Roby Erin, Shaw Daniel S, Morris Pamela, Canfield Caitlin F, Miller Elizabeth B, Dreyer Benard, Klass Perri, Ettinger Anna, Miller Elizabeth, Mendelsohn Alan L
Department of Pediatrics, NYU Grossman School of Medicine (E Roby, CF Canfield, EB Miller, B Dreyer, P Klass, and AL Mendelsohn), New York, NY.
Department of Psychology, University of Pittsburgh (DS Shaw), Pittsburgh, Pa.
Acad Pediatr. 2021 Mar;21(2):228-235. doi: 10.1016/j.acap.2020.12.002. Epub 2020 Dec 19.
Poverty remains a critical predictor of children's school readiness, health and longer term outcomes. Early relational health (ERH) (ie, parenting practices and relationship quality) mediates the impact of poverty on child development, and thus has been the focus of many parenting interventions. Despite the documented efficacy of parenting interventions at reducing poverty-related disparities in child health and development, several key barriers prevent achieving population-level reach to families with young children. In the current paper we highlight several of these barriers including gaining population-level access to young children and families, reaching families only through single points of access, addressing the significant heterogeneity of risk that exists among families living in poverty, as well as addressing each of these barriers in combination. We suggest that understanding and confronting these barriers will allow family-centered interventions to more effectively address issues related to ERH at a population level, which in turn will reduce poverty-related disparities in child development.
贫困仍然是儿童入学准备、健康状况及长期发展结果的关键预测指标。早期关系健康(即育儿方式和关系质量)介导了贫困对儿童发展的影响,因此一直是许多育儿干预措施的重点。尽管有文献证明育儿干预措施在减少与贫困相关的儿童健康和发展差距方面具有成效,但仍存在几个关键障碍,阻碍了这些措施覆盖到有幼儿的家庭。在本文中,我们重点介绍其中几个障碍,包括在人群层面接触幼儿及其家庭、仅通过单一途径接触家庭、应对贫困家庭中存在的显著风险异质性,以及综合应对上述每一个障碍。我们认为,理解并克服这些障碍将使以家庭为中心的干预措施在人群层面更有效地解决与早期关系健康相关的问题,进而减少与贫困相关的儿童发展差距。