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在现金转移项目中通过基于群体的家长支持促进儿童发展:对儿童成果的实验效果

Promoting child development through group-based parent support within a cash transfer program: Experimental effects on children's outcomes.

作者信息

Fernald Lia C H, Kagawa Rose M C, Knauer Heather A, Schnaas Lourdes, Guerra Armando Garcia, Neufeld Lynnette M

机构信息

School of Public Health, University of California.

Division of Research on Community Interventions, Instituto Nacional de Perinatología.

出版信息

Dev Psychol. 2017 Feb;53(2):222-236. doi: 10.1037/dev0000185. Epub 2016 Oct 17.

Abstract

We examined effects on child development of a group-based parenting support program ( - EI) when combined with Mexico's conditional cash transfer (CCT) program (, originally and ). This cluster-randomized trial included 204 communities (n = 1,113 children in final sample), stratified by community indigenous status, and assigned to receive either: (T0) CCT only; (T1) CCT plus availability of EI in the community; or (T2) T1 plus promotion of the EI program by the CCT program. Interviews were conducted with the mother or primary caregiver of each child at baseline (2008, children 0-18 months old), and at follow-up (2012, children 3-5 years old); the intervention began after baseline and continued for all eligible households. Cognitive development was assessed with the Extended Ages and Stages Questionnaire (baseline) and the McCarthy Scales of Children's Development (follow-up); assessors were blinded to treatment. All analyses were intention to treat. There were significant effects on child development when EI received support and promotion from the CCT program (T₂ vs. T₀: General Cognitive Index, β = 3.90; 95% CI [0.51, 7.30], Verbal Score, β = 4.28; 95% CI [0.51, 8.05], and Memory Score, β = 4.14; 95% CI [0.62, 7.66]), effects equivalent to 0.26-0.29 SD. There were no significant benefits when the programs operated independently (T₁ vs. T₀). In stratified analyses, EI showed significant effects in indigenous communities only. We found consistent results in regressions controlling for covariates, with some reductions in magnitude of differences. Our findings suggest that group-based, parenting support programs can improve child outcomes within the context of a CCT, but only when the 2 programs are integrated and mutually supportive. (PsycINFO Database Record

摘要

我们研究了基于群体的育儿支持项目(-EI)与墨西哥有条件现金转移支付(CCT)项目(最初为 ,后为 )相结合时对儿童发育的影响。这项整群随机试验纳入了204个社区(最终样本中有1113名儿童),按社区的原住民身份进行分层,并分配接受以下任一干预:(T0)仅CCT;(T1)CCT加上社区中有EI服务;或(T2)T1加上CCT项目对EI项目的推广。在基线期(2008年,儿童年龄为0 - 18个月)和随访期(2012年,儿童年龄为3 - 5岁)对每个孩子的母亲或主要照料者进行访谈;干预在基线期之后开始,并持续针对所有符合条件的家庭。使用扩展的年龄与阶段问卷(基线期)和麦卡锡儿童发展量表(随访期)评估认知发展;评估人员对治疗分组不知情。所有分析均采用意向性分析。当EI项目得到CCT项目的支持和推广时,对儿童发育有显著影响(T₂ 与 T₀ 相比:一般认知指数,β = 3.90;95%可信区间[0.51, 7.30],语言得分,β = 4.28;95%可信区间[0.51, 8.05],以及记忆得分,β = 4.14;95%可信区间[0.62, 7.66]),效果相当于0.26 - 0.29个标准差。当两个项目独立实施时没有显著益处(T₁ 与 T₀ 相比)。在分层分析中,EI仅在原住民社区显示出显著效果。在控制协变量的回归分析中我们得到了一致的结果,差异幅度有所减小。我们的研究结果表明,基于群体的育儿支持项目在CCT背景下可以改善儿童的发育结果,但前提是这两个项目相互整合且相互支持。(PsycINFO数据库记录

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