats:tbody>\n              <\/jats:table>\n            <\/jats:table-wrap>\n          <\/jats:p>","DOI":"10.1007\/s00431-024-05967-9","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T05:02:15Z","timestamp":1736830935000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A community-based intervention (the Omama Project) improves neurodevelopment in impoverished 2-year-old Roma children: a quasi-experimental observational study"],"prefix":"10.1007","volume":"184","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0051-3389","authenticated-orcid":false,"given":"M.","family":"Fernandes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Matuskova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Babelova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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Routledge, pp 325\u2013340. https:\/\/doi.org\/10.4324\/9781315562193-23","DOI":"10.4324\/9781315562193-23"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-024-05967-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-024-05967-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-024-05967-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T03:04:48Z","timestamp":1739934288000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-024-05967-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,14]]},"references-count":46,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["5967"],"URL":"https:\/\/doi.org\/10.1007\/s00431-024-05967-9","relation":{},"ISSN":["1432-1076"],"issn-type":[{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,14]]},"assertion":[{"value":"29 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 December 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 December 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 January 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. The Omama Project was approved by the Ethics Committee at the National Institute of Children Diseases, Slovakia (Reference: V Bratislave 18.12.19). Mothers provided written informed consent for themselves and their children.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"133"}}