Digital support systems to improve child development in Peru: A cluster-randomized controlled open-label trial
Digital technologies have the potential to transform early childhood development (ECD) interventions by delivering personalized support at scale. We conducted a cluster-randomized controlled trial in rural Peru to evaluate the effectiveness and cost-effectiveness of an artificial intelligence-supported digital parenting chatbot as well as traditional home visits as interventions to improve child development. Among 2461 caregiver-child dyads, both the digital and home-visiting interventions improved child development outcomes at 2.5 years of age, with standardized effect sizes of 0.11 and 0.17, respectively. At <sup>1</sup>/<sub>15</sub> of the cost of in-person support, the digital intervention yielded superior cost-effectiveness. These findings suggest that digital platforms can be a viable, scalable alternative to support children's development in resource-constrained settings.
Authors
- Andreana Castellanos (ORCID: https://orcid.org/0009-0005-1353-2457)
- Daniel Mäusezahl
- Dana Charles McCoy (ORCID: https://orcid.org/0000-0002-0896-1813)
- Kristen Hinckley (ORCID: https://orcid.org/0000-0001-7161-3769)
- Marta Dormal
- María Cabello (ORCID: https://orcid.org/0000-0003-2362-6092)
- Günther Fink
- Stella Hartinger Pena
- María Luisa Huaylinos Bustamante
- Sarah Farnsworth Hatch (ORCID: https://orcid.org/0009-0005-9642-280X)
- Lena Jäggi
- Milagros Alvarado
- Ce Zhang
- Leonel Aguilar
- Jorge Cuartas
Institutions
- Swiss Tropical and Public Health Institute (CH)
- Universidad de Los Andes (CO)
- University of Basel (CH)
- Universidad Peruana Cayetano Heredia (PE)
- University of Chicago (US)
- Agricultural Research Service - Plains Area (US)
- New York University (US)
Publication Details
- Journal
- Science Advances
- Published
- 2026-03-04
- DOI
- https://doi.org/10.1126/sciadv.aeb9403
- Primary Topic
- Mobile Health and mHealth Applications
- Type
- article
- Field-Weighted Citation Impact
- 0.00