{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:09:09Z","timestamp":1790258949429,"version":"4.1.0"},"reference-count":36,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"unspecified","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018325","name":"LEGO Foundation","doi-asserted-by":"publisher","award":["Early Journey of Life (EJoL) Vietnam"],"award-info":[{"award-number":["Early Journey of Life (EJoL) Vietnam"]}],"id":[{"id":"10.13039\/100018325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000861","name":"Burroughs Wellcome Fund","doi-asserted-by":"publisher","award":["NextGen Pregnancy award (#1051932)"],"award-info":[{"award-number":["NextGen Pregnancy award (#1051932)"]}],"id":[{"id":"10.13039\/100000861","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010825","name":"Society for Research in Child Development","doi-asserted-by":"publisher","award":["Small Grants"],"award-info":[{"award-number":["Small Grants"]}],"id":[{"id":"10.13039\/100010825","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000923","name":"Australian Research Council","doi-asserted-by":"publisher","award":["CE230100004"],"award-info":[{"award-number":["CE230100004"]}],"id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Alan and Elizabeth Finkel Foundation","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,9,5]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Parents are crucial as providers of nurturing care for their children to grow and thrive. A community-based multicomponent intervention for women\u2019s health and early childhood health and development was conducted in rural Vietnam, spanning from mid-pregnancy through the first postpartum year. A cluster-randomised controlled trial of the programme conducted between 2018 and 2021 found that children aged 2 years whose parents were in the intervention group and had received the programme had higher cognitive, language and motor development than those in the control group who had received the usual standard of care. The intervention was also found to be cost-effective and improve equity. The aim of this follow-up study is to examine the mid-term effects of the intervention and describe the views of caregivers, service providers and policymakers on the programme, the evidence of its impact and its translation into policies and practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a follow-up study of participants in a cluster-randomised controlled trial to examine the mid-term effects of the intervention when children are 7 and 9 years old in Vietnam. We will re-enrol mother\u2013child dyads from the original trial (622\u2009women and their children in the intervention; 546 dyads in the control group). The primary outcome is children\u2019s intellectual ability. Secondary outcomes include children\u2019s emotional and behavioural development, quality of life, anthropometric indices, health conditions, health behaviour and education and parenting, maternal mental health, maternal quality of life, cardiovascular health and biomarkers of ageing together with women\u2019s and children\u2019s experiences of family violence.<\/jats:p>\n                    <jats:p>Outcomes will be measured using culturally and linguistically adapted standardised tools and study-specific structured questions. Differences in outcomes between trial groups will be assessed using mediation analyses and mixed-effects models, including a fixed effect for the trial group and adjusting for cluster effects as a random effect based on the intention-to-treat principle. An economic evaluation will estimate the cost-effectiveness of the intervention in improving child development at ages 7 and 9 years from healthcare and societal perspectives. A qualitative study will be conducted alongside the follow-up study using purposive sampling to describe the perspectives of caregivers, service providers and policymakers on the intervention, the evidence about its impact and its integration into national policies and services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics approval was obtained from the Monash University Human Research Ethics Committee (2025\u201346034-125952). Study findings will be disseminated through multiple channels, including peer-reviewed publications, national and international conference presentations, seminars, policy briefings, lay language summaries to communes and media reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ACTRN12625001113448.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-117515","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:50:17Z","timestamp":1790257817000},"page":"e117515","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mid-term effects of a parenting programme on early childhood development and maternal health in Vietnam: protocol for a follow-up of a cluster-randomised controlled trial"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0466-7385","authenticated-orcid":false,"given":"Yeji","family":"Baek","sequence":"first","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Health Economics and Policy Evaluation Research (HEPER), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4686-8601","authenticated-orcid":false,"given":"Thach","family":"Tran","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neve","family":"Davison","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha","family":"Tran","sequence":"additional","affiliation":[{"name":"Research and Training Centre for Community Development (RTCCD), Hanoi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy","family":"Tran","sequence":"additional","affiliation":[{"name":"Research and Training Centre for Community Development (RTCCD), Hanoi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hau","family":"Nguyen","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0625-3522","authenticated-orcid":false,"given":"Zanfina","family":"Ademi","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"},{"name":"Health Economics and Policy Evaluation Research (HEPER), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hanieh","sequence":"additional","affiliation":[{"name":"Medicine, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverley-Ann","family":"Biggs","sequence":"additional","affiliation":[{"name":"Medicine, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia"},{"name":"The Royal Melbourne Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Lombroso","sequence":"additional","affiliation":[{"name":"Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA"},{"name":"Department of Obstetrics Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran J","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA"},{"name":"Department of Obstetrics Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1959-6807","authenticated-orcid":false,"given":"Jane","family":"Fisher","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"2026092406501192000_16.9.e117515.1","unstructured":"World Health Organization, United Nations Children\u2019s Fund, World Bank Group . Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential. Geneva World Health Organization; 2018."},{"key":"2026092406501192000_16.9.e117515.2","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.10.010427","article-title":"Early childhood suspected developmental delay in 63 low- and middle-income countries: Large within- and between-country inequalities documented using national health surveys","volume":"10","author":"Gil","year":"2020","journal-title":"J Glob Health"},{"key":"2026092406501192000_16.9.e117515.3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002034","article-title":"Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modeling","volume":"13","author":"McCoy","year":"2016","journal-title":"PLoS Med"},{"key":"2026092406501192000_16.9.e117515.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2020-002314","article-title":"Inequalities in early childhood care and development in low\/middle-income countries: 2010-2018","volume":"5","author":"Lu","year":"2020","journal-title":"BMJ Glob Health"},{"key":"2026092406501192000_16.9.e117515.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003602","article-title":"Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis","volume":"18","author":"Jeong","year":"2021","journal-title":"PLoS Med"},{"key":"2026092406501192000_16.9.e117515.6","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-023539","article-title":"Addressing multiple modifiable risks through structured community-based Learning Clubs to improve maternal and infant health and infant development in rural Vietnam: protocol for a parallel group cluster randomised controlled trial","volume":"8","author":"Fisher","year":"2018","journal-title":"BMJ Open"},{"key":"2026092406501192000_16.9.e117515.7","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/S2352-4642(23)00032-9","article-title":"Structured, multicomponent, community-based programme for women\u2019s health and infant health and development in rural Vietnam: a parallel-group cluster randomised controlled trial","volume":"7","author":"Fisher","year":"2023","journal-title":"Lancet Child Adolesc Health"},{"key":"2026092406501192000_16.9.e117515.8","doi-asserted-by":"crossref","first-page":"e1269","DOI":"10.1016\/S2214-109X(23)00271-1","article-title":"Promoting early childhood development in Viet Nam: cost-effectiveness analysis alongside a cluster-randomised trial","volume":"11","author":"Baek","year":"2023","journal-title":"Lancet Glob Health"},{"key":"2026092406501192000_16.9.e117515.9","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1093\/heapol\/czad057","article-title":"Considering equity and cost-effectiveness in assessing a parenting intervention to promote early childhood development in rural Vietnam","volume":"38","author":"Baek","year":"2023","journal-title":"Health Policy Plan"},{"key":"2026092406501192000_16.9.e117515.10","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2020-004067","article-title":"Short-term, medium-term and long-term effects of early parenting interventions in low- and middle-income countries: a systematic review","volume":"6","author":"Jeong","year":"2021","journal-title":"BMJ Glob Health"},{"key":"2026092406501192000_16.9.e117515.11","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1186\/s12913-019-4325-5","article-title":"Protocol for a process evaluation of a cluster randomized controlled trial of the Learning Club intervention for women\u2019s health, and infant\u2019s health and development in rural Vietnam","volume":"19","author":"Fisher","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"2026092406501192000_16.9.e117515.12","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-031721","article-title":"Protocol for an economic evaluation alongside a cluster randomised controlled trial: cost-effectiveness of Learning Clubs, a multicomponent intervention to improve women\u2019s health and infant\u2019s health and development in Vietnam","volume":"9","author":"Nguyen","year":"2019","journal-title":"BMJ Open"},{"key":"2026092406501192000_16.9.e117515.13","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-025-12516-z","article-title":"Economic returns on investing in early childhood development in Vietnam: a cost-benefit analysis","volume":"25","author":"Baek","year":"2025","journal-title":"BMC Health Serv Res"},{"key":"2026092406501192000_16.9.e117515.14","unstructured":"General Statistics Office . Statistical yearbook of Vietnam. 2021."},{"key":"2026092406501192000_16.9.e117515.15","unstructured":"Viet Nam General Statistics Office . Results of the Viet Nam household living standards survey 2020. 2022."},{"key":"2026092406501192000_16.9.e117515.16","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1111\/cch.12235","article-title":"Common mental disorders among women, social circumstances and toddler growth in rural Vietnam: a population-based prospective study","volume":"41","author":"Fisher","year":"2015","journal-title":"Child Care Health Dev"},{"key":"2026092406501192000_16.9.e117515.17","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2019-001801","article-title":"The Stunting Tool for Early Prevention: development and external validation of a novel tool to predict risk of stunting in children at 3 years of age","volume":"4","author":"Hanieh","year":"2019","journal-title":"BMJ Glob Health"},{"key":"2026092406501192000_16.9.e117515.18","unstructured":"The United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) . United nations inter-agency group for child mortality estimation. 2026. Available: https:\/\/childmortality.org\/ [Accessed 5 Aug 2026]."},{"key":"2026092406501192000_16.9.e117515.19","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1177\/0734282906288389","article-title":"Test Review: Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV)","volume":"24","author":"Kaufman","year":"2006","journal-title":"J Psychoeduc Assess"},{"key":"2026092406501192000_16.9.e117515.20","unstructured":"Pearson Assessments US . WISC-iv and wiat-ii test scores report to parents\/guardians. 2003."},{"key":"2026092406501192000_16.9.e117515.21","unstructured":"EuroQol Research Foundation . EQ-5d-y-3l user guide. 2024."},{"key":"2026092406501192000_16.9.e117515.22","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001470","article-title":"The effect of intermittent antenatal iron supplementation on maternal and infant outcomes in rural Viet Nam: a cluster randomised trial","volume":"10","author":"Hanieh","year":"2013","journal-title":"PLoS Med"},{"key":"2026092406501192000_16.9.e117515.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0074876","article-title":"Impact on infants\u2019 cognitive development of antenatal exposure to iron deficiency disorder and common mental disorders","volume":"8","author":"Tran","year":"2013","journal-title":"PLoS One"},{"key":"2026092406501192000_16.9.e117515.24","doi-asserted-by":"crossref","DOI":"10.1016\/j.lansea.2025.100564","article-title":"Cost-effectiveness analysis of two integrated early childhood development programs into Bangladeshi primary health-care services","volume":"35","author":"Hossain","year":"2025","journal-title":"Lancet Reg Health Southeast Asia"},{"key":"2026092406501192000_16.9.e117515.25","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003746","article-title":"Cost-effectiveness and economic returns of group-based parenting interventions to promote early childhood development: Results from a randomized controlled trial in rural Kenya","volume":"18","author":"Lopez Garcia","year":"2021","journal-title":"PLoS Med"},{"key":"2026092406501192000_16.9.e117515.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2015.02.001"},{"key":"2026092406501192000_16.9.e117515.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2013.02.002"},{"key":"2026092406501192000_16.9.e117515.28","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2026092406501192000_16.9.e117515.29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.1997.tb01545.x"},{"key":"2026092406501192000_16.9.e117515.30","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200111000-00015"},{"key":"2026092406501192000_16.9.e117515.31","unstructured":"Beusenberg M , Orley JH . World health organization. a user\u2019s guide to the self reporting questionnaire (SRQ). Geneva World Health Organization; 1994."},{"key":"2026092406501192000_16.9.e117515.32","unstructured":"EuroQol Research Foundation . EQ-5d-5l user guide. 2019."},{"key":"2026092406501192000_16.9.e117515.33","unstructured":"Australian Institute of Family Studies . The longitudinal study of australian children annual statistical report 2010. Commonwealth of Australia; 2011."},{"key":"2026092406501192000_16.9.e117515.34","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1007\/s10578-023-01583-0","article-title":"I Know What to Do; I Can Do It; It Will Work: The Brief Parental Self Efficacy Scale (BPSES) for Parenting Interventions","volume":"56","author":"Woolgar","year":"2025","journal-title":"Child Psychiatry Hum Dev"},{"key":"2026092406501192000_16.9.e117515.35","unstructured":"General Statistics Office of Viet Nam, United Nations Children\u2019s Fund . Survey measuring viet nam sustainable development goal indicators on children and women 2020-2021, survey findings report. Viet Nam Ha Noi; 2021."},{"key":"2026092406501192000_16.9.e117515.36","unstructured":"Garc\u00eda-Moreno C , Jansen H , Ellsberg M , et al . WHO Multi-country study on women\u2019s health and domestic violence against women: Initial results on prevalence, health outcomes and women\u2019s responses. Geneva: World Health Organization, 2005."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-117515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:50:29Z","timestamp":1790257829000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-117515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":36,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,24]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bmjopen-2026-117515"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-117515","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}