Promoting early childhood development through nurturing parenting: Feasibility of the ASCENDI program for adolescent mothers in the Dominican Republic

This study evaluated the feasibility and preliminary effectiveness of a 12-session group-based nurturing care intervention for adolescent mothers in the Dominican Republic. We conducted a one-group pretest-posttest feasibility study in Boca Chica, Dominican Republic. Participants were adolescent mothers under 20 years of age with a child enrolled in an early childhood development (ECD) center operated by the National Institute for Early Childhood Comprehensive Care. The intervention, based on the World Health Organization's Nurturing Care Framework, addressed ECD, affective care, positive discipline, and maternal well-being. We calculated effect sizes using Cohen's d. Of 14 adolescent mothers who started the program, 11 completed both assessments (78.6% retention). Participants had a mean age of 16.91 years (SD = 1.35), with children averaging 1.15 years (SD = 0.84). Two outcomes showed statistically significant improvements. Parental efficacy (1-4 scale) increased from M = 3.38 to M = 3.84 (d = 0.99, p = .008), with significant gains observed in three subdomains: protective (d = 1.21, p = .003), formative (d = 0.90, p = .014), and bonding competencies (d = 0.81, p = .023). Cognitive stimulation activities (0-1 scale) increased from M = 0.42 to M = 0.65 (d = 0.81, p = .036). Participant satisfaction was high (M = 4.64 on a 5-point scale). ASCENDI demonstrated feasibility and preliminary effectiveness in improving parental efficacy and cognitive stimulation among adolescent mothers. Large effect sizes and high retention and satisfaction support the potential of group-based nurturing care interventions for adolescent mothers in resource-limited settings.