Towards a better understanding of real-world home-visiting programs: a large-scale effectiveness study of parenting mechanisms in Brazil
Background The scale-up of parenting programmes to support early childhood development (ECD) is poorly understood. Little is known about how and when early interventions are most effective. Sustainability of ECD programming requires a better understanding of the mechanisms of real-world intervention...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-02-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/9/2/e013787.full |
| _version_ | 1797289261980975104 |
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| author | Paul G Ramchandani Joseph Murray Fernando Pires Hartwig Eduardo Viegas da Silva Morgan Rebecca Healy Anton Rask Lundborg Tiago Neuenfeld Munhoz Adriane Xavier Arteche |
| author_facet | Paul G Ramchandani Joseph Murray Fernando Pires Hartwig Eduardo Viegas da Silva Morgan Rebecca Healy Anton Rask Lundborg Tiago Neuenfeld Munhoz Adriane Xavier Arteche |
| author_sort | Paul G Ramchandani |
| collection | DOAJ |
| description | Background The scale-up of parenting programmes to support early childhood development (ECD) is poorly understood. Little is known about how and when early interventions are most effective. Sustainability of ECD programming requires a better understanding of the mechanisms of real-world interventions. We examined the effects on caregiving practices of Primeira Infância Melhor (PIM), a state-wide home-visiting programme in Brazil.Methods This propensity score matched, longitudinal, quasiexperimental study uses data from the 2015 Pelotas Birth Cohort. We matched children who received PIM at any age with other cohort children on 25 key covariates. Sensitivity, guidance and responsiveness were assessed using video-recorded play tasks. Coerciveness and the parent–child relationship were assessed using the Parenting and Family Adjustment Scales. All parenting outcomes were examined at age 4 years. Separate moderation analyses were conducted for each effect modifier: family income, child age and duration of participation.Results Out of 4275 children in the cohort, 797 were enrolled in PIM up to age 4 years. 3018 children (70.6%) were included in the analytic sample, of whom 587 received PIM and 2431 were potential controls. We found a positive effect of PIM on responsiveness (β=0.08, 95% CIs 0.002 to 0.16) and sensitivity (β=0.10, 95% CIs 0.02 to 0.19). No effect was found for any secondary outcomes. Moderation analyses revealed a stronger positive effect on sensitivity for low-income parents (β=0.18, 95% CIs 0.03 to 0.34).Conclusion A state-wide, home-visiting programme in Brazil improved aspects of responsive caregiving. Effects were more pronounced for low-income families, suggesting benefits of purposeful targeting. |
| first_indexed | 2024-03-07T19:02:23Z |
| format | Article |
| id | doaj.art-6617e96c288840ef9c190feb7f0d79c7 |
| institution | Directory Open Access Journal |
| issn | 2059-7908 |
| language | English |
| last_indexed | 2024-03-07T19:02:23Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj.art-6617e96c288840ef9c190feb7f0d79c72024-03-01T12:50:07ZengBMJ Publishing GroupBMJ Global Health2059-79082024-02-019210.1136/bmjgh-2023-013787Towards a better understanding of real-world home-visiting programs: a large-scale effectiveness study of parenting mechanisms in BrazilPaul G Ramchandani0Joseph Murray1Fernando Pires Hartwig2Eduardo Viegas da Silva3Morgan Rebecca Healy4Anton Rask Lundborg5Tiago Neuenfeld Munhoz6Adriane Xavier Arteche7PEDAL, Faculty of Education, University of Cambridge, Cambridge, UKPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, BrazilPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, BrazilPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, BrazilPEDAL, Faculty of Education, University of Cambridge, Cambridge, UKUniversity of Copenhagen Department of Mathematical Sciences, Kobenhavn, DenmarkDepartment of Psychology, Federal University of Pelotas, Pelotas, BrazilDepartment of Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, BrazilBackground The scale-up of parenting programmes to support early childhood development (ECD) is poorly understood. Little is known about how and when early interventions are most effective. Sustainability of ECD programming requires a better understanding of the mechanisms of real-world interventions. We examined the effects on caregiving practices of Primeira Infância Melhor (PIM), a state-wide home-visiting programme in Brazil.Methods This propensity score matched, longitudinal, quasiexperimental study uses data from the 2015 Pelotas Birth Cohort. We matched children who received PIM at any age with other cohort children on 25 key covariates. Sensitivity, guidance and responsiveness were assessed using video-recorded play tasks. Coerciveness and the parent–child relationship were assessed using the Parenting and Family Adjustment Scales. All parenting outcomes were examined at age 4 years. Separate moderation analyses were conducted for each effect modifier: family income, child age and duration of participation.Results Out of 4275 children in the cohort, 797 were enrolled in PIM up to age 4 years. 3018 children (70.6%) were included in the analytic sample, of whom 587 received PIM and 2431 were potential controls. We found a positive effect of PIM on responsiveness (β=0.08, 95% CIs 0.002 to 0.16) and sensitivity (β=0.10, 95% CIs 0.02 to 0.19). No effect was found for any secondary outcomes. Moderation analyses revealed a stronger positive effect on sensitivity for low-income parents (β=0.18, 95% CIs 0.03 to 0.34).Conclusion A state-wide, home-visiting programme in Brazil improved aspects of responsive caregiving. Effects were more pronounced for low-income families, suggesting benefits of purposeful targeting.https://gh.bmj.com/content/9/2/e013787.full |
| spellingShingle | Paul G Ramchandani Joseph Murray Fernando Pires Hartwig Eduardo Viegas da Silva Morgan Rebecca Healy Anton Rask Lundborg Tiago Neuenfeld Munhoz Adriane Xavier Arteche Towards a better understanding of real-world home-visiting programs: a large-scale effectiveness study of parenting mechanisms in Brazil BMJ Global Health |
| title | Towards a better understanding of real-world home-visiting programs: a large-scale effectiveness study of parenting mechanisms in Brazil |
| title_full | Towards a better understanding of real-world home-visiting programs: a large-scale effectiveness study of parenting mechanisms in Brazil |
| title_fullStr | Towards a better understanding of real-world home-visiting programs: a large-scale effectiveness study of parenting mechanisms in Brazil |
| title_full_unstemmed | Towards a better understanding of real-world home-visiting programs: a large-scale effectiveness study of parenting mechanisms in Brazil |
| title_short | Towards a better understanding of real-world home-visiting programs: a large-scale effectiveness study of parenting mechanisms in Brazil |
| title_sort | towards a better understanding of real world home visiting programs a large scale effectiveness study of parenting mechanisms in brazil |
| url | https://gh.bmj.com/content/9/2/e013787.full |
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