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Oflu A, Yalcin SS. Exploring the interplay: Maternal electronic health literacy and its impact on early childhood development and parenting practices. Child Care Health Dev 2024; 50:e13261. [PMID: 38606995 DOI: 10.1111/cch.13261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/29/2024] [Accepted: 03/14/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Mothers need a competent electronic health literacy (eHL) skill for beneficial gains for the health of their children in the virtual environment, which is a new health platform. We predict that a competent eHL of mothers who play a central role in early childhood will positively affect the health of their children. This study aimed to determine the level of eHL of mothers of young children and investigate the relationship between mothers' eHL and early childhood development (ECD) and early parenting practices (EPP). METHODS This cross-sectional study was conducted on mothers with children aged 36-59 months using eHealth. Sociodemographic and personal characteristics form, Early Childhood Development Module and eHealth Literacy Scale were administered to the participating mothers. RESULTS The data from 440 mother-child pairs were analysed. Children of mothers with sufficient eHL levels were more likely to be Early Childhood Development Index (ECDI)-on-track, adjusted odds ratio (AOR), 95% confidence interval (CI): 2.16 (1.29-3.61); have adequate support in learning, AOR (%95 CI): 3.23 (1.69-6.18); and have adequate daily meals and snacks, AOR (%95 CI): 2.43 (1.56-3.78). CONCLUSION These results revealed that there is a need for interventions that will contribute to child health by improving mothers' eHL levels.
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Affiliation(s)
- Ayse Oflu
- Department of Pediatrics, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Siddika Songul Yalcin
- Department of Social Pediatrics, Institute of Child Health, Hacettepe University, Ankara, Turkey
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López M, Mira A, Mauricia D, Acevedo P, Lopez R, Molina P, Gutiérrez L, de Billerbeck E, Breinbauer C. Are children under five with disabilities' educational rights acknowledged and supported in Chile? Front Public Health 2024; 12:1304152. [PMID: 38560435 PMCID: PMC10979822 DOI: 10.3389/fpubh.2024.1304152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/14/2024] [Indexed: 04/04/2024] Open
Affiliation(s)
- Mauricio López
- Millennium Nucleus Studies on Disability and Citizenship (DISCA), Santiago, Chile
| | - Andrea Mira
- Exercise and Rehabilitation Sciences Institute, School of Occupational Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Daniela Mauricia
- Department of Child and Adolescent Development, Center for Healthy Development, Round Hill, VA, United States
| | - Paulina Acevedo
- Department of Child and Adolescent Development, Center for Healthy Development, Round Hill, VA, United States
| | - Ruth Lopez
- Department of Child and Adolescent Development, Center for Healthy Development, Round Hill, VA, United States
| | | | | | - Eloisa de Billerbeck
- Department of Child and Adolescent Development, Center for Healthy Development, Round Hill, VA, United States
| | - Cecilia Breinbauer
- Department of Child and Adolescent Development, Center for Healthy Development, Round Hill, VA, United States
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Delbiso TD, Nigatu YD, Tilahun N. Early childhood development and nutritional status in urban Ethiopia. Matern Child Nutr 2024:e13638. [PMID: 38450957 DOI: 10.1111/mcn.13638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
Early childhood development (ECD) is crucial for better health and well-being throughout life, but few studies have examined how ECD relates to child malnutrition. This is mainly due to lack of reliable and disaggregated data on ECD. We estimated the prevalence of ECD delays (communication, fine motor, gross motor, problem-solving and personal-social) and examined how different ECD domains were associated with child nutritional status in urban Ethiopia. Using a community-based cross-sectional survey design, 627 mother-child (12-36 months old) pairs were included in the study. The ECD was assessed using the Age and Stage Questionnaire (ASQ-3), and the nutritional status was assessed using anthropometric measurements. The association between the ECD domains and nutritional status was analysed using ordinal logistic regression, adjusting for confounding variables. Delays in ECD domains were common, especially in fine motor domain (41.9%); and more than half of the children were stunted (52.8%). Stunting and underweight were associated with ECD delays, while wasting was not. Accordingly, stunted children were more likely to have worst ECD delays in fine motor (odds ratios [OR] = 1.54; 95% confidence interval [CI]: 1.11; 2.15), gross motor (OR = 1.47; 95% CI: 1.05; 2.04) and problem-solving (OR = 1.41; 95% CI: 1.02; 1.96) domains compared to non-stunted children. Similarly, underweight children were more likely to have worse ECD delays in gross motor (OR = 1.91; 95% CI: 1.20; 3.04) and fine motor (OR = 1.90; 95% CI: 1.15; 3.15) domains compared to normal children. Coordinated and targeted ECD interventions, such as nurturing care, should be promoted and implemented widely to improve ECD outcomes and child nutrition.
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Affiliation(s)
- Tefera Darge Delbiso
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yakob Desalegn Nigatu
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Ltifi MA, Turki O, Ben-Bouzaiene G, Pagaduan JC, Okely A, Chelly MS. Exploring 24-Hour Movement Behaviors in Early Years: Findings From the SUNRISE Pilot Study in Tunisia. Pediatr Exerc Sci 2024:1-8. [PMID: 38364818 DOI: 10.1123/pes.2023-0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/27/2023] [Accepted: 01/12/2024] [Indexed: 02/18/2024]
Abstract
PURPOSE The International Study of Movement Behaviors in the Early Years (SUNRISE) was conducted in Tunisia to assess the proportion of preschoolers who met the World Health Organization guidelines for physical activity, sedentary behavior, and sleep. The study also evaluated the feasibility of the methods for the SUNRISE study. METHODS Five kindergartens were recruited from urban and rural areas in Tunisia. Physical activity and sleep duration were assessed using a waist-worn ActiGraph. Screen time and sleep quality were assessed via an interview-administered parent questionnaire. The NIH Toolbox was used. RESULTS A total of 112 preschoolers were assessed (50 boys, age = 4.1 [0.58]). Only 18% of children met all recommendations of the World Health Organization guidelines, while 53% met the sedentary screen time (in minutes per day), and 41% met physical activity recommendation (in minutes per day). Eighty-one percent of children met the sleep duration recommendation (in minutes per day). There was good compliance with the ActiGraph protocol. CONCLUSIONS This pilot study provided important insights into the feasibility of the study and the movement behaviors of Tunisian preschool children. The results suggest there is a need to promote healthy levels of physical activity and sedentary screen time in children, which should be a priority in public health initiatives, including preschool curricula, in Tunisia.
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Affiliation(s)
- Mohamed Amine Ltifi
- Research Laboratory (LR23JS01) "Sport Performance, Health and Society," Higher Institute of Sport and Physical Education of Ksar Saîd, University of Manouba, Tunis,Tunisia
| | - Olfa Turki
- Research Laboratory (LR23JS01) "Sport Performance, Health and Society," Higher Institute of Sport and Physical Education of Ksar Saîd, University of Manouba, Tunis,Tunisia
| | - Ghaith Ben-Bouzaiene
- Research Laboratory (LR23JS01) "Sport Performance, Health and Society," Higher Institute of Sport and Physical Education of Ksar Saîd, University of Manouba, Tunis,Tunisia
| | | | - Anthony Okely
- School of Health and Society, University of Wollongong, Wollongong,Australia
| | - Mohamed Souhaiel Chelly
- Research Laboratory (LR23JS01) "Sport Performance, Health and Society," Higher Institute of Sport and Physical Education of Ksar Saîd, University of Manouba, Tunis,Tunisia
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Vohra C, Shah M, Mishra A, Gupta A. Measuring for change/Mobile Creches. Front Public Health 2024; 11:1165642. [PMID: 38348380 PMCID: PMC10859431 DOI: 10.3389/fpubh.2023.1165642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 12/15/2023] [Indexed: 02/15/2024] Open
Abstract
Introduction Research spanning decades across fields such as psychology, education, and neuroscience consistently highlights the crucial role of social-emotional skills in various aspects of personal, academic, and professional development (1-3). The fact that UNESCO recognises social-emotional learning (SEL) as essential not just for meeting its educational objectives but also for accomplishing the Sustainable Development Goals highlights the crucial role robust social-emotional development plays in establishing sustainable societies. Whilst various studies highlight the importance of SEL, there is limited attention on how organizations can contribute to building such development by consciously including SEL in their work practice. Process/methods Our case study presents the process of integrating SEL into organizational practice over a period of 9 months. The selected constructs of SEL were determined by the organisation's needs and values. The Measurement for Change approach was used to frame and implement the intervention, with interactive discussions being the key methodology. Data were collected via surveys, reflective sharing, and observations. Results A shift in the selected constructs of SEL was recorded, with data highlighting individual differences. Conclusion The process of co-design and continual reflective practice was key to achieving change within the subset of the organisation rather than the specific content of the materials used.
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Affiliation(s)
- Chavi Vohra
- Utrecht University, Utrecht, Netherlands
- Grand Challenges Canada, Victoriaville, QC, Canada
- Save the Children, Kathmandu, Nepal
- Mobile Creches, New Delhi, India
| | - Minal Shah
- Utrecht University, Utrecht, Netherlands
- Grand Challenges Canada, Victoriaville, QC, Canada
- Agha Khan Academy, Mombasa, Kenya
| | - Atishi Mishra
- Utrecht University, Utrecht, Netherlands
- Grand Challenges Canada, Victoriaville, QC, Canada
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Wright AL, Butt ML, Valerio C, Ahmed O, Russell LM, Ferron EM. The experiences of gender and sexually diverse parents using support and services for their young children: An integrative review. J Clin Nurs 2024. [PMID: 38284462 DOI: 10.1111/jocn.17036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 12/11/2023] [Accepted: 01/07/2024] [Indexed: 01/30/2024]
Abstract
AIM To address: What are the experiences of 2SLGBTQQIA+ parents using parenting supports and services to meet their children's early childhood development needs (<5 years of age)? DESIGN Whittemore and Knafl's (2005) integrative review methodology. METHODS Electronic databases were searched from 2000 to October 14, 2022 for empirical studies or reviews addressing the research question. The title and abstract of 12,158 articles were screened for inclusion in the review by two independent researchers; 175 of these articles underwent full-text review. Studies selected were critically appraised using a Joanna Briggs Institute Critical Appraisal tool. Relevant key findings were extracted from each study and entered into N-VIVO-12. Thematic content analysis was employed and PRISMA guidelines were adhered to. RESULTS A total of 18 articles (15 qualitative and three multi-method studies) met the inclusion criteria and were selected for the review. Seven themes were revealed from analysis of the studies: (1) 2SLGBTQQIA+ Status kept a secret; (2) Forced to come out; (3) Heteronormative messaging; (4) Feeling excluded; (5) Stigmatised; (6) Parents act as educators; and (7) Positive experiences. CONCLUSION This integrative review provides nurses with insight into the experiences of 2SLGBTQQIA+ parents using health care services for their young child. IMPLICATIONS FOR THE PROFESSION This article highlights what changes nurses need to make to their practice to ensure appropriate, inclusive care for clients of diverse sexual and gender identities and their families. IMPACT Health care providers, especially nurses, have an opportunity to improve the experiences of these families and positively impact their health and well-being. Additionally, there is a need for research with the 2SLGBTQQIA+ parent community and the use of rigorous methodological techniques, including clearly linking participants' gender and sexual identities with study findings, to improve our understanding of 2SLGBTQQIA+ parent experiences. PATIENT OR PUBLIC CONTRIBUTION Although there was no direct patient contribution to the work since it was an integrative review of the literature, indirectly patient contributions are incorporated from the original research results of studies incorporated into this review.
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Affiliation(s)
- Amy L Wright
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Michelle L Butt
- School of Nursing and Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Claudia Valerio
- College of Early Childhood Educators, Toronto, Ontario, Canada
| | - Ossaid Ahmed
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Lisa M Russell
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Era Mae Ferron
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Liu S, Curenton SM, Sims J, Fisher PA. The promotive and protective effects of parents' perceived changes during the COVID-19 pandemic on emotional well-being among U.S. households with young children: an investigation of family resilience processes. Front Psychol 2024; 14:1270514. [PMID: 38259548 PMCID: PMC10800496 DOI: 10.3389/fpsyg.2023.1270514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The COVID-19 pandemic may constitute a traumatic event for families with young children due to its acute onset, the unpredictable and ubiquitous nature, and the highly distressing disruptions it caused in family lives. Despite the prevalent challenges such as material hardships, child care disruptions, and social isolation, some families evinced remarkable resilience in the face of this potentially traumatic event. This study examined domains of changes perceived by parents of young children that were consistent with the post-traumatic growth (PTG) model as factors that facilitate family resilience processes. Methods This study drew data from the RAPID project, a large ongoing national study that used frequent online surveys to examine the pandemic impact on U.S. households with young children. A subsample of 669 families was leveraged for the current investigation, including 8.07% Black, 9.57% Latino(a), 74.44% non-Latino(a) White families, and 7.92% households of other racial/ethnic backgrounds. In this subsample, 26.36% were below 200% federal poverty level. Results Approximately half of the parents reported moderate-to-large degrees of changes during the pandemic, and the most prevalent domain of change was appreciation of life, followed by personal strengths, new possibilities, improved relationships, and spiritual growth. Black and Latino(a) parents reported more changes in all five domains than White parents and more spiritual growth than parents of the other racial/ethnic groups. Moreover, parent-reported improved relationships were found to indirectly reduce young children's overall fussiness/defiance and fear/anxiety symptoms through reducing parents' emotional distress. Perceived changes in the new possibilities, personal strengths, and appreciation of life domains were found to serve as protective factors that buffered the indirect impacts of material hardship mean levels on child behavioral symptoms via mitigating parents' emotional distress. Discussion These findings shed light on resilience processes of a family system in a large-scale, disruptive, and stressful socio-historical event such as the COVID-19 pandemic. The five PTG domains could inform therapeutic and intervention practices in the face of future similar events. Importantly, these findings and the evinced family resilience should not negate the urgent needs of policy and program efforts to address material hardships, financial instabilities, and race/ethnicity-based structural inequalities for families of young children.
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Affiliation(s)
- Sihong Liu
- Stanford Center on Early Childhood, Stanford University, Stanford, CA, United States
| | - Stephanie M. Curenton
- Center on Ecology of Early Development, Boston University, Boston, MA, United States
| | - Jacqueline Sims
- Center on Ecology of Early Development, Boston University, Boston, MA, United States
| | - Philip A. Fisher
- Stanford Center on Early Childhood, Stanford University, Stanford, CA, United States
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Waldman MR, Raikes A, Hepworth K, Black MM, Cavallera V, Dua T, Janus M, Martin-Herz SP, McCoy DC, Weber AM. Psychometrics of psychosocial behavior items under age 6 years: Evidence from Nebraska, USA. Infant Ment Health J 2024; 45:56-78. [PMID: 38053329 DOI: 10.1002/imhj.22090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 10/11/2023] [Accepted: 10/19/2023] [Indexed: 12/07/2023]
Abstract
Because healthy psychosocial development in the first years of life is critical to lifelong well-being, governmental, and nongovernmental organizations are increasingly interested in monitoring psychosocial behaviors among populations of children. In response, the World Health Organization is developing the Global Scales of Early Development Psychosocial Form (GSED PF) to facilitate population-level psychosocial monitoring. Once validated, the GSED PF will be an open-access, caregiver-reported measure of children's psychosocial behaviors that is appropriate for infants and young children. This study examines the psychometric validity evidence from 45 items under consideration for inclusion in the GSED PF. Using data from N = 836 Nebraskan (USA) children aged 180 days to 71 months, results indicate that scores from 44 of the 45 (98%) items exhibit positive evidence of validity and reliability. A bifactor model with one general factor and five specific factors best fit the data, exhibited strong reliability, and acceptable model fit. Criterion associations with known predictors of children's psychosocial behaviors were in the expected direction. These findings suggest that measurement of children's psychosocial behaviors may be feasible, at least in the United States. Data from more culturally and linguistically diverse settings is needed to assess these items for global monitoring.
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Affiliation(s)
- Marcus R Waldman
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, USA
| | - Abbie Raikes
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, USA
| | - Katelyn Hepworth
- College of Education and Human Sciences, University of Nebraska-Lincoln, Lincoln, USA
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, USA
- RTI International, Research Triangle Park, USA
| | - Vanessa Cavallera
- Department of Mental Health and Substance Use, World Health Organization†, Geneva, Switzerland
| | - Tarun Dua
- Department of Mental Health and Substance Use, World Health Organization†, Geneva, Switzerland
| | - Magdalena Janus
- Offord Centre for Child Studies, Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Susanne P Martin-Herz
- Department of Pediatrics, Division of Developmental Medicine, University of California San Francisco, San Francisco, USA
| | - Dana C McCoy
- Harvard Graduate School of Education, Cambridge, USA
| | - Ann M Weber
- School of Public Health, University of Nevada, Reno, USA
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Li M, Du Y, Zhao C, Shi H, Wang X, Zhang J. Family responsive care mediating the home visiting effects on left-behind children's early development in rural China. Child Care Health Dev 2024; 50:e13226. [PMID: 38265138 DOI: 10.1111/cch.13226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/22/2023] [Accepted: 12/17/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND The early development of left-behind children requires great concern and improvement. Yet, current interventions for left-behind children are mainly focussed on children older than 3. This study aims to assess the effectiveness of a home visiting programme on family responsive care and early development of rural left-behind children and examine whether family responsive care mediates the effects of intervention on child development. METHODS A quasi-experimental study design was utilized in this study. A stratified clustered sampling was employed to choose villages in programme towns into intervention group. A control village was matched with every intervention village. All of the left-behind children and their caregivers meeting the inclusion criteria in the chosen villages were enrolled in the survey. The outcomes included child development, caregiver's early stimulation, parent-child communication, and learning materials. Baseline assessments were conducted in 2018, and endline assessments were conducted in 2020. RESULTS In the endline survey, we enrolled 608 children with 258 in the intervention group and 350 in the control group. Left-behind children in the intervention group were less likely to have development delay compared with the control group (odds ratio [OR] = 0.59, 95% confidence interval [CI]: 0.36, 0.96). Migrant parents of children in the intervention group showed higher proportion of expressing emotional support to their children when communicating (OR = 1.69, 95% CI: 1.05, 2.72). Children who received home visits more than once per 2 months had lower level of suspected development delay than children in the control group (OR = 0.34, 95% CI: 0.18, 0.68). Caregiver's early stimulation and migrant parents' emotional support to left-behind children mediated the intervention dose and left-behind children's development. CONCLUSION Caregiver's early stimulation mediates the intervention and child's development. The findings suggest a promising future for scaling similar early childhood development interventions for left-behind children in rural settings.
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Affiliation(s)
- Mengshi Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Yufeng Du
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Chunxia Zhao
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Huifeng Shi
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Xiaoli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China
| | - Jingxu Zhang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China
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Brien M, Coutinho F, Krishna D, van der Haar L, de Laat J, Srinivasan SR, Venkatachalapathy N. Leveraging monitoring, evaluation, and learning to scale the Enabling Inclusion ® program for children with disabilities in India and globally. Front Public Health 2023; 11:1165034. [PMID: 38162603 PMCID: PMC10757565 DOI: 10.3389/fpubh.2023.1165034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 11/07/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Children with disabilities in low- and middle-income countries face many challenges and lack adequate services, including access to rehabilitation professionals. To address this lack of access, Amar Seva Sangam Ayikudy (ASSA), a non-governmental organization (NGO) in India, designed a technology-leveraged rehabilitation program called Enabling Inclusion® (EI®), and implemented it in one state (Tamil Nadu, India) before scaling it. The model is supported by the EI® app, which enables organizations to screen, assess and monitor progress of children with disabilities via rehabilitation specialists and community rehabilitation workers, and to provide family-centered, goal-based interventions. An extensive monitoring, evaluation, and learning (MEL) framework is embedded into the program. This paper explores how this MEL system supported the scaling of the EI® model, reaching additional beneficiaries nationally and globally. Methods This paper describes ASSA's MEL framework and demonstrates its use for decision-making in the process of scaling. It also explores how collaborations with various government departments, NGOs, and private partners contributed to the scaling of the EI® model and technology. Results Scaling of the EI® program was achieved by (1) expansion of the program in rural Tamil Nadu (vertical scale-up) in partnership with the Tamil Nadu government and private partners, and (2) by licensing the EI® app and model to other NGOs in various states in India and globally (horizontal scale-up). Systematic examination of key program and performance indicators, as well as stakeholder feedback, informed decisions to modify the EI® app over time. This included further customizing to the needs of children and service providers, covering a greater range of age groups and contexts, and modifying service delivery models. Child functional independence, participation, and inclusion was further strengthened by mobilizing parent empowerment groups, community awareness programs, school advocacy, and entitlements from the government. Flexibility in the implementation model of the EI® app allowed for adaptation to local contexts and organizations, and facilitated its scale-up. Conclusion A dynamic, inclusive, and locally grounded MEL system, a flexible and collaborative approach, and an adaptive implementation model increased the accessibility of an early intervention and childhood rehabilitation program for children with disabilities and their families throughout the state of Tamil Nadu, across India, and internationally.
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Affiliation(s)
- Marie Brien
- Enabling Inclusion Program, Amar Seva Sangam, Tenkasi, Tamil Nadu, India
| | - Franzina Coutinho
- Enabling Inclusion Program, Amar Seva Sangam, Tenkasi, Tamil Nadu, India
| | - Dinesh Krishna
- Enabling Inclusion Program, Amar Seva Sangam, Tenkasi, Tamil Nadu, India
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Lotte van der Haar
- Utrecht Centre for Global Challenges, Utrecht School of Economics, Utrecht University, Utrecht, Netherlands
| | - Joost de Laat
- Utrecht Centre for Global Challenges, Utrecht School of Economics, Utrecht University, Utrecht, Netherlands
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Leite Ongilio F, Gaspardo CM, Linhares MBM. Maternal History of Adversity and Subsequent Mother-Child Interactions at Early Ages: A Systematic Review. Trauma Violence Abuse 2023; 24:3412-3432. [PMID: 36367204 DOI: 10.1177/15248380221130355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Adverse childhood experiences (ACEs) can negatively impact physical, emotional, cognitive, and social development, consequently affecting the next generation. The aim of the present study was to systematically review evidence from empirical studies on the association between maternal history of adversity in childhood (maltreatment and household dysfunction) and subsequent mother-child interactions at an early age. A search was performed in the PubMed, Web of Science, PsycINFO, EMBASE, Scopus, LILACS, and SciELO databases to identify studies, including measures of maternal childhood adversities and mother-child interaction, published between 2016 and 2022. Twenty-nine studies met the inclusion criteria. The results showed that in 90% of the studies, maternal childhood adversities negatively impacted subsequent mother-child interactions in early childhood, reducing maternal displays of affection, emotional availability, sensitivity, mother-child communication, and bonding. Biological factors (e.g., genetic and hormonal) and maternal emotional recognition moderated these associations. In addition, biological factors (i.e., neurobiological and hormonal) and psychosocial factors (e.g., depression, executive functioning, and violence) acted as mediators. Preventive interventions should be implemented to break out of the intergenerational cycle of violence that impacts mother-child interactions.
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Fang Z, Liu X, Zhang C, Lachman JM, Qiao D. Parenting Interventions That Promote Child Protection and Development for Preschool-Age Children with Developmental Disabilities: A Global Systematic Review and Meta-Analysis. Trauma Violence Abuse 2023:15248380231207965. [PMID: 37978829 DOI: 10.1177/15248380231207965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Global guidelines emphasize the critical role of responsive caregiving in terms of reducing violence against children and promoting early childhood development. However, there is an absence of global evidence synthesis on the effects of early childhood parenting programs for children with developmental disabilities. This systematic review and meta-analysis aims to investigate the effectiveness of parenting interventions delivered for preschool-age children with developmental disabilities in reducing violence against children, altering violence-related factors, and promoting child development. We searched for randomized controlled trials with inactive control. Estimates were pooled using robust variance estimations. Meta-regressions were conducted to explore sources of heterogeneity. In all, 33 studies met the inclusion criteria. The results showed that parenting programs improved child behavior, parental mental health, parenting practices, parental self-efficacy, parent-child interaction, child language skills, and child social skills post-intervention. No studies provided data on the actual occurrence of violence against children. Effects might vary by diagnosis, delivery modality, and world region. The findings supported the delivery of parenting programs to alter factors associated with violence against children and promote child language and social skills for families of young children with developmental disabilities, especially attention deficit hyperactivity disorder, autism, intellectual disability, and language disorders. More research using rigorous methods, long-term follow-ups, and transparent reporting is needed, particularly within more low- and middle-income countries.
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Affiliation(s)
| | | | | | - Jamie M Lachman
- University of Oxford, UK
- University of Cape Town, South Africa
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Alghamdi HM, Altirkistani BA, Baatya RA, Marghalani YO, Alshaikh NM. Bridging the Gap: Parents' Knowledge of Childhood Developmental Milestones and the Early Identification of Children With Developmental Delay. Cureus 2023; 15:e48232. [PMID: 38050522 PMCID: PMC10693921 DOI: 10.7759/cureus.48232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 12/06/2023] Open
Abstract
Background Monitoring children's acquisition of developmental milestones is integral to pediatric practice. Though pediatricians are responsible for evaluating children's development, parents have a crucial role in addressing delays as early as possible, where early detection of developmental delay can help in early intervention and ultimately potentiate a child's cognitive and social abilities toward an independent life. This study assesses parental knowledge of the warning signs denoting delayed developmental milestone acquisition, in addition to analyzing demographic variables that may influence their level of knowledge. Methods This cross-sectional study included 376 parents of children attending pediatric clinics in National Guard Health Affairs- King Abdulaziz Medical City, in Jeddah, Saudi Arabia. A two-section structured questionnaire was utilized. It included 16 option-based questions with one correct answer, while the other options were either an under or overestimate of the age at which the child should acquire a particularly significant milestone development across different domains. A score of 10 out of 16 was chosen as the minimum to show the appropriate level of knowledge. Results Most participants (n=282; 75%) were women, and 174 (46.27%) were between 29 and 39 years old. The highest reported level of education was college or higher (n=214; 56.91%). Only 41 (11%) parents had the required level of knowledge, while the remaining 335 (89%) fell short of meeting the passing level (mean 6.59, SD= 2.72). The motor domain had the highest level of accuracy, followed closely behind the cognitive domain. The language and social domains exhibited lower levels of accuracy. Conclusions Despite the majority of parents in this group possessing a college education and availing multiple health resources, there is a significant gap in their knowledge of typical trajectories of development milestones. Thus, there is a need for a nationwide initiative to promote the parent's proactive role in monitoring their children's growth.
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Affiliation(s)
- Haitham M Alghamdi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
- College of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Bsaim A Altirkistani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Rabea A Baatya
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Yasir O Marghalani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
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Cuartas J, McCoy D, Sánchez J, Behrman J, Cappa C, Donati G, Heymann J, Lu C, Raikes A, Rao N, Richter L, Stein A, Yoshikawa H. Family play, reading, and other stimulation and early childhood development in five low-and-middle-income countries. Dev Sci 2023; 26:e13404. [PMID: 37114644 DOI: 10.1111/desc.13404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 02/20/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023]
Abstract
This paper used longitudinal data from five studies conducted in Bangladesh, Bhutan, Cambodia, Ethiopia, and Rwanda to examine the links between family stimulation and early childhood development outcomes (N = 4904; Mage = 51.5; 49% girls). Results from random-effects and more conservative child-fixed effects models indicate that across these studies, family stimulation, measured by caregivers' engagement in nine activities (e.g., reading, playing, singing), predicted increments in children's early numeracy, literacy, social-emotional, motor, and executive function skills (standardized associations ranged from 0.05 to 0.11 SD). Study-specific models showed variability in the estimates, with null associations in two out of the five studies. These findings indicate the need for additional research on culturally specific ways in which caregivers may support early development and highlight the importance of promoting family stimulation to catalyze positive developmental trajectories in global contexts. RESEARCH HIGHLIGHTS: Research on the links between family stimulation and early childhood development in low-and-middle-income countries (LMICs) is limited. We used longitudinal data from studies conducted in five LMICs to examine the links between family stimulation and early childhood development outcomes. Results suggest that family stimulation predicted increments in children's numeracy, literacy, social-emotional, motor, and executive function skills. We found variability in the observed estimates, with null associations in two out of the five studies, suggesting the need for additional research in LMICs.
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Affiliation(s)
- Jorge Cuartas
- Harvard Graduate School of Education, Cambridge, Massachusetts, USA
- Centro de Estudio sobre Seguridad y Drogas (CESED), Universidad de los Andes, Bogota, Colombia
| | - Dana McCoy
- Harvard Graduate School of Education, Cambridge, Massachusetts, USA
| | - Juliana Sánchez
- Facultad de Economía, Universidad de los Andes, Bogota, Colombia
| | - Jere Behrman
- Department of Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Claudia Cappa
- Data and Analytics Section, UNICEF, New York, New York, USA
| | - Georgina Donati
- Department of Psychiatry, University of Oxford, Oxford, Oxfordshire, UK
| | - Jody Heymann
- WORLD Policy Analysis Center, University of California, Los Angeles, California, USA
| | - Chunling Lu
- Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Abbie Raikes
- College of Public Health, University of Nebraska, Omaha, Nebraska, USA
| | - Nirmala Rao
- Faculty of Education, University of Hong Kong, Hong Kong, China
| | - Linda Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, Oxfordshire, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- African Health Research Institute, Durban, South Africa
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Rosenfeld LE, McCullagh K, King CJ, Torres M, Litt JS. Organizational Health Literacy as a Tool for Health Equity: Application in a High-Risk Infant Follow-Up Program. Children (Basel) 2023; 10:1658. [PMID: 37892321 PMCID: PMC10605611 DOI: 10.3390/children10101658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/19/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Healthy People 2030 emphasizes personal health literacy (individual skills) and organizational health literacy-the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. However, research on the latter is in the early stages. METHODS This study describes an organizational health literacy assessment in a U.S. urban academic children's hospital. A variety of evidence-based health literacy assessments were used to assess patient information materials and the environment, including institutional practices, navigation, culture and language, and communication. Trained interviewers and analysts reached consensus for all assessments. RESULTS Information Items: SMOG scores (n = 9) ranged from 7th- to 14th-grade reading level (average = 11.3). PEMAT-P scores (n = 9) ranged from 43.8% to 93.8% understandability and 0% to 80% actionability. CDC CCI scores (literacy demand) (n = 6) ranged from 18.2% to 58.8% (≥90% = excellent). SAM scores (suitability) (n = 6) fell in the "adequate" range (43.2-58.3%). The PMOSE/IKIRSCH scores (complexity) (n = 3) noted low-moderate difficulty. Apter's Hierarchy (n = 4) revealed three numeracy domains (50% = descriptive purposes and decision-making, 100% = interpreting information). Organization-level: Walking interviews highlighted organizational facilitators and barriers related to the pre-visit and visit environments. HLE2 domain scores ranged from 52% to 68%. CONCLUSIONS Organizational health literacy demands far outweigh the average literacy skills of adults in the U.S. (patients and staff). Findings can be used to hone quality improvement and other processes to focus on structural solutions to increase health equity.
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Affiliation(s)
- Lindsay E. Rosenfeld
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Boston Children’s Hospital, Boston, MA 02115, USA; (K.M.); (C.J.K.)
- Heller School for Social Policy & Management, Brandeis University, Waltham, MA 02453, USA
| | - Kelly McCullagh
- Boston Children’s Hospital, Boston, MA 02115, USA; (K.M.); (C.J.K.)
| | - Carolyn J. King
- Boston Children’s Hospital, Boston, MA 02115, USA; (K.M.); (C.J.K.)
| | - Micaela Torres
- Charles R. Drew, UCLA Medical Education Program, Los Angeles, CA 90059, USA;
- UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Jonathan S. Litt
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Boston Children’s Hospital, Boston, MA 02115, USA; (K.M.); (C.J.K.)
- Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
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Gordon NA, Brijlal P, Rayner CA, Abdullah M, Funa M. Enabling educator oral health literacy: An impetus for oral health promotion in early childhood development. Int J Dent Hyg 2023. [PMID: 37661690 DOI: 10.1111/idh.12736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/14/2023] [Accepted: 08/20/2023] [Indexed: 09/05/2023]
Abstract
INTRODUCTION This study reports on the process evaluation of an oral health promotion intervention for educators (principals and teachers) at early childhood development (ECD) centres within a low-socioeconomic community in South Africa. This approach was based on the premise that oral health literacy plays a significant role in shaping personal health and serves as an impetus to influence change in others. METHODS Using a cross-sectional, descriptive study design, 91 educators participated in the oral health intervention as part of their 1-year ECD training programme. The pre-test questionnaire measured perceived dental status, oral health-related knowledge, attitudes and practices and impact of oral health problems on oral health-related quality of life (OHRQoL). The post-test questionnaire evaluated the usefulness of the oral health workshop to participants, intentions for personal change as well as for the inclusion of oral health in their ECD centre programme. RESULTS Participants reported: having their natural teeth (80%), being happy with their mouth (56.2%), having oral problems (34%), inadequate oral hygiene practices (43%), dental visits when symptomatic (74%), a compromised OHRQoL and inadequate knowledge of oral problems experienced. Oral health promotion activities at ECD centres were limited, with only 34% reporting on toothbrushing programmes. Following the intervention, participants reported positively on aspects such as, the value of the workshop for themselves and their ECD centres, intentions for personal change to hygiene practices (56%), dietary practices (76%) and dental visits (63%). The incorporation of oral health education in their ECD centres was mentioned by most educators. Daily toothbrushing was noted by up to 40% while some highlighted their engagement with parents. CONCLUSION Building oral health literacy among educators has the potential for personal change and serves as an impetus to introduce oral health promotion programmes at ECD centres. The findings may be used to advocate for oral health partnerships with established community-based structures to increase access to oral care in ECD centres in underserved communities.
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Affiliation(s)
- Natalie Ann Gordon
- Department of Oral Hygiene, University of the Western Cape and Provincial Government of the Western Cape, Bellville, Republic of South Africa
| | - Priscilla Brijlal
- Department of Oral Hygiene, University of the Western Cape and Provincial Government of the Western Cape, Bellville, Republic of South Africa
| | - Chrisleen Ann Rayner
- Department of Oral Hygiene, University of the Western Cape and Provincial Government of the Western Cape, Bellville, Republic of South Africa
| | - Mubeena Abdullah
- Department of Oral Hygiene, University of the Western Cape and Provincial Government of the Western Cape, Bellville, Republic of South Africa
| | - Mthunzi Funa
- Department of Oral Hygiene, University of the Western Cape and Provincial Government of the Western Cape, Bellville, Republic of South Africa
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Burak EW, Wachino V. Promoting the Mental Health of Parents and Children by Strengthening Medicaid Support for Home Visiting. Psychiatr Serv 2023; 74:970-977. [PMID: 36987708 DOI: 10.1176/appi.ps.20220608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
As state and federal policy makers seek to improve mental health, many aim to boost upstream approaches to prevent or mitigate diagnosable conditions. Home visiting offers a wholistic approach for new parents and children at home through health education, parenting support, and other services. Evidence of its benefits has accumulated across a growing number of home visiting models, some of which have demonstrated direct mental health outcomes, such as improved access to mental health services and reductions in family stress and maternal depression. Despite growing federal investments, home visiting reaches only a small fraction of families who might benefit. Public and private grant funding has successfully built and expanded home visiting in every state, but the current landscape of programs remains limited. As the nation's largest single coverage source for children, Medicaid, along with the Children's Health Insurance Program, has unsurpassed reach, to more than 40 million children and millions more families annually. Medicaid offers a natural vehicle to scale home visiting programs to promote early childhood development and address the mental health of both mothers and young children. To scale home visiting and reach far more families across the country who could benefit, federal policy makers should establish home visiting as a required Medicaid benefit and make additional investments to help states build capacity as the approach is scaled.
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Affiliation(s)
- Elisabeth Wright Burak
- Center for Children and Families, McCourt School of Public Policy, Georgetown University, Washington, D.C. (Burak); independent consultant, Washington, D.C. (Wachino)
| | - Vikki Wachino
- Center for Children and Families, McCourt School of Public Policy, Georgetown University, Washington, D.C. (Burak); independent consultant, Washington, D.C. (Wachino)
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Anago R, Forzy T, Guei S, Pelras C, Ramde S, Tevenart C, Vera Rueda J, Macours K. Piloting, testing and scaling parental training: a multi-partnership approach in Côte d'Ivoire. Front Public Health 2023; 11:1106565. [PMID: 37655283 PMCID: PMC10466389 DOI: 10.3389/fpubh.2023.1106565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 07/26/2023] [Indexed: 09/02/2023] Open
Abstract
Background and objectives Early Childhood Development is high on the policy agenda in Côte d'Ivoire, where the government has identified it as part of its overall approach to improve human capital outcomes. This paper describes a multi-partner approach to piloting, monitoring, adaption, testing and scaling of parental training for ECD. It discusses the learnings from the pilots, and present early evaluation results from two RCTs, focusing on parental participation in trainings and acceptability of messages, with the objective to inform national scaling strategies. As such, this paper illustrates how "MEL systems contributed to ensuring that positive early childhood development (ECD) outcomes were improved as interventions were seeking to achieve scale," one of the research questions outlined in the call description for the special issue. The paper further provides a real-world example of "How MEL systems can support contributions and buy-in from a variety of stakeholders as ECD interventions (seek to) achieve impacts at scale (e.g., through the public system)? Methods Five training approaches to improve caregivers' knowledge and practices around nutrition, preventive health, stimulation, and disciplining were piloted at small scale between 2018 and 2020. An intensive process evaluation was embedded to identify strengths and weaknesses, adapt through an iterative phase, and ultimately make recommendations for their scale up against 11 defined criteria. In early 2021, the two most promising approaches were scaled through two clustered randomized control trials to more than 150 villages each. A cost-effectiveness study was designed in consultation with government stakeholders, centered around targeting different caregivers and decision makers in the household and the extended family and on enhancing community interactions around ECD. Results The evaluation of the five pilots identified one model recommended to be scaled, and one other model to scale after further adaptations. Monitoring and evaluation data from the two models at scale show high levels of participation and acceptability of core messages. Experimental variations involving community champions and fathers increase participation. Conclusion The iterative and multi-partner process led to two models of parenting training that have wide acceptability. Future work will analyze impacts on cognitive and socio-emotional outcomes, together with cost analysis.
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Affiliation(s)
- Romuald Anago
- Innovation for Poverty Action, Abidjan, Côte d'Ivoire
| | | | - Sosthene Guei
- Transformer L’éducation Dans Les Communautés de Cacao, Abidjan, Côte d'Ivoire
| | | | - Samuel Ramde
- Innovation for Poverty Action, Abidjan, Côte d'Ivoire
| | | | | | - Karen Macours
- Paris School of Economics, Paris, France
- Institut National de Recherche Pour L’agriculture, L’alimentation et L’environnement (INRAE), Paris, France
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Liu Y, Chang C. The relationship between early childhood development and feeding practices during the dietary transitional period in rural China: a cross-sectional study. Front Public Health 2023; 11:1202712. [PMID: 37637814 PMCID: PMC10450922 DOI: 10.3389/fpubh.2023.1202712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Early childhood feeding environments and practices not only affect children's nutritional status but also provide children with a variety of external stimulations to affect the development of the child's brain, especially for the first 1,000 days of children. The relationship between early childhood development (ECD) and feeding practices during the dietary transitional period has not previously been described. Method This study used quantitative survey data from the Integrated Early Childhood Development Project to investigate this association between ECD and feeding practices during the dietary transitional period in poor rural areas of China. Data concerning the child and family characteristics and feeding practices were collected through the questionnaire completed by caregivers. Developmental delays were explored through a five-pronged, structured, parent-completed Age and Stage Questionnaire. The chi-squared test and multivariate logistic regression analyses were used to explore the associated factors in ECD. Results The results showed that 33.6% of children had at least one area of developmental delay during the dietary transitional period. Of all five regions evaluated, the prevalence of fine motor developmental delays was highest (17.7%), followed by communication (14.9%), problem-solving (13.8%), personal-social skills (11.9%), and gross motor (11.8%), respectively. Significant predictors of increased odds of developmental delay included types of complementary foods (OR = 0.70, 95% CI = 0.53-0.94), adequate feeding frequency (OR = 0.69, 95% CI = 0.52-0.90), and breastfeeding time and bottle feeding (OR = 0.66, 95% CI = 0.50-0.88). Discussion According to the results, a high prevalence of developmental delay was observed in children during the dietary transitional period in the rural areas of China. The feeding practices of children were associated with their developmental status, including factors such as inadequate feeding frequency, types of complementary foods, breastfeeding duration, and low family income. These findings highlight the focus and potential direction for early identification and intervention.
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Affiliation(s)
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
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Dusabe C, Abimpaye M, Kabarungi N, Uwamahoro MD. Monitoring, evaluation and accountability evidence use for design, adaptation, and scale-up of an early childhood development program in Rwanda. Front Public Health 2023; 11:1165353. [PMID: 37588121 PMCID: PMC10426743 DOI: 10.3389/fpubh.2023.1165353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/07/2023] [Indexed: 08/18/2023] Open
Abstract
Introduction The first three years of a child's life are the most critical to child development and have an impact on the future achievement of the child. Young children's healthy development depends on nurturing care that ensures health, nutrition, responsive caregiving, safety, and security. Parents & other adult caregivers play a critical role in moderating children's early experiences, which has a lasting impact be it positive or negative on the children's future. Parenting education programs are proven to improve parental skills, capacity, and efficacy in a way that supports improved child development outcomes. Yet, most parents in low-middle-income countries such as Rwanda lack access to information and skills on how to support their children's holistic development. In response, Save The Children implemented the First Steps "Intera za Mbere" holistic parenting education project in Rwanda from 2014 to 2021. This paper reflects on how monitoring, evaluation, accountability, and learning (MEAL) approaches were applied throughout the project cycle and their impact on program improvement and national policy and advocacy. This paper explores how the aspirations for measurement for change, considerations for innovation uptake and frameworks for learning about improvement are reflected in this project. Methods The project utilized qualitative and quantitative MEAL across the program cycle. Action research at the start of the project identified promoters and inhibitors of high-quality nurturing care and program delivery modalities. The project utilized a randomized control trial to provide insight into components that work better for parenting education. Evidence from surveys done remotely via phones was used to inform COVID-19 adaptations of the program. Results The application of MEAL evidence led to the successful development and improvement of the program. At the policy level, evidence from the project influenced the review of the 2016 National Integrated ECD policy and the development of the national parenting education framework. Conclusion The regular use of evidence from MEAL is critical for program improvement, scale-up, and policy influence.
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Affiliation(s)
- Caroline Dusabe
- Save the Children Australia, Melbourne, VIC, Australia
- Save the Children (Rwanda), Kigali, Rwanda
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Batura N, Roy R, Aziz S, Sharma K, Kumar D, Verma D, Correa Ossa A, Spinola P, Soremekun S, Sikander S, Zafar S, Divan G, Hill Z, Avan BI, Rahman A, Kirkwood B, Skordis J. Maternal time investment in caregiving activities to promote early childhood development: evidence from rural India. Front Pediatr 2023; 11:1120253. [PMID: 37484767 PMCID: PMC10360126 DOI: 10.3389/fped.2023.1120253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 06/09/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Intervention strategies that seek to improve early childhood development outcomes are often targeted at the primary caregivers of children, usually mothers. The interventions require mothers to assimilate new information and then act upon it by allocating sufficient physical resources and time to adopt and perform development promoting behaviours. However, women face many competing demands on their resources and time, returning to familiar habits and behaviours. In this study, we explore mothers' allocation of time for caregiving activities for children under the age of 2, nested within a cluster randomised controlled trial of a nutrition and care for development intervention in rural Haryana, India. Methods We collected quantitative maternal time use data at two time points in rural Haryana, India, using a bespoke survey instrument. Data were collected from 704 mothers when their child was 12 months old, and 603 mothers when their child was 18 months old. We tested for significant differences in time spent by mothers on different activities when children are 12 months of age vs. 18 months of age between arms as well as over time, using linear regression. As these data were collected within a randomised controlled trial, we adjusted for clusters using random effects when testing for significant differences between the two time points. Results At both time points, no statistically significant difference in maternal time use was found between arms. On average, mothers spent most of their waking time on household chores (over 6 h and 30 min) at both time points. When children were aged 12 months, approximately three and a half hours were spent on childcare activities for children under the age of 2 years. When children were 18 months old, mothers spent more time on income generating activities (30 min) than when the children were 12 years old, and on leisure (approximately 4 h and 30 min). When children were 18 months old, less time was spent on feeding/breastfeeding children (30 min less) and playing with children (15 min). However, mothers spent more time talking or reading to children at 18 months than at 12 months. Conclusion We find that within a relatively short period of time in early childhood, maternal (or caregiver) time use can change, with time allocation being diverted away from childcare activities to others. This suggests that changing maternal time allocation in resource poor households may be quite challenging, and not allow the uptake of new and/or optimal behaviours.
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Affiliation(s)
- Neha Batura
- Institute for Global Health, University College London, London, United Kingdom
| | - Reetabrata Roy
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Child Development Group, Sangath, New Delhi, India
| | - Sarmad Aziz
- Department of Anthropology, University College London, United Kingdom
| | | | - Divya Kumar
- Child Development Group, Sangath, New Delhi, India
| | | | - Ana Correa Ossa
- Institute for Global Health, University College London, London, United Kingdom
| | - Paula Spinola
- Institute for Global Health, University College London, London, United Kingdom
| | - Seyi Soremekun
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Siham Sikander
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
- Global Institute of Human Development, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Shamsa Zafar
- Fazaia Medical College, Air University, Islamabad, Pakistan
| | - Gauri Divan
- Child Development Group, Sangath, New Delhi, India
| | - Zelee Hill
- Institute for Global Health, University College London, London, United Kingdom
| | - Bilal Iqbal Avan
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Atif Rahman
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
| | - Betty Kirkwood
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jolene Skordis
- Institute for Global Health, University College London, London, United Kingdom
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Rahman F, Tuli SN, Mondal P, Sultana S, Hossain A, Kundu S, Clara AA, Hossain A. Home environment factors associated with early childhood development in rural areas of Bangladesh: evidence from a national survey. Front Public Health 2023; 11:1209068. [PMID: 37448657 PMCID: PMC10338095 DOI: 10.3389/fpubh.2023.1209068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Background Knowing the relationship between the factors related to home environment and early childhood development (ECD) in Bangladeshi children aged 3 to 4 years would help to find out appropriate interventions for the children with lower ECD outcomes. Therefore, we aimed to understand the relationship between the home environment factors and ECD in rural Bangladeshi children aged 3 to 4 years. Methods We used data from the Multiple Indicator Cluster Survey (MICS) 2019, and included 7,326 rural children aged 3 to 4 years. The ECD index (ECDI) included four domains: literacy-numeracy, learning, physical and socio-emotional development. If a child met at least three of these four domains, the child was indicated as developmentally "on track". Results The findings show that 27.4% of rural children missed to reach developmentally on-track while 72.2% of children did not attain the literacy-numeracy domain of ECD. The home environment factors including parental participation in children's activities, was found to be associated with ECD. For instance, reading books to child had 26% (aOR = 1.26, 95% CI = 1.08-1.48), and telling stories to child had 29% (aOR = 1.29, 95% CI = 1.09-1.53) more developmentally on-track in overall ECDI. Similar associations between home environment factors and specific ECD domains were also obtained. We also identified that children aged 4 years, girls, and children of mothers with higher socio-economic status (SES) were higher developmentally on-track than their counterparts. Conclusion Home environment factors like reading books and telling stories to children were found to be significantly associated with ECD in rural areas of Bangladesh. Our study's findings would assist in implementing the essential public health intervention to enhance the ECD program especially in the rural Bangladeshi context.
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Affiliation(s)
- Farzana Rahman
- Department of Public Health, North South University, Dhaka, Bangladesh
- Armed Forces Medical College, Dhaka, Bangladesh
| | - Samiha Nahar Tuli
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Prasenjit Mondal
- Department of Public Health, North South University, Dhaka, Bangladesh
- School of Medicine and Dentistry, Griffith University, QLD, Australia
| | - Shakina Sultana
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Asmita Hossain
- Department of Public Health, North South University, Dhaka, Bangladesh
- Z.H. Sikder Women’s Medical College and Hospital, Dhaka, Bangladesh
| | - Satyajit Kundu
- School of Public Health, Southeast University, Nanjing, China
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Afrin Ahmed Clara
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Ahmed Hossain
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Global Health Institute, North South University, Dhaka, Bangladesh
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23
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Poulsen A, Hickie IB, Alam M, LaMonica HM. User Experience Co-Design of a Mobile Application to Support Childrearing in Low- and Middle-Income Countries. Stud Health Technol Inform 2023; 304:86-90. [PMID: 37347576 DOI: 10.3233/shti230377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
The widespread adoption of mobile phones and increasing mobile connectivity globally create opportunities to access remote and disadvantaged populations. Mobile health interventions in low- and middle-income countries have substantial reach and potential to promote the socio-emotional and cognitive development of children. This study presents co-design workshop findings relating to the user experience of a mobile application - Thrive by Five - which intends to promote healthy early childhood development globally, particularly in low- and middle-income countries. Here, findings from workshops conducted in 11 countries in Asia, Africa, and Oceania are presented. Key feedback on the mobile application user experience indicated several necessary changes, such as simplifying and localising the language, incorporating short videos or animations, adding more bright colours and illustrations, and making numerous improvements and additions to the app features and functionality. The findings contribute to advancing mobile health, context-sensitive technologies, user experience design, and low-resource setting technology co-design.
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Affiliation(s)
- Adam Poulsen
- Brain and Mind Centre, The University of Sydney, Sydney, NSW Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, NSW Australia
| | - Mafruha Alam
- Brain and Mind Centre, The University of Sydney, Sydney, NSW Australia
| | - Haley M LaMonica
- Brain and Mind Centre, The University of Sydney, Sydney, NSW Australia
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24
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Chan SWY, Cheung WM, Marton F. The early language gap between first- and second-language learners: acquisition of Chinese characters among preschoolers. Front Psychol 2023; 14:1142128. [PMID: 37397327 PMCID: PMC10313221 DOI: 10.3389/fpsyg.2023.1142128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/17/2023] [Indexed: 07/04/2023] Open
Abstract
For culturally and linguistically diverse children, early second language (L2) development is important for school achievement and social inclusion. These children face challenges in acquiring L2, especially in Hong Kong, where the dominant Chinese language contrasts strongly with their home languages. Studies that compared the language abilities of first language (L1) and L2 students in English-speaking contexts have reported young L2 learners' disadvantage in using the dominant language in oral language and comprehension at school entry. The findings raise the question of whether L2 learners who fall behind their L1 peers in language abilities will be further disadvantaged, showing a weaker development gradient. This study used the Chinese Character Acquisition Assessment (CCAA) to compare character acquisition of 491 L2 children aged from 3 to 6 years against that of 240 of their L1 peers from Hong Kong kindergartens. The CCAA is comprised of six subtests and assesses children's abilities to make associations among character written form (orthography), sound, and meaning. Results showed that L2 learners had greater development in meaning and sound associations across class levels, implying that they may first develop oral language related abilities. In addition, results indicate that diverging gaps between L1 and L2 learners' Chinese character acquisition existed across class levels for the associations involving written character form, but not in regard to associations between character meaning and sound. This study highlights the Chinese learning needs of L2 preschoolers and provides understanding of their abilities in mapping among character written forms, sounds, and meanings. The findings suggest the importance of supporting L2 children's oral language at earlier stages of Chinese learning, and the need to provide instructional support to compensate for their relative weakness in literacy at school entry.
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Affiliation(s)
- Stephanie W. Y. Chan
- Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Wai Ming Cheung
- Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Ference Marton
- Department of Pedagogical, Curricular and Professional Studies, University of Gothenburg, Gothenburg, Sweden
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25
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Bentley B, Hoang TMH, Arroyo Sugg G, Jenkins KV, Reinhart CA, Pouw L, Accove AM, Tabb KM. Parent Perceptions of an Early Childhood System's Community Efforts: A Qualitative Analysis. Children (Basel) 2023; 10:1001. [PMID: 37371233 DOI: 10.3390/children10061001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
Understanding how parents, and other primary caregivers, perceive and experience early childhood programs and services is essential for identifying family-centered facilitators and barriers to service utilization. Therefore, this paper aims to explore parent knowledge of and experiences with community efforts of an early childhood system in Illinois: the All Our Kids Early Childhood Networks (AOK Networks). Our research team conducted focus group interviews with 20 parents across four Illinois counties. A semi-structured interview guide was used to examine parent perceptions of an early childhood system's community efforts in promoting the health and well-being of children aged from birth to five. Thematic network analysis was used to analyze all focus group data. Parents indicated three salient themes, including: (1) comprehensive information sharing practices, (2) diverse service engagement, and (3) barriers to service access. Overall, parents reported general satisfaction with the quality of available services and provided feedback regarding identified areas of need to increase the accessibility and utilization of local services. Engaging parents as partners is essential to the effective implementation of family-centered early childhood services. Families are the experts of their lived experiences, and incorporating their voices in program development and evaluation efforts works to increase positive child and family outcomes.
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Affiliation(s)
- Brandie Bentley
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Tuyet Mai Ha Hoang
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Gloria Arroyo Sugg
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Karen V Jenkins
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Crystal A Reinhart
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Leah Pouw
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | | | - Karen M Tabb
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
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26
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Córdoba-Gamboa L, Vázquez-Salas RA, Romero-Martínez M, Cantoral A, Riojas-Rodríguez H, Bautista-Arredondo S, Bautista-Arredondo LF, de Castro F, Tamayo-Ortiz M, Téllez-Rojo MM. Lead Exposure Can Affect Early Childhood Development and Could Be Aggravated by Stunted Growth: Perspectives from Mexico. Int J Environ Res Public Health 2023; 20:5174. [PMID: 36982080 PMCID: PMC10049063 DOI: 10.3390/ijerph20065174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Lead can affect early childhood development (ECD) differentially due to nutritional deficiencies that lead to stunted growth, defined as being at least two standard deviations below the average height-for-age. These deficiencies are more frequent among children living in rural locations or with lower socioeconomic status (SES); however, studies at a population level are scarce worldwide. Early childhood development plays a crucial role in influencing a child's health and wellbeing throughout life. Therefore, the aim of this study was to analyze how stunted growth can modify the association between lead exposure and ECD in children from disadvantaged communities. METHODS Data were analyzed from the 2018 National Health and Nutrition Survey in localities with fewer than 100,000 inhabitants in Mexico (ENSANUT-100K). Capillary blood lead (BPb) levels were measured using a LeadCare II device and dichotomized as detectable (cutoff point ≥ 3.3 µg/dL) and non-detectable. As a measure of ECD, language development was assessed in n = 1394 children, representing 2,415,000 children aged 12-59 months. To assess the association between lead exposure and language z-scores, a linear model was generated adjusted by age, sex, stunted growth, maternal education, socioeconomic status, area, region (north, center, south), and family care characteristics; afterwards, the model was stratified by stunted growth. RESULTS Fifty percent of children had detectable BPb and 15.3% had stunted growth. BPb showed a marginal inverse association with language z-scores (β: -0.08, 95% CI: -0.53, 0.36). Children with detectable BPb and stunted growth had significantly lower language z-scores (β: -0.40, 95% CI: -0.71, -0.10) than those without stunted growth (β: -0.15, 95% CI: -0.36, 0.06). CONCLUSIONS Children with stunted growth are more vulnerable to the adverse effects of lead exposure. These results add to previous research calling for action to reduce lead exposure, particularly in children with chronic undernutrition.
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Affiliation(s)
- Leonel Córdoba-Gamboa
- Dirección de Salud Ambiental, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico; (L.C.-G.)
| | - Ruth Argelia Vázquez-Salas
- Dirección de Salud Reproductiva, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Ciudad de México 14080, Morelos, Mexico
| | - Martin Romero-Martínez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico
| | - Alejandra Cantoral
- Departamento de Salud, Universidad Iberoamericana, Ciudad de Mexico 01219, Morelos, Mexico
| | - Horacio Riojas-Rodríguez
- Dirección de Salud Ambiental, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico; (L.C.-G.)
| | - Sergio Bautista-Arredondo
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico
| | - Luis F. Bautista-Arredondo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico
| | - Filipa de Castro
- Research, Evidence, and Learning, Department of Education and Child Population, Save the Children, 501 Kings Highway East, Suite 400, Fairfield, CT 06825, USA
| | - Marcela Tamayo-Ortiz
- Unidad de Investigación de Salud en el Trabajo, Instituto Mexicano del Seguro Social, Ciudad de México 6720, Morelos, Mexico
| | - Martha María Téllez-Rojo
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca 62100, Morelos, Mexico
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27
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Shimizu H. The Impact of Working Memory on the Development of Social Play in Japanese Preschool Children: Emotion Knowledge as a Mediator. Children (Basel) 2023; 10:children10030524. [PMID: 36980082 PMCID: PMC10047190 DOI: 10.3390/children10030524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023]
Abstract
Through enriched play, children learn social-emotional skills necessary for academic achievement and interpersonal relationships with others. Further research is needed on how specific factors associated with social play, such as working memory and emotion knowledge, interact to promote it. Previous studies have examined the association of working memory and emotion knowledge with social play. However, there are no consistent results as to which abilities influence which skills first. Thus, the present study examines the impact of working memory on the development of social play and the role of emotion knowledge in the relationship between working memory and social play. Forty-seven Japanese preschoolers were tested on working memory, social play, and emotion knowledge. Regression analysis indicated that working memory was significantly related to social play. Furthermore, mediation analysis indicated that emotion recognition mediates the effects of working memory on social play. Working memory was found to contribute to social play by improving emotion recognition in children. These results indicate that the pathway from working memory to social play is mediated by emotion recognition and expands previous perspectives on the developmental mechanisms of emotion knowledge in children.
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Affiliation(s)
- Hisayo Shimizu
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashihiroshima 7398524, Japan
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28
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Olusanya BO, Smythe T, Ogbo FA, Nair MKC, Scher M, Davis AC. Global prevalence of developmental disabilities in children and adolescents: A systematic umbrella review. Front Public Health 2023; 11:1122009. [PMID: 36891340 PMCID: PMC9987263 DOI: 10.3389/fpubh.2023.1122009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/24/2023] [Indexed: 02/18/2023] Open
Abstract
Aim The provisions of the United Nation's Sustainable Development Goals (SDGs) for disability-inclusive education have stimulated a growing interest in ascertaining the prevalence of children with developmental disabilities globally. We aimed to systematically summarize the prevalence estimates of developmental disabilities in children and adolescents reported in systematic reviews and meta-analyses. Methods For this umbrella review we searched PubMed, Scopus, Embase, PsycINFO, and Cochrane Library for systematic reviews published in English between September 2015 and August 2022. Two reviewers independently assessed study eligibility, extracted the data, and assessed risk of bias. We reported the proportion of the global prevalence estimates attributed to country income levels for specific developmental disabilities. Prevalence estimates for the selected disabilities were compared with those reported in the Global Burden of Disease (GBD) Study 2019. Results Based on our inclusion criteria, 10 systematic reviews reporting prevalence estimates for attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, developmental intellectual disability, epilepsy, hearing loss, vision loss and developmental dyslexia were selected from 3,456 identified articles. Global prevalence estimates were derived from cohorts in high-income countries in all cases except epilepsy and were calculated from nine to 56 countries. Sensory impairments were the most prevalent disabilities (approximately 13%) and cerebral palsy was the least prevalent disability (approximately 0.2-0.3%) based on the eligible reviews. Pooled estimates for geographical regions were available for vision loss and developmental dyslexia. All studies had a moderate to high risk of bias. GBD prevalence estimates were lower for all disabilities except cerebral palsy and intellectual disability. Conclusion Available estimates from systematic reviews and meta-analyses do not provide representative evidence on the global and regional prevalence of developmental disabilities among children and adolescents due to limited geographical coverage and substantial heterogeneity in methodology across studies. Population-based data for all regions using other approaches such as reported in the GBD Study are warranted to inform global health policy and intervention.
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Affiliation(s)
| | - Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Felix A. Ogbo
- Riverland Academy of Clinical Excellence (RACE), Riverland Mallee Coorong Local Health Network, SA Health | Government of South Australia, Berri, SA, Australia
- Translational Health Research Institute (THRI), Campbelltown Campus, Western Sydney University, Penrith, NSW, Australia
| | - M. K. C. Nair
- NIMS-Spectrum-Child Development Research Centre, NIMS Medicity, Thiruvananthapuram, Kerala, India
| | - Mark Scher
- Department of Pediatrics, Division of Pediatric Neurology, Fetal-Neonatal Neurology Program, Rainbow Babies and Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
- MacDonald Hospital for Women, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Adrian C. Davis
- Department of Population Health, London School of Economics, London, United Kingdom
- Vision and Eye Research Institute, School of Medicine Anglia Ruskin University, Cambridge, United Kingdom
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29
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Crouse JJ, LaMonica HM, Song YJC, Boulton KA, Rohleder C, DeMayo MM, Wilson CE, Loblay V, Hindmarsh G, Stratigos T, Krausz M, Foo N, Teo M, Hunter A, Guastella AJ, Banati RB, Troy J, Hickie IB. Designing an App for Parents and Caregivers to Promote Cognitive and Socioemotional Development and Well-being Among Children Aged 0 to 5 Years in Diverse Cultural Settings: Scientific Framework. JMIR Pediatr Parent 2023; 6:e38921. [PMID: 36780220 PMCID: PMC9972208 DOI: 10.2196/38921] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 11/02/2022] [Accepted: 12/28/2022] [Indexed: 12/29/2022] Open
Abstract
Recent years have seen remarkable progress in our scientific understanding of early childhood social, emotional, and cognitive development, as well as our capacity to widely disseminate health information by using digital technologies. Together, these scientific and technological advances offer exciting opportunities to deliver high-quality information about early childhood development (ECD) to parents and families globally, which may ultimately lead to greater knowledge and confidence among parents and better outcomes among children (particularly in lower- and middle-income countries). With these potential benefits in mind, we set out to design, develop, implement, and evaluate a new parenting app-Thrive by Five-that will be available in 30 countries. The app will provide caregivers and families with evidence-based and culturally appropriate information about ECD, accompanied by sets of collective actions that go beyond mere tips for parenting practices. Herein, we describe this ongoing global project and discuss the components of our scientific framework for developing and prototyping the app's content. Specifically, we describe (1) 5 domains that are used to organize the content and goals of the app's information and associated practices; (2) 5 neurobiological systems that are relevant to ECD and can be behaviorally targeted to potentially influence social, emotional, and cognitive development; (3) our anthropological and cultural framework for learning about local contexts and appreciating decolonization perspectives; and (4) our approach to tailoring the app's content to local contexts, which involves collaboration with in-country partner organizations and local and international subject matter experts in ECD, education, medicine, psychology, and anthropology, among others. Finally, we provide examples of the content that was incorporated in Thrive by Five when it launched globally.
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Affiliation(s)
- Jacob J Crouse
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Haley M LaMonica
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Yun Ju Christine Song
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Kelsie A Boulton
- Clinic for Autism and Neurodevelopment Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Cathrin Rohleder
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marilena M DeMayo
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Chloe E Wilson
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Victoria Loblay
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,The Australian Prevention Partnership Centre, Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
| | - Gabrielle Hindmarsh
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Tina Stratigos
- Sydney School of Education and Social Work, Faculty of Arts and Social Sciences, University of Sydney, Sydney, Australia
| | - Michael Krausz
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | | | | | - Adam J Guastella
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Clinic for Autism and Neurodevelopment Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Richard B Banati
- Australian Nuclear Science and Technology Organisation, Sydney, Australia
| | - Jakelin Troy
- Faculty of Arts and Social Sciences, University of Sydney, Sydney, Australia
| | - Ian B Hickie
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
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30
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Olusanya BO, Storbeck C, Cheung VG, Hadders-Algra M; Global Research on Developmental Disabilities Collaborators (GRDDC). Disabilities in Early Childhood: A Global Health Perspective. Children (Basel) 2023; 10. [PMID: 36670705 DOI: 10.3390/children10010155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
Prior to the launch of the United Nations' Sustainable Development Goals (SDGs) in 2015, childhood disability was rarely considered an important subject in global health. The SDGs till 2030 now require that children under 5 years who are at risk of not benefitting from inclusive quality education are identified, monitored, and promptly supported. A new tool for identifying children who are not developmentally on track has been developed by UNICEF but has limited sensitivity for detecting children with disabilities due to reliance on parental assessment of child behavior in certain everyday situations. In this paper, we identified conditions that are commonly associated with developmental disabilities based on the International Classification of Diseases (ICD) codes and clarified the concept of "developmentally on track" as it relates to children with developmental disabilities and developmental delays. We summarized the latest evidence on the global burden of developmental disabilities in children under 5 years based on the diagnostic and functional approaches for measuring disabilities at the population level. We highlighted the global health context for addressing the needs of children with developmental disabilities and provided an overview of the opportunities and the role of pediatric caregivers in supporting children with developmental disabilities.
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31
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Pokharel A, Webb P, Miller LC, Zaharia S, Shrestha R, Davis D, Trevino JA, Baral KP, Paudel K, Ghosh S. Relationship between Animal Sourced Food Consumption and Early Childhood Development Outcomes. Nutrients 2023; 15:nu15020315. [PMID: 36678186 PMCID: PMC9861056 DOI: 10.3390/nu15020315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/18/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Early-childhood development (ECD) is an important determinant of a child’s cognitive ability, learning, productivity, and lifetime earnings. Animal-sourced food (ASF), which is a rich source of high-quality protein and micronutrients, has been linked with ECD outcomes. This study investigates the relationship between the number, frequency, and cumulative consumption of ASF at 6, 9, 12, and 18 months of age and ECD outcomes at 24 months of age, controlling for physical growth. The study uses data collected from 701 mother−child pairs from an observational birth cohort study carried out in Banke, Nepal. ECD outcomes were assessed through a standardized ages and stages questionnaire (ASQ-3) tool. Separate multivariable ordinary least squares regression models were used to test for associations. Significant positive association was seen between total ASQ-3 score at 24 months of age and any ASF consumption at 18 months (β = 8.98, p-value < 0.01), controlling for growth outcomes. The study findings highlight the positive contribution and the accumulating benefit of consistent ASF consumption on ECD outcomes. This study recommends support and promotion of ASF intake among young children in Nepal through policy and programming actions relevant to female education; nutrition knowledge; quality ASF production; improved market access; cold storage; and poverty reduction.
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Affiliation(s)
- Ashish Pokharel
- Helen Keller International, Lalitpur 44600, Nepal
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Correspondence:
| | - Patrick Webb
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Laurie C. Miller
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Sonia Zaharia
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Robin Shrestha
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Dale Davis
- Helen Keller International, Lalitpur 44600, Nepal
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
| | - Johanna Andrews Trevino
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Kedar Prasad Baral
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- School of Public Health, Patan Academy of Health Sciences, Lalitpur 44600, Nepal
| | | | - Shibani Ghosh
- Feed the Future Innovation Lab for Nutrition, Lalitpur 44600, Nepal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
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Kaiser JL, Ngoma T, Rockers PC, Fink G, Juntunen A, Hamer DH, Chirwa B, Scott NA. A Qualitative Assessment of Community Acceptability and Use of a Locally Developed Children's Book to Increase Shared Reading and Parent-Child Interactions in Rural Zambia. Ann Glob Health 2023; 89:28. [PMID: 37124937 PMCID: PMC10143943 DOI: 10.5334/aogh.3920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/09/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Early reading interventions hold promise for increasing language and literacy development in young children and improving caregiver-child interactions. To engage rural caregivers and young children in home reading, Zambian child psychologists and education specialists developed a culturally representative, local language children's book targeted at pre-grade 1 children. Objectives We qualitatively assessed community acceptability and use of the book distributed to households with young children in two provinces of Zambia. Methods We conducted 15 focus group discussions (FGDs) with women (n=117) who received the "Zambian folktales adapted stories for young children" book. A codebook was created a priori, based on established themes in the guide; content analysis was conducted in Nvivo v12. Data were interpreted against the Theoretical Framework on Acceptability. Findings Respondents described wide acceptability of the children's book across multiple framework constructs. Respondents believed the book was culturally appropriate for its folktale structure and appreciated the morals and lessons provided by the stories. Respondents described using the book in multiple ways including reading in one-on-one or group settings, asking the child questions about the narrative or pictures, and providing additional commentary on the actions or figures in the pictures. Respondents believed the books were helping children grow their vocabulary and early literacy skills. The book's simple vocabulary facilitated use by less educated caregivers. The primary concern voiced was the ability of low literacy caregivers to utilize the book for reading. Discussion The children's book was widely considered acceptable by rural Zambian communities. It provided a platform for an additional method of caregiver-child interactions in these households for reading, dialogue, and oral storytelling. Shared reading experiences have potentially substantial benefits for the language development and emergent literacy of young children. Programs to develop and deliver culturally acceptable books to households with limited access should be considered by governments and funders.
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Affiliation(s)
- Jeanette L. Kaiser
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Thandiwe Ngoma
- Department of Research, Right to Care Zambia, Lusaka, Zambia
| | - Peter C. Rockers
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Günther Fink
- Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland
| | - Allison Juntunen
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Davidson H. Hamer
- Department of Global Health, Boston University School of Public Health, USA
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | | | - Nancy A. Scott
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
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Momberg DJ, Voth-Gaeddert LE, Richter LM, Norris SA, Said-Mohamed R. Rethinking water, sanitation, and hygiene for human growth and development. Glob Public Health 2022; 17:3815-3824. [PMID: 35184678 DOI: 10.1080/17441692.2022.2036218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Life history theory emphasises plasticity in developmental and biological programming where conditions in early life, lead to long-term consequences for health and wellbeing. Studies linking water, sanitation, and hygiene, nutrition, and child growth and development have emphasised the optimisation of linear growth as a key metric for the evaluation of intervention efficacy. Life history characteristics pertaining to human growth and phenotypic plasticity, suggest that different developmental outcomes in early childhood may be responsive to different stimuli at different ages. Energy utilisation by the human brain, from birth through childhood, accounts for a disproportionate percentage of the resting metabolic rate. Undernutrition in early life, and its relative resultant energy deficiency, may trigger adaptive physiological mechanisms prioritising brain growth at the expense of body growth. Emphasis placed on linear growth may have impeded the significance of WASH due to excluding aspects of child development beyond height/weight. We propose that incorporating evolutionary public health and life history theory perspectives, allows for the identification of age-appropriate biological outcomes and WASH indicators, while anticipating the timing and life-course suitability of the interventions being operationalised. Finally, integrating reflections regarding context allows for the development of transformative WASH interventions.
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Affiliation(s)
- Douglas J Momberg
- Department of Archaeology, Biological Anthropology, University of Cambridge, Cambridge, UK.,SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lee E Voth-Gaeddert
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Linda M Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Rihlat Said-Mohamed
- Department of Archaeology, Biological Anthropology, University of Cambridge, Cambridge, UK.,SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Bagur S, Paz‐Lourido B, Mut‐Amengual B, Verger S. Relationship between parental mental health and developmental disorders in early childhood. Health Soc Care Community 2022; 30:e4840-e4849. [PMID: 35762200 PMCID: PMC10084383 DOI: 10.1111/hsc.13891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 05/07/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Social intervention with children with disabilities and their families should be understood through the principles of family-centred practice. In Spain, early intervention is understood as interventions aimed at children from 0 to 6 years old and their families. Professionals carry out the reception, assessment and intervention. This study aims to analyse the relationship between mental and physical health, caregivers' levels of anxiety and depression and the child's development during the fostering and assessment phase. The sample is made up of 135 families using child development centres in the Balearic Islands. Four questionnaires were completed: Health-Related Quality of Life SF-12, Anxiety and Depression Scale, Child Behaviour Checklist (CBCL 1½-5) and socio-demographic questionnaire. The results show that parents of children with disabilities have higher levels of mental health impairment than physical health impairment. They also score higher on anxiety than on depression. It is worth noting that professional discipline is a variable to be taken into account in relation to parents' perception of their child's developmental improvement. In addition, the association between the developmental subscales, where the more the child is affected, the more the parents' mental health is affected. The same pattern occurs with caregivers' levels of anxiety and depression. In short, we propose a reflection on the application of family-centred practices during interventions, understanding the lack of professional training as a predictor of the quality of early intervention.
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Affiliation(s)
- Sara Bagur
- Department of Applied Pedagogy and Educational PsychologyUniversity of the Balearic IslandsPalma de MallorcaSpain
- Institute of Research and Innovation in Education (IRIE)University of the Balearic IslandsPalma de MallorcaSpain
| | - Berta Paz‐Lourido
- Institute of Research and Innovation in Education (IRIE)University of the Balearic IslandsPalma de MallorcaSpain
- Department of Nursing and PhysiotherapyUniversity of the Balearic IslandsPalma de MallorcaSpain
| | - Bartomeu Mut‐Amengual
- Department of Applied Pedagogy and Educational PsychologyUniversity of the Balearic IslandsPalma de MallorcaSpain
- Institute of Research and Innovation in Education (IRIE)University of the Balearic IslandsPalma de MallorcaSpain
| | - Sebastià Verger
- Department of Applied Pedagogy and Educational PsychologyUniversity of the Balearic IslandsPalma de MallorcaSpain
- Institute of Research and Innovation in Education (IRIE)University of the Balearic IslandsPalma de MallorcaSpain
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du Plessis D, Mahomed-Asmail F, le Roux T, Graham MA, de Kock T, van der Linde J, Swanepoel DW. mHealth-Supported Hearing Health Training for Early Childhood Development Practitioners: An Intervention Study. Int J Environ Res Public Health 2022; 19:14228. [PMID: 36361108 PMCID: PMC9658621 DOI: 10.3390/ijerph192114228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
(1) Hearing health training and promotion is a priority for early childhood development (ECD) practitioners, but training opportunities are limited, especially in low- and middle-income countries (LMIC). mHealth (mobile health) has the potential to deliver scalable ear and hearing training to ECD practitioners. (2) This study investigated the effect of an mHealth training intervention program for ECD practitioners to improve knowledge and perceptions of hearing health in young children. An experimental one-group, pre-post-test study included ECD practitioners working with children between birth and 6 years old across 31 neighbouring communities in the Western Cape Province, South Africa. Hearing health training was provided using WhatsApp messages that encompassed infographics and voice notes. Knowledge and perceptions regarding hearing and hearing-related problems in children were surveyed pre-training, directly post training, and 6 months post training. (3) ECD practitioners (N = 1012) between 17 and 71 years of age received the mHealth training program and completed both the pre-and post-training surveys. Overall, knowledge scores indicated a significant improvement from pre- to post training (Z = -22.49; p < 0.001). Six-month post-training knowledge scores were sustained. Content analysis of ECD practitioners' application of the training information 6 months post training indicated improved awareness, practical application, better assistance for hearing problems, and widespread advocacy. (4) The mHealth training program supports improved knowledge and perceptions of ECD practitioners regarding hearing health for young children. With improved knowledge scores maintained 6 months post training, mHealth hearing health training is an effective intervention. An mHealth training program for ECD practitioners provides a scalable, low-cost intervention for primary and secondary prevention in childhood hearing loss, especially in LMICs.
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Affiliation(s)
- Divan du Plessis
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0028, South Africa
| | - Faheema Mahomed-Asmail
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0028, South Africa
- Virtual Hearing Lab, Collaborative Initiative between University of Colorado and the University of Pretoria, Aurora, CO 80309, USA
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0028, South Africa
| | - Marien Alet Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Pretoria 0028, South Africa
| | | | - Jeannie van der Linde
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0028, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0028, South Africa
- Virtual Hearing Lab, Collaborative Initiative between University of Colorado and the University of Pretoria, Aurora, CO 80309, USA
- Ear Science Institute Australia, Subiaco 6008, Australia
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Benjamin F, Adebiyi BO, Rich E, Roman NV. Developing an Anxiety Screening Tool for Children in South Africa: Protocol for a Mixed Methods Study. JMIR Res Protoc 2022; 11:e37364. [PMID: 36166280 PMCID: PMC9555325 DOI: 10.2196/37364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/04/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early childhood experiences such as trauma, exposure to violence, and poverty can significantly contribute to childhood anxiety, which is viewed as the most common mental health issue among children. In South Africa, there is no uniform tool to screen for anxiety during early childhood. This study aims to develop a tool to screen for anxiety in children aged 4 to 8 years, which could be utilized by preschool and foundation phase teachers to aid in the early identification of childhood anxiety. OBJECTIVE The overall objective of this study is to explore understanding and perceptions of childhood anxiety among teachers, parents, and experts and to develop a tool to screen for anxiety in children aged 4 to 8 years. METHODS This project will use a mixed method design that will consist of 4 stages. Stage 1 will consist of a scoping review. In Stage 2, data will be collected via semistructured interviews with 60 participants, including parents, teachers, and experts, and will be thematically analyzed. Stage 3 will consist of 20 experts and the researcher collaboratively formulating the proposed screening tool in the form of an e-Delphi component. Once the tool is refined, it will be piloted in Stage 4 with 20 teachers, and data will be analyzed with the Shapiro-Wilk test to test for normality. Additionally, factor analysis will be done to refine and restructure the tool as necessary. RESULTS This project was funded from April 2020 to December 2021. Data collection began in September 2022 and is projected to conclude in December 2022 for the qualitative component. The e-Delphi component is expected to be carried out from March to November 2023. Ethical approval was obtained from the Biomedical Research Ethics Committee in November 2021. CONCLUSIONS Anxiety in early childhood has been linked to various repercussions in adolescence and adulthood, such as school dropout, substance abuse, anxiety disorders, depression, and suicide ideation. Therefore, identifying the presence of anxiety earlier on and providing the necessary referral services could aid in reducing the negative consequences of unidentified and untreated anxiety in early childhood. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/37364.
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Affiliation(s)
- Fatiema Benjamin
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Bellville, South Africa
| | - Babatope O Adebiyi
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Bellville, South Africa
| | - Edna Rich
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Bellville, South Africa
| | - Nicolette Vanessa Roman
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, Bellville, South Africa
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Abboah-Offei M, Amboka P, Nampijja M, Owino GE, Okelo K, Kitsao-Wekulo P, Chumo I, Muendo R, Oloo L, Wanjau M, Mwaniki E, Mutisya M, Haycraft E, Hughes R, Griffiths P, Elsey H. Improving early childhood development in the context of the nurturing care framework in Kenya: A policy review and qualitative exploration of emerging issues with policy makers. Front Public Health 2022; 10:1016156. [PMID: 36238244 PMCID: PMC9551223 DOI: 10.3389/fpubh.2022.1016156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/09/2022] [Indexed: 01/28/2023] Open
Abstract
Introduction The Nurturing Care Framework (NCF) describes "nurturing care" as the ability of nations and communities to support caregivers and provide an environment that ensures children's good health and nutrition, protects them from threats, and provides opportunities for early learning through responsive and emotionally supportive interaction. We assessed the extent to which Kenyan government policies address the components of the NCF and explored policy/decision makers' views on policy gaps and emerging issues. Methods A search strategy was formulated to identify policy documents focusing on early childhood development (ECD), health and nutrition, responsive caregiving, opportunities for early learning and security and safety, which are key components of the NCF. We limited the search to policy documents published since 2010 when the Kenya constitution was promulgated and ECD functions devolved to county governments. Policy/decision-maker interviews were also conducted to clarify emerging gaps from policy data. Data was extracted, coded and analyzed based on the components of the NCF. Framework analysis was used for interview data with NCF being the main framework of analysis. The Jaccard's similarity coefficient was used to assess similarities between the themes being compared to further understand the challenges, successes and future plans of policy and implementation under each of the NCF domains. Results 127 policy documents were retrieved from government e-repository and county websites. Of these, n = 91 were assessed against the inclusion criteria, and n = 66 were included in final analysis. The 66 documents included 47 County Integrated Development Plans (CIDPs) and 19 national policy documents. Twenty policy/decision-maker interviews were conducted. Analysis of both policy and interview data reveal that, while areas of health and nutrition have been considered in policies and county level plans (coefficients >0.5), the domains of early learning, responsive caregiving and safety and security face significant policy and implementation gaps (coefficients ≤ 0.5), particularly for the 0-3 year age group. Inconsistencies were noted between county level implementation plans and national policies in areas such as support for children with disabilities and allocation of budget to early learning and nutrition domains. Conclusion Findings indicate a strong focus on nutrition and health with limited coverage of responsive caregiving and opportunities for early learning domains. Therefore, if nurturing care goals are to be achieved in Kenya, policies are needed to support current gaps identified with urgent need for policies of minimum standards that provide support for improvements across all Nurturing Care Framework domains.
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Affiliation(s)
- Mary Abboah-Offei
- School of Health and Life Sciences, University of the West of Scotland, London, United Kingdom,*Correspondence: Mary Abboah-Offei
| | - Patrick Amboka
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Margaret Nampijja
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | | | - Kenneth Okelo
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | | | - Ivy Chumo
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Ruth Muendo
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Linda Oloo
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Maryann Wanjau
- Community Engagement Associate, UNICEF, Greater Houston, TX, United States
| | - Elizabeth Mwaniki
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Maurice Mutisya
- African Population and Health Research Center, APHRC Campus, Nairobi, Kenya
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Robert Hughes
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Paula Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Helen Elsey
- Department of Health Sciences, University of York, York, United Kingdom
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Mahmassani HA, Switkowski KM, Johnson EJ, Scott TM, Rifas-Shiman SL, Oken E, Jacques PF. Early Childhood Lutein and Zeaxanthin Intake Is Positively Associated with Early Childhood Receptive Vocabulary and Mid-Childhood Executive Function But No Other Cognitive or Behavioral Outcomes in Project Viva. J Nutr 2022; 152:2555-2564. [PMID: 36774121 PMCID: PMC9644167 DOI: 10.1093/jn/nxac188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/19/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lutein and zeaxanthin are carotenoids associated with better cognition in older adults. Recent evidence suggests that their dietary intake may also have cognitive implications in childhood. OBJECTIVE The aim was to examine associations of early childhood lutein and zeaxanthin (L/Z) intake with cognition in early and mid-childhood. METHODS Among 1378 children in Project Viva, a prospective cohort, mothers reported their child's dietary intake in early childhood (median: 3.2 y) using a food-frequency questionnaire. Child cognition and behavior were assessed at the same time point using the Peabody Picture Vocabulary Test (PPVT-III) and the Wide Range Assessment of Visual Motor Abilities (WRAVMA) and at mid-childhood (median: 7.7 y) using the Kaufman Brief Intelligence Test, the WRAVMA drawing subtest, the Wide Range Assessment of Memory and Learning, the Behavior Rating Inventory of Executive Function (BRIEF), and the Strengths and Difficulties Questionnaire. RESULTS Children consumed a daily mean (SD) of 1.0 (0.4) mg L/Z in early childhood. Children in the third-quartile category of L/Z intake had a mean PPVT-III score 2.40 (95% CI: 0.27, 4.53) points higher than children in the lowest quartile category in early childhood, suggesting better receptive vocabulary. Children in the highest quartile category of L/Z intake had a parent-reported mean BRIEF Global Executive Composite score 1.65 (95% CI: -3.27, -0.03) points lower than children in the lowest quartile category in mid-childhood, indicating better executive function. We did not observe associations between L/Z intake and any of the other cognitive or behavioral outcomes assessed. CONCLUSIONS The overall findings do not provide strong evidence of an association between child L/Z intake and cognition and behavior. However, the positive associations found between early childhood L/Z intake and early childhood receptive vocabulary and mid-childhood executive function, in addition to previous evidence of neurodevelopmental benefit of L/Z intake, suggest that this relation deserves further investigation.
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Affiliation(s)
- Hiya A Mahmassani
- Dorothy J and Gerald R Friedman School of Nutrition and Science Policy at Tufts University, Boston, MA, USA,Jean Mayer–USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Karen M Switkowski
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Elizabeth J Johnson
- Dorothy J and Gerald R Friedman School of Nutrition and Science Policy at Tufts University, Boston, MA, USA
| | - Tammy M Scott
- Dorothy J and Gerald R Friedman School of Nutrition and Science Policy at Tufts University, Boston, MA, USA
| | - Sheryl L Rifas-Shiman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Paul F Jacques
- Dorothy J and Gerald R Friedman School of Nutrition and Science Policy at Tufts University, Boston, MA, USA; Jean Mayer-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
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Agrawal P, Nair D, Salam SS, Islam MI, Hamadani JD, Alonge O. Does Long-Term Enrollment in Day-Care Maintain or Increase Early Developmental Gains-Findings from an Intervention Study in Rural Bangladesh. Children (Basel) 2022; 9. [PMID: 35883913 DOI: 10.3390/children9070929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022]
Abstract
Objective: Community day-care centers (or crèches) are gaining popularity; access to these centers can reduce cognitive gaps. This paper describes the sustained impact of enrollment in day-cares on cognitive gains. Methods: As part of a larger study, a census of all children was conducted in 2012−2013 to identify children between 9 and 17 months of age in rural Bangladesh. A sub-sample of children (n = ~1000) were assigned to receive either a day-care or playpen. Children from two sub-districts were randomly selected and assessed at 9−17 months of age for cognitive and behavioral domains using the Ages and Stages Questionnaire-III. The same children were then followed-up with after one year to see if the scores obtained by the children in the day-care intervention were different from those enrolled in the playpen intervention using a difference-in-difference estimator. Results: Children enrolled in the day-care intervention performed better (in communication, gross-motor, personal-social, and problem-solving domains) than children enrolled in the playpens when followed up with after a one-year period. Total scores were 0.31 (95% CI 0.141−0.472) higher (p value < 0.001) among children in the day-cares. Family care indicators as well as the child’s and mother’s weight were significantly associated with sustained and increased cognitive gains. Conclusion and relevance: The cognitive and psychosocial improvements seen with short-term exposure to structured ECD programs (day-care) were observed to be sustained over time with continued exposure. Home stimulation and parental involvement add to the long-term benefits of ECD.
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Hammersley ML, Buchanan L, Xu H, Wen LM. Early Childhood Dietary Intake and Subsequent Socioemotional and Cognitive School Readiness Among Australian Children. Health Educ Behav 2022; 49:10901981221096100. [PMID: 35668635 DOI: 10.1177/10901981221096100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dietary intake can affect the physical, cognitive, and socioemotional development of young children. Few studies have explored the relationships between dietary intake and the cognitive and socioemotional dimensions of school readiness. This study aimed to investigate the longitudinal associations between children's dietary intake in early childhood, and cognitive and socioemotional school readiness indicators at age 4-5 years using data from the Longitudinal Study of Australian Children. A total of 4,253 children were included in the analysis. Multiple linear regression models were built to investigate whether dietary intake (measured by questionnaire at parent interview) at age 2-3 years predicted school readiness indicators of socioemotional and behavioral functioning (measured by parent-reported Strengths and Difficulties Questionnaire [SDQ total score and pro-social scale]), verbal (assessed by Peabody Picture Vocabulary Test-Third Edition [PPVT-III]) and nonverbal (assessed by "Who Am I" test [WAI] cognitive skills) at age 4-5 years. Furthermore, using cross-sectional data at age 4-5 years, four multiple linear regression models were built to investigate if dietary intake was correlated with the aforementioned school readiness indicators. All models were adjusted for potential confounders. It was found that every one-point increase in child dietary intake score at age 2-3 years led to a decrease in SDQ total score by 0.19 (95% confidence interval [CI] = [0.10, 0.28], and an increase in SDQ pro-social scale, WAI score and PPVT score by 0.07 (95% CI = [0.03, 0.10]), 0.27 (95% CI = [0.13, 0.41]), and 0.20 (95% CI = [0.09, 0.30]), respectively, at age 4-5 years. Children's dietary intake was also a correlate of their school readiness at age 4-5 years. These results add to the limited evidence base suggesting that children's early dietary intake may play an important role in later socioemotional and behavioral development, and the development of cognitive skills, which are critical school readiness indicators.
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Affiliation(s)
- Megan L Hammersley
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Limin Buchanan
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Forest Lodge, NSW, Australia
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Camperdown, NSW, Australia
| | - Huilan Xu
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Forest Lodge, NSW, Australia
| | - Li Ming Wen
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Forest Lodge, NSW, Australia
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Camperdown, NSW, Australia
- The National Health and Medical Research Council Centre for Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, NSW, Australia
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She X, Perera S, Andre M, St. Fleur J, Hilaire J, Evans A, Long J, Wing D, Carpenter C, Wilson K, Palfrey J, Stulac S. Associations Between Parental Depression, Self-efficacy, and Early Childhood Development in Malnourished Haitian Children. Glob Pediatr Health 2022; 9:2333794X221098311. [PMID: 35592789 PMCID: PMC9112296 DOI: 10.1177/2333794x221098311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Haiti lacks early childhood development data and guidelines in malnourished populations. Literature shows that developmental interventions are crucial for improving developmental outcomes malnourished children. This study examines the prevalence of early childhood development delays in a cohort of malnourished Haitian children and their associations with parental depression and self-efficacy. Methods. We used cross-sectional data from 42 patients 6 months to 2 years old in Saint-Marc, Haiti. We assessed their developmental status using the Ages and Stages Questionnaire. Parents were surveyed on depression symptoms and self-efficacy using validated surveys developed for low-resource settings. Demographic and socio-economic data were included. Prevalence of early childhood development delays and high parental depression risk were calculated. Multivariable logistic regression analyses were used to test whether parental depression risk and low self-efficacy were associated with a higher risk for childhood developmental delays. Results. Among participants, 45.2% (SD = 7.7%) of children with a recorded ASQ met age-specific cutoffs for developmental delay in one or more domains. 64.3% (SD = 7.4%) of parents were at high risk for depression. 47.6% (SD = 7.7%) of parents reported relatively low self-efficacy. Multivariable analysis showed that low parental self-efficacy was strongly associated with developmental delays (OR 17.5, CI 1.1-270.0) after adjusting for socioeconomic factors. Parental risk for depression was associated with higher odds (OR 4.6, CI 0.4-50.6) of children having developmental delays but did not reach statistical significance in this study. Conclusion. Parental self-efficacy was protectively associated with early childhood developmental delays in malnourished Haitian children. More research is needed to design contextually appropriate interventions.
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Affiliation(s)
- Xinshu She
- Stanford U School of Medicine,
Stanford, CA, USA
| | | | | | | | | | - Andrea Evans
- Toronto University School of Medicine,
Toronto, ON, Canada
| | - Jack Long
- University of Vermont Robert Larner
College of Medicine, Burlington, VT, USA
| | - Delight Wing
- University of Vermont Robert Larner
College of Medicine, Burlington, VT, USA
| | | | - Kim Wilson
- Harvard U Medical School, Boston, MA,
USA
| | | | - Sara Stulac
- Boston U School of Medicine, Boston,
MA, USA
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Wu S, Zhang D, Li X, Zhao J, Sun X, Shi L, Mao Y, Zhang Y, Jiang F. Siblings and Early Childhood Development: Evidence from a Population-Based Cohort in Preschoolers from Shanghai. Int J Environ Res Public Health 2022; 19:ijerph19095739. [PMID: 35565134 PMCID: PMC9099463 DOI: 10.3390/ijerph19095739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 11/16/2022]
Abstract
(1) Background: The current study aims to investigate the association between the presence of a sibling and early childhood development (ECD). (2) Methods: Data were obtained from a large-scale population-based cohort in Shanghai. Children were followed from three to six years old. Based on birth order, the sample was divided into four groups: single child, younger child, elder child, and single-elder transfer (transfer from single-child to elder-child). Psychosocial well-being and school readiness were assessed with the total difficulties score from the Strengths and Difficulties Questionnaire (SDQ) and the overall development score from the early Human Capability Index (eHCI), respectively. A multilevel model was conducted to evaluate the main effect of each sibling group and the group × age interaction effect on psychosocial well-being and school readiness. (3) Results: Across all measures, children in the younger child group presented with lower psychosocial problems (β = −0.96, 95% CI: −1.44, −0.48, p < 0.001) and higher school readiness scores (β = 1.56, 95% CI: 0.61, 2.51, p = 0.001). No significant difference, or marginally significant difference, was found between the elder group and the single-child group. Compared to the single-child group, the single-elder transfer group presented with slower development on both psychosocial well-being (Age × Group: β = 0.37, 95% CI: 0.18, 0.56, p < 0.001) and school readiness (Age × Group: β = −0.75, 95% CI: −1.10, −0.40, p < 0.001). The sibling-ECD effects did not differ between children from families of low versus high socioeconomic status. (4) Conclusion: The current study suggested the presence of a sibling was not associated with worse development outcomes in general. Rather, children with an elder sibling are more likely to present with better ECD.
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Affiliation(s)
- Saishuang Wu
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (S.W.); (J.Z.); (X.S.)
| | - Donglan Zhang
- Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, New York, NY 11501, USA;
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong 999077, China;
| | - Jin Zhao
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (S.W.); (J.Z.); (X.S.)
| | - Xiaoning Sun
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (S.W.); (J.Z.); (X.S.)
- Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai 201602, China
| | - Lu Shi
- Department of Public Health Science, College of Behavioral, Social and Health Science, Clemson University, Clemson, SC 29634, USA;
| | - Yuping Mao
- Department of Communication Studies, California State University Long Beach, Long Beach, CA 90840, USA;
| | - Yunting Zhang
- Child Health Advocacy Institute, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Correspondence: (Y.Z.); (F.J.); Tel.: +86-189-3083-0698 (Y.Z.); +86-189-3083-0668 (F.J.)
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China; (S.W.); (J.Z.); (X.S.)
- Pediatric Translational Medicine Institution, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai 201602, China
- Correspondence: (Y.Z.); (F.J.); Tel.: +86-189-3083-0698 (Y.Z.); +86-189-3083-0668 (F.J.)
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Villanueva K, Alderton A, Higgs C, Badland H, Goldfeld S. Data to Decisions: Methods to Create Neighbourhood Built Environment Indicators Relevant for Early Childhood Development. Int J Environ Res Public Health 2022; 19:ijerph19095549. [PMID: 35564944 PMCID: PMC9102076 DOI: 10.3390/ijerph19095549] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/07/2022] [Accepted: 04/29/2022] [Indexed: 02/01/2023]
Abstract
Healthy development in the early years lays the foundations for children’s ongoing physical, emotional, and social development. Children develop in multiple contexts, including their local neighbourhood. Neighbourhood-built environment characteristics, such as housing, walkability, traffic exposure, availability of services, facilities, and parks, are associated with a range of health and wellbeing outcomes across the life course, but evidence with early years’ outcomes is still emerging. Data linkage techniques were used to assemble a dataset of spatial (objectively-measured) neighbourhood-built environment (BE) measures linked to participant addresses in the 2015 Australian Early Development Census (AEDC) for children living in the 21 most populous urban and regional Australian cities (n = 235,655) to help address this gap. This paper describes the methods used to develop this dataset. This linked dataset (AEDC-BE) is the first of its kind worldwide, enabling opportunities for identifying which features of the built environment are associated with ECD across Australia at scale, allow comparisons between diverse contexts, and the identification of where best to intervene. National data coverage provides statistical power to model real-world complexities, such as differences by city, state/territory, and remoteness. The neighbourhood-built environment can be modified by policy and practice at scale, and has been identified as a way to help reduce inequitable early childhood development outcomes.
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Affiliation(s)
- Karen Villanueva
- Centre for Urban Research, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, VIC 3000, Australia; (A.A.); (C.H.); (H.B.)
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia;
- Correspondence: or
| | - Amanda Alderton
- Centre for Urban Research, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, VIC 3000, Australia; (A.A.); (C.H.); (H.B.)
| | - Carl Higgs
- Centre for Urban Research, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, VIC 3000, Australia; (A.A.); (C.H.); (H.B.)
| | - Hannah Badland
- Centre for Urban Research, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, VIC 3000, Australia; (A.A.); (C.H.); (H.B.)
| | - Sharon Goldfeld
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia;
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia
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Broadbent E, McConkie M, Aleson E, Kim L, Stewart R, Mulokozi G, Dearden KA, Linehan M, Cherian D, Torres S, Crookston BT, Hall PC, West JH. Promoting Caregiver Early Childhood Development Behaviors through Social and Behavioral Change Communication Program in Tanzania. Int J Environ Res Public Health 2022; 19:ijerph19095149. [PMID: 35564545 PMCID: PMC9103222 DOI: 10.3390/ijerph19095149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 12/04/2022]
Abstract
Objectives: Stunting remains a prevalent issue in Tanzania. The consequences of stunting include reduced height, greater susceptibility to disease, and diminished cognitive ability throughout the lifespan. Lack of psychosocial stimulation is associated with increased stunting, particularly in terms of its cognitive impact. The Addressing Stunting in Tanzania Early (ASTUTE) program was a large social and behavior change communication (SBCC) intervention that aimed to reduce childhood stunting in the region by targeting early childhood development (ECD) behaviors. The purpose of this study is to report on the extent to which exposure to ASTUTE might be related to ECD behaviors. Methods: ASTUTE disseminated program messages via a mass media campaign and interpersonal communication (IPC). Logistic regression models were used to explore the relationship between exposure to TV, radio, IPC messages, and key ECD behaviors of female primary caregivers and male heads of household. Results: Among primary caregivers, IPC was positively associated with all ECD behaviors measured. Radio was associated with all behaviors except drawing with their child. TV was associated with all behaviors except playing with their child. Among heads of household, only the radio was positively associated with the ECD behaviors measured. Conclusions for practice: Findings indicate that SBCC interventions that include mass media and IPC components may be effective at promoting parental engagement in ECD behaviors. Significance: We know that ECD is important for a child’s development. We know that parents play a critical role in promoting ECD behaviors. We are still exploring ways to influence parents so that they are more involved in ECD behaviors. The results presented here provide evidence for successful mass media and IPC efforts to improve parents’ ECD behaviors. We hope this study will add more evidence for large interventions such as these to the literature, and we are very hopeful that governments and large international NGOs will prioritize SBCC approaches in the future, especially in locations where face-to-face interventions may be challenging.
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Affiliation(s)
- Eliza Broadbent
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - McKayla McConkie
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - Emily Aleson
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - Lily Kim
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - Rebekah Stewart
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | | | - Kirk A. Dearden
- Corus International, Washington, DC 20036, USA; (K.A.D.); (M.L.); (D.C.)
| | - Mary Linehan
- Corus International, Washington, DC 20036, USA; (K.A.D.); (M.L.); (D.C.)
| | - Dennis Cherian
- Corus International, Washington, DC 20036, USA; (K.A.D.); (M.L.); (D.C.)
| | | | - Ben T. Crookston
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - Parley C. Hall
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - Joshua H. West
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
- Correspondence: ; Tel.: +1-801-422-3444
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Wang L, Wang T, Li H, Guo K, Hu L, Zhang S, Rozelle S. Parental Self-Perception, Parental Investment, and Early Childhood Developmental Outcomes: Evidence From Rural China. Front Public Health 2022; 10:820113. [PMID: 35433599 PMCID: PMC9008586 DOI: 10.3389/fpubh.2022.820113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
Using a three-wave longitudinal survey conducted in 815 households in rural Western China, this study aims to examine the association between parental self-perception and early childhood development and the mediation effect of parental investment on the association between parental self-perception and child development when the sample children are at different ages in the early childhood (18-30, 22-36, and 49-65 months). The results demonstrate that parental self-perception are positively and significantly associated with child social-emotional development in all three ages of childhood (from 18 to 65 months). Positive and significant association between parental self-perception and child cognitive development is found in the ages from 22 to 65 months. In addition, findings of this study show that parental investment plays a mediating role in the association between parental self-perception and child cognitive development. The study calls on policymakers to help to strengthen parental self-perception and parental investment related to early childhood development, which should result in better child development in rural China.
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Affiliation(s)
- Lei Wang
- International Business School, Shaanxi Normal University, Shaanxi, China
| | - Ting Wang
- International Business School, Shaanxi Normal University, Shaanxi, China
| | - Hui Li
- International Business School, Shaanxi Normal University, Shaanxi, China
| | | | - Lynn Hu
- Pardee RAND Graduate School, Santa Monica, CA, United States
| | - Siqi Zhang
- Stanford Center on China's Economy and Institution, Stanford University, Stanford, CA, United States
| | - Scott Rozelle
- Stanford Center on China's Economy and Institution, Stanford University, Stanford, CA, United States
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46
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Gomez ML, Bernal R, Baker-Henningham H. Qualitative evaluation of a scalable early childhood parenting programme in rural Colombia. Child Care Health Dev 2022; 48:225-238. [PMID: 34738243 DOI: 10.1111/cch.12921] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 08/08/2021] [Accepted: 10/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Integrating early childhood parenting programmes into existing government services is a key strategy for reducing the loss of children's developmental potential in low- and middle-income countries. There is limited evidence of participants' perceptions of these programmes, especially when implemented at scale. We integrated an intervention into an existing government programme targeting pregnant women and mothers of children up to 2 years of age and their families in rural Colombia. METHODS As part of a cluster randomized trial, 171 government workers (facilitators) implemented the intervention. The intervention included four components: (1) structured curricula, (2) play materials, (3) nutrition and (4) training and supervision. In this qualitative evaluation of the programme, we conducted semi-structured interviews with beneficiary mothers (n = 62), facilitators (n = 40) and supervisors (n = 8). Topic guides were developed to collect information on participants' perspectives of the acceptability, feasibility and effectiveness of the intervention and the enablers and barriers to implementation. All interviews were audiotaped and transcribed, and data were analysed using the framework approach. RESULTS Participants' responses indicated that the intervention was acceptable, feasible and effective. Key enablers to implementation were (1) the use of evidence-based behaviour change techniques leading to interactive, fun and participatory sessions; (2) structured curricula with easy to use, simple activities and materials; (3) the focus on positive, supportive relationships; and (4) the perceived benefits of the programme to the beneficiary mothers, children and families, facilitators and programme supervisors. The main barriers were (1) facilitators took time to become comfortable and competent in using the new participatory methodology and (2) the logistics related to making and distributing the play materials. CONCLUSION Providing structured curricula and play materials with training and ongoing supervision to enhance an existing programme targeting mothers, families and children was reported as acceptable, feasible and effective by beneficiary mothers and programme staff.
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Affiliation(s)
| | - Raquel Bernal
- Economics Department, Universidad de Los Andes, Bogotá, Colombia
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Palmer E, Marais L, Engelbrecht M. Parental decision-making in infant and child male circumcision: a case study in two townships in Gauteng, South Africa. Afr J AIDS Res 2022; 21:32-40. [PMID: 35361063 DOI: 10.2989/16085906.2022.2038645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/01/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Parental decision-making in infant and child male circumcision is influenced by complex, interrelated factors on many levels. Several studies have highlighted reasons for the acceptance and non-acceptance of child male circumcision. This study investigates the factors that influence parental decision-making in this matter and proposes a parental decision-making framework. The study was conducted in the townships of Diepsloot and Diepkloof in Gauteng, South Africa, using 48 in-depth interviews with parents, grandparents and uncles of the boys, as well as government officials and members of civil society as part of an explorative case study. Purposive and snowball sampling were used to select the participants. Thematic analysis was used to analyse the data by applying the conceptual framework of Bronfenbrenner's ecological systems theory. Three main themes emerged from the data: microsystem factors related to health and hygiene, the father's circumcision status, cultural expectations, pain, the child's autonomy and the extended family; mesosystem factors related to early childhood development centres; and exosystem factors related to circumcision policies and financial considerations.
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Affiliation(s)
- Eurica Palmer
- Centre for Development Support, Faculty of Economic and Management Sciences, University of the Free State, Bloemfontein, South Africa
| | - Lochner Marais
- Centre for Development Support, Faculty of Economic and Management Sciences, University of the Free State, Bloemfontein, South Africa
| | - Michelle Engelbrecht
- Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa
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Fahmida U, Hidayat AT, Oka AASI, Suciyanti D, Pathurrahman P, Wangge G. Effectiveness of an Integrated Nutrition Rehabilitation on Growth and Development of Children under Five Post 2018 Earthquake in East Lombok, Indonesia. Int J Environ Res Public Health 2022; 19:ijerph19052814. [PMID: 35270504 PMCID: PMC8910115 DOI: 10.3390/ijerph19052814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023]
Abstract
Background: In August 2018 Lombok Island in Indonesia was hit by a 7 Richter scale earthquake. This study aimed to assess the effectiveness of comprehensive nutrition disaster rehabilitation, based on the holistic integrated early child development concept, on the growth and development of children under five. Methods: A community-based intervention was performed in the East Lombok district; four villages in two sub-districts were randomly allocated into intervention or control groups. Mothers of 6–49-month-old children in the intervention group (n = 240) attended parenting classes (twice weekly) and received shredded fish/liver/anchovy and optimized complementary feeding/food-based recommendations, developed using linear programming. Health staff from the public health center and teachers from early childhood education (ECE) centers delivered parenting sessions on health–nutrition and care–education. The control group (n = 240) received existing health services. Indicators measured at baseline and the end line point were weight, length/height, hemoglobin, feeding practices, psychosocial care (HOME) and maternal stress (SRQ). At the end line point, child development was assessed using BSID-III. Results: At the end line point, maternal stress and child morbidity (cough) were lower and dietary diversity (+1) in 6–23-month-old children, and weight-for-age Z-score (+0.26) and social emotional score (+10 points) in ≥24-month-old children were higher in the intervention group. Conclusions: The nutrition rehabilitation intervention delivered through ECE centers has a positive effect on the growth and development of children under five in post-disaster conditions.
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Affiliation(s)
- Umi Fahmida
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta 10430, Indonesia; (A.T.H.); (A.A.S.I.O.); (D.S.); (G.W.)
- Early Childhood Care, Nutrition and Education (ECCNE) Working Group, Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Jakarta 10430, Indonesia
- Correspondence:
| | - Ahmad Thohir Hidayat
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta 10430, Indonesia; (A.T.H.); (A.A.S.I.O.); (D.S.); (G.W.)
- Early Childhood Care, Nutrition and Education (ECCNE) Working Group, Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Jakarta 10430, Indonesia
| | - Anak Agung Sagung Indriani Oka
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta 10430, Indonesia; (A.T.H.); (A.A.S.I.O.); (D.S.); (G.W.)
- Early Childhood Care, Nutrition and Education (ECCNE) Working Group, Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Jakarta 10430, Indonesia
| | - Dini Suciyanti
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta 10430, Indonesia; (A.T.H.); (A.A.S.I.O.); (D.S.); (G.W.)
| | | | - Grace Wangge
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta 10430, Indonesia; (A.T.H.); (A.A.S.I.O.); (D.S.); (G.W.)
- Early Childhood Care, Nutrition and Education (ECCNE) Working Group, Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Jakarta 10430, Indonesia
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Bhopal SS, Roy R, Verma D, Kumar D, Khan B, Soremekun S, Oates J, Divan G, Kirkwood BR. Using the Mothers Object Relations Scale for early childhood development research in rural India: Findings from the Early Life Stress Sub-study of the SPRING Cluster Randomised Controlled Trial (SPRING-ELS). Wellcome Open Res 2022; 6:54. [PMID: 35224208 PMCID: PMC8847700 DOI: 10.12688/wellcomeopenres.16591.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 11/30/2023] Open
Abstract
Background: The World Health Organization and others promote responsive caregiving to support all children to thrive, particularly in low- and middle-income countries. The 14-item Mother's Object Relations Scales - Short Form (MORS-SF) may be of use in research and public health programmes because of its basis in attachment theory and ability to capture parental feelings towards their child. Methods: We culturally adapted the MORS-SF for use with mothers in the SPRING home visits trial when their infants were 12 months old. The same dyads were assessed using the HOME inventory concurrently and Bayley Scales of Infant Development III (BSID-III) at 18 months of age. Mixed effects linear regression was used to examine associations between MORS-SF (explanatory variable) and HOME-IT, and the cognitive, language and motor domains of BSID-III (outcome variables). Results: 1273 dyads completed all assessments. For the motor and language BSID-III scales and for HOME-IT there were strong and positive associations with the MORS-SF warmth sub-scale, and strong and negative associations with the invasion sub-scale. Important but less strong associations were seen with the BSID-III cognitive scale. Evidence of interaction suggested that both are individually important for child development. Conclusions: This is the first time MORS-SF has been used in India where optimising responsive caregiving is of importance in supporting all children to reach their potential. It is also the first time that the tool has been used in relation to child development. MORS-SF could be a valuable addition to evaluation in early childhood development.
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Affiliation(s)
- Sunil S. Bhopal
- Population Health Sciences Institute, Newcatle University, Newcastle upon Tyne, UK
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Reetabrata Roy
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Sangath, New Delhi, India
| | | | - Divya Kumar
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Sangath, New Delhi, India
| | - Bushra Khan
- Department of Psychology, University of Karachi, Karachi, Pakistan
| | - Seyi Soremekun
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - John Oates
- Faculty of Wellbeing, Education & Language Studies, Open University, Milton Keynes, UK
| | | | - Betty R. Kirkwood
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Ozalp Akin E, Akbas A, Atasoy SC, Kanatli MC, Ince Acici S, Mustafayev R, Karaaslan BT, Ertem HD, Bingoler Pekcici B, Ertem I. Applicability of the Guide for Monitoring Child Development as a Telehealth Delivered Intervention During the Pandemic. Front Pediatr 2022; 10:884779. [PMID: 35722494 PMCID: PMC9204056 DOI: 10.3389/fped.2022.884779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early intervention delivered through telehealth is critically needed during crises, particularly for children in low and middle-income countries (LMICs). We aimed to determine the applicability of the international Guide for Monitoring Child Development (GMCD) intervention delivered through telehealth during the COVID-19 lockdown in Turkey. METHODS Using a mixed-methods longitudinal design, we recruited children with developmental difficulties aged 0-42 months with an appointment during the first lockdown at Ankara University Developmental Pediatrics Division and seen face-to-face only once before. Developmental pediatricians applied the GMCD intervention during a single telephone call. As a novel intervention component, caregivers were asked to record and send back videos of the child's development when there were doubts about the child's functioning. Caregivers were called 1 year later by blinded independent researchers and a semi-structured interview on applicability was conducted. Applicability of the caregiver recorded video component of the intervention was assessed by a blinded observer using the GMCD Video Observation Tool. RESULTS Of 122 children that received the telehealth delivered GMCD intervention, 114 (93.4%) were included in the 1-year outcome study. Most were boys (51.8%); median age was 16.5 (IQR: 10.0-29.0) months, 51.0% had chronic health conditions, and 66.7% had developmental delay. All caregivers that received the intervention were mothers; 75.4% had at least high school education. The intervention was reported as applicable by 80.7% with high levels of satisfaction. On multivariate regression analysis, absence of chronic health related conditions was significantly associated with applicability (OR = 2.87, 95% CI = 1.02-8.09). Of 31 caregivers that were asked for videos, 19 sent back 93 videos that were technically observable. One or more developmental domains were observed in all videos; in 52.6%, caregivers provided early learning opportunities. CONCLUSIONS The findings of this study imply that the telehealth delivered GMCD intervention for children with developmental difficulties is applicable during the pandemic. The intervention content and frequency needs to be augmented for children with chronic health conditions. Further research is required to examine applicability and effectiveness of the GMCD intervention in other settings, particularly in LMICs.
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Affiliation(s)
- Ezgi Ozalp Akin
- Developmental Pediatrics Division, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Aysen Akbas
- Developmental Pediatrics Division, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Sidika Canan Atasoy
- Developmental Pediatrics Division, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Merve Cicek Kanatli
- Developmental Pediatrics Division, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Selin Ince Acici
- Developmental Pediatrics Division, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Revan Mustafayev
- Department of Pediatrics, Acibadem Maslak Hospital, Istanbul, Turkey
| | - Bedriye Tugba Karaaslan
- Department of Child Development, Faculty of Health Sciences, Izmir Katip Çelebi University, Izmir, Turkey
| | - Hilmi Deniz Ertem
- Developmental Pediatrics Division, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Bahar Bingoler Pekcici
- Developmental Pediatrics Division, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Ilgi Ertem
- Developmental Pediatrics Division, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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