A Feasibility RCT Evaluating a Play-Informed, Caregiver-Implemented, Home-Based Intervention to Improve the Play of Children Who Are HIV Positive.
Elelwani Ramugondo, Anande Ferreira, Donna Chung and 1 others
PMID 30662380WHAT IT FOUND
A caregiver-led home play programme did not improve playfulness scores more than standard one-on-one therapy.
The main finding was that children with HIV struggled most with shared control and pretend play, despite being motivated to engage.
Key findings
01Children with HIV and progressive HIV encephalopathy showed low playfulness scores, particularly in shared control, pretend play, and framing skills, while intrinsic motivation remained relatively high.
02The play-informed, caregiver-implemented home-based intervention (PICIHBI) did not produce statistically significant improvements in overall playfulness scores compared to baseline or conventional therapy.
03High attrition and low attendance due to socioeconomic barriers, such as lack of transport money, reduced the study's power and limited the analysis of intervention effectiveness.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was a feasibility trial with a very small final sample size (24 participants) due to high attrition, which significantly reduced statistical power. Participants were excluded if they attended less than 50% of sessions, meaning the results reflect only the most adherent families. The trial was conducted in a single clinic in South Africa with a specific socioeconomic and cultural context, limiting generalisability. Blinding of therapists and participants was not possible, which may have influenced engagement with the interventions. Playfulness was assessed only in an indoor clinic setting, which may not reflect natural play behaviours in home or outdoor environments.
Declared interests
The authors declared no conflicts of interest. The study was part of a larger project registered with the South African National Clinical Trial Registry.
The easy way to misread this
Do not conclude that caregiver-led group interventions are ineffective for playfulness; the null result is likely due to the small sample size and high dropout rate rather than the intervention itself failing. Additionally, do not assume these findings apply to all children with HIV, as the sample was drawn from a specific low-socioeconomic context in South Africa.