Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Jamaica.
School of Psychology, Bangor University, Bangor, United Kingdom.
Ann N Y Acad Sci. 2018 May;1419(1):120-140. doi: 10.1111/nyas.13678.
Young children need nurturing care, which includes responsive caregiver-child interactions and opportunities to learn. However, there are few extant large-scale programs that build parents' abilities to provide this. We have developed an early childhood parenting training package, called Reach Up, with the aim of providing an evidence-based, adaptable program that is feasible for low-resource settings. Implementation of Reach Up was evaluated in Brazil and Zimbabwe to inform modifications needed and identify challenges that implementers and delivery agents encountered. Interview guides were developed to collect information on the program's appropriateness, acceptability, and feasibility from mothers, home visitors, and supervisors. Information on adaptation was obtained from country program leads and Reach Up team logs, as well as quality of visits from observations conducted by supervisors. The program was well accepted by mothers and visitors, who perceived benefits for the children; training was viewed as appropriate, and visitors felt well-prepared to conduct visits. A need for expansion of supervisor training was identified and the program was feasible to implement, although challenges were identified, including staff turnover; implementation was less feasible for staff with other work commitments (in Brazil). However, most aspects of visit quality were high. We conclude that the Reach Up program can expand capacity for parenting programs in low- and middle-income countries.
幼儿需要养育关怀，包括有回应的照顾者与儿童的互动以及学习机会。然而，目前很少有大规模的项目可以培养家长提供这种关怀的能力。我们开发了一个名为 ReachUp 的幼儿养育培训包，旨在提供一个基于证据、可适应的项目，适用于资源有限的环境。ReachUp 在巴西和津巴布韦进行了实施评估，以了解需要进行哪些修改，并确定实施者和提供服务者遇到的挑战。我们制定了访谈指南，以从母亲、家访者和主管那里收集有关该项目适宜性、可接受性和可行性的信息。关于适应情况的信息是从国家项目负责人和 ReachUp 团队日志以及主管观察到的访问质量中获得的。该项目深受母亲和家访者的欢迎，他们认为对孩子有益；培训被认为是合适的，家访者觉得自己已经做好了充分的准备进行家访。确定了扩大主管培训的需求，并认为该项目具有可行性，但也确定了一些挑战，包括员工流失；对于有其他工作承诺的员工来说（在巴西），实施起来不太可行。然而，大多数访问质量方面都很高。我们的结论是，ReachUp 项目可以为中低收入国家的养育项目提供能力。
