| Sumario: | Fine motor and cognitive skills are vital for early learning; however, children from skipped-generation families may face developmental risks due to limited caregiver stimulation. This cluster-randomized controlled trial evaluated the effectiveness of the Caregiver-Promoting Play Program in Thailand, organizing play activities to enhance f ine motor and cognitive development in preschool children from skipped-generation families. Two community clusters were randomly assigned to the experimental and control groups, and 50 caregiver--child pairs were recruited from selected sites. Data were collected using the Caregiver Competency Questionnaire and the Developmental Surveillance and Promotion Manual (DSPM). Statistical analyses comprised descriptive statistics and generalized estimating equations to account for correlated pre--post measurements. The study found that at the post-intervention assessment, children in the experimental group achieved greater gains in f ine motor and cognitive development than those in the control group. Caregivers in the experimental group also demonstrated signif icantly higher caregiving competency in organizing play activities after completing the program. These f indings indicated the effectiveness of the Caregiver-Promoting Play Program in strengthening caregiver capacity and improving developmental outcomes among preschool children in skipped-generation families. The f indings suggest that nurses and community health personnel can implement the program to support early childhood development in vulnerable family contexts. However, further study with longer follow-up periods is recommended to examine the sustainability of program effects.
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