Developmental Screening Outcomes Following a Theory of Planned Behavior-Based Parental Intervention for Pesticide Exposure Prevention in Agricultural Communities

Pesticide exposure is an environmental health concern in agricultural communities, where young children are particularly vulnerable during critical developmental periods. This study evaluated a Theory of Planned Behavior (TPB)-based parental intervention for pesticide exposure prevention and child developmental screening outcomes. A quasi-experimental study included 121 parents or caregivers and their children aged 1–3 years in an intervention (n = 54) or routine-care control group (n = 67). The intervention comprised four structured learning activities delivered over four consecutive weeks (six hours in total), targeting attitudes, subjective norms, and perceived behavioral control related to pesticide exposure prevention and caregiving practices. The first three activities were group-based sessions delivered by trained public health officers, while the fourth consisted of individualized home visits and follow-up conducted by trained village health volunteers. Child developmental screening was conducted at baseline and at the 6-month follow-up using the Developmental Surveillance and Promotion Manual (DSPM) across five domains: gross motor, fine motor and cognitive, receptive language, expressive language, and personal–social development. At baseline, no statistically significant between-group differences were observed across the five developmental screening domains. Longitudinal differences were analyzed using generalized estimating equations (GEE). Significant group × time interactions indicated more favorable changes over time in the risk of not passing developmental screening in the intervention group relative to the control group for gross motor (RR = 0.14, 95% CI: 0.03–0.75), fine motor and cognitive (RR = 0.16, 95% CI: 0.03–0.92), expressive language (RR = 0.24, 95% CI: 0.10–0.56), and personal–social development (RR = 0.29, 95% CI: 0.10–0.82). These findings provide preliminary, hypothesis-generating evidence that participation in the TPB-based parental intervention was associated with more favorable changes over time in developmental screening outcomes across several domains.