Home environment: Short‐term trends and predictors in early childhood from an Indian community birth cohort

Abstract

Background Early childhood home environment is intricately linked to child development and later cognitive and academic skills. There is limited literature evaluating home environmental trends and predictors in the low‐ and middle‐income country settings. Aims Determine the trends of early childhood home environment changes between 6 and 36 months of age, and the factors associated with these changes. Study design Longitudinal community‐based birth cohort follow‐up study in a semi‐urban slum in Vellore, South India. Subjects Consecutive sampling of a birth cohort between March 2010 and February 2012. Outcome measures Home environment was objectively assessed using the ‘Home Observation for the Measurement of the Environment’ (HOME) scale. Predictors of change in the home environment over time also were analyzed. Multivariable linear regression models and linear mixed effect models were used to identify the factors associated with HOME score at individual time points and over‐a‐time period, respectively. Results The birth cohort enrolled 251 children with a follow‐up of 235, 228 and 218 children at 6, 24 and 36 months, respectively. The socio‐economic status (SES) was the single biggest predictor for the HOME score at each time point, with increasing strength over time. Maternal education predicted home environment at 24 months, while maternal depression was negatively associated at 6 and 24 months of age. SES and maternal factors contributed to the overall change in the HOME score. Maternal factors predicted relational home environmental change over time. Conclusion SES and maternal factors consistently predicted early childhood home environment at 6, 24 and 36 months of age and its change over time. It is important to support maternal education and wellbeing along with socio‐economic measures to optimize early childhood environment.

Secular Growth Trends in Early Childhood—Evidence from Two Low-Income Birth Cohorts Recruited over a Decade in Vellore, India

“…In the MAL-ED cohort itself, our previous publication has shown that SES improved between 6 and 36 months of age due to gains in water and sanitation access, assets, and reported family income. 26 These SES improvements are in concurrence with economic surveys and reports from India and the World Bank indicating similar improvements in SES all over the world specifically in southern India where Vellore is situated. 36 – 38 …”

“…Details of recruitment, exclusion criteria, and follow-up are already published. [26][27][28] Birth cohort studies and their subsequent follow-up were approved by the Institutional review board of Christian Medical College, Vellore.…”

Developmental trends in early childhood and their predictors from an Indian birth cohort

“…The Indian study site was a densely populated urban slum in Vellore, South India and covered a population of 12,000 [ 25 ]. Children were enrolled at birth by consecutive sampling and details of enrollment, exclusion criteria, follow up and details are available in previously published articles from the same birth cohort [ 26 – 28 ]. The original birth cohort enrollment and consequent follow-ups were approved by the Institutional Review Board of Christian Medical College, Vellore and children were recruited at each stage after informed parental consent.…”

“…The WAMI measure with components of access to improved water and sanitation, assets, maternal education and total household income is a simplified measure of socio-economic position (SEP) developed during the MAL-ED study, [ 31 ] and details are provided in other published articles from the same cohort [ 26 – 28 ].…”

“…Supplementary information was obtained using a mother/caregiver interview as per the MAL-ED study protocol [ 35 ]. Further details about this measure is provided in another published article from the same birth cohort [ 26 ].…”