{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T17:14:27Z","timestamp":1772212467085,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The World Bank Early Learning Partnership"},{"name":"The Strategic Impact Evaluation Fund"},{"name":"The Japan Trust Fund"},{"name":"USAID Rwanda"},{"name":"The Network of European Foundations"},{"name":"The ELMA Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Intervention effectiveness studies rarely empirically assess Theories of Change (ToC) to determine how an intervention worked. We examine the ToC underlying the Sugira Muryango (SM) parenting program in rural Rwanda to understand whether the intervention improved child development outcomes via changes in caregivers\u2019 behaviors to improve the home caregiving environment, as hypothesized. Methods: SM uses coaching of parents to create a safe, affectionate, stimulating, and violence-free home environment. A cluster randomized trial enrolled 1049 families with young children. SM had immediate effects on caregiver behaviors, improving scores on the Home Observation for Measurement of the Environment (HOME), harsh discipline, caregiver emotion regulation, and provision of dietary diversity. We use structural equation modeling to examine whether change in caregivers\u2019 behaviors explains intervention-related improvements in child development (Ages and Stages Questionnaire) one year after the intervention ended. Results: Improvements in positive caregiving practices, including stimulation and early language learning as captured by the HOME, explained some of the intervention-related changes in child development, including gross motor, communication, problem-solving, and personal-social development. Increased dietary diversity explained intervention-related change in gross motor, problem-solving, and personal-social development. Change in harsh discipline and caregiver emotion regulation did not explain child outcomes. Conclusions: Intervention-related changes related to constructs captured on the HOME and dietary diversity were associated with changes in child development scores, but violent discipline and caregiver emotion regulation were not. Future research should examine whether these components of the intervention can be strengthened and may influence child development via other pathways, for example, via caregiver mental health.<\/jats:p>","DOI":"10.3390\/children13030344","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T15:52:38Z","timestamp":1772207558000},"page":"344","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanisms of Change Underlying Effects of an Early Parenting Intervention on Child Development Among Vulnerable Families in Rwanda"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6407-3055","authenticated-orcid":false,"given":"Sarah K. G.","family":"Jensen","sequence":"first","affiliation":[{"name":"Women and Infants Hospital, Providence, RI 02905, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4927-3344","authenticated-orcid":false,"given":"Matias","family":"Placencio-Castro","sequence":"additional","affiliation":[{"name":"School of Social Work, Boston College, Chestnut Hill, MA 02467, USA"},{"name":"Lynch School of Education and Human Development, Boston College, Chestnut Hill, MA 02467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5768-5931","authenticated-orcid":false,"given":"Shauna M.","family":"Murray","sequence":"additional","affiliation":[{"name":"School for Global Inclusion & Social Development, University of Massachusetts, Boston, MA 02125, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Sezibera","sequence":"additional","affiliation":[{"name":"Center for Mental Health, University of Rwanda, Kigali P.O. Box 3286, Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3683-4440","authenticated-orcid":false,"given":"Theresa S.","family":"Betancourt","sequence":"additional","affiliation":[{"name":"School of Social Work, Boston College, Chestnut Hill, MA 02467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1177\/0193841X9702100405","article-title":"How can theory-based evaluation make greater headway?","volume":"21","author":"Weiss","year":"1997","journal-title":"Eval. Rev."},{"key":"ref_2","unstructured":"United Nations Children\u2019s Fund (2024). Why It Matters for Children\u2019s Protection and Well-Being: Addressing the Intersections of Violence Against Children and Violence Against Women (Brief 1), UNICEF Innocenti Global Office of Research and Foresight. 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