Postgraduate Program in Human Nutrition, University of Brasilia, Brasília, Federal District, Brazil.
Postgraduate Program in Public Health, University of São Paulo, São Paulo, Brazil.
PLoS One. 2023 Jul 19;18(7):e0288940. doi: 10.1371/journal.pone.0288940. eCollection 2023.
Investing in early childhood programs such as Brazil's Criança Feliz Program (PCF) to support low-income families in providing a nurturing care environment is critical to ensure that children reach their full developmental potential. We aimed to analyze the influence of the PCF on the nurturing care environment provided by families enrolled in the program in the Federal District, Brazil. A qualitative case study was conducted based on in-depth interviews with a purposive sampling of 22 caregivers enrolled in the PCF for at least six months. Eighteen subthemes emerged from the thematic analysis following the five components of the Nurturing Care Framework (i.e., good health, adequate nutrition, responsive care, early learning, and security and safety). Caregivers recognized the benefits of the PCF on children's mental health (good health) and reported challenges in providing adequate nutrition due to food insecurity (adequate nutrition). A bond between the home visitor and families was identified as critical to promote responsive parenting practices (responsive care). Caregivers appreciated the early stimulation activities provided during PCF home visits (opportunities for early learning). Access to social welfare programs, such as conditional cash transfer and food assistance, were facilitated through PCF multisectoral actions (safety and security). On the other hand, families reported not receiving support from PCF for issues such as breastfeeding, maternal mental health, and disciplinary practices. In summary, PCF enhanced the components of the nurturing care environment provided by families. However, their vulnerabilities and contextual implementation barriers may prevent families from fully benefiting from PCF activities.
投资于儿童早期计划，如巴西的 Criança Feliz 计划（PCF），以支持低收入家庭提供培养关爱环境，对于确保儿童充分发挥其发展潜力至关重要。我们旨在分析 PCF 对巴西联邦区参加该计划的家庭提供的养育照护环境的影响。采用基于目的抽样的深度访谈方法，对至少参加 PCF 六个月的 22 名照顾者进行了定性案例研究。在对养育照护框架的五个组成部分（即良好的健康、充足的营养、回应性照护、早期学习以及安全保障）进行主题分析后，出现了 18 个亚主题。照顾者认识到 PCF 对儿童心理健康（良好的健康）的益处，并报告由于粮食不安全（充足的营养）而在提供充足营养方面存在挑战。家访员与家庭之间的联系被认为是促进回应性养育实践（回应性照护）的关键。照顾者赞赏 PCF 家访中提供的早期刺激活动（早期学习的机会）。通过 PCF 的多部门行动，为家庭提供了获得社会福利计划（如有条件现金转移和粮食援助）的便利（安全保障）。另一方面，家庭报告说，他们没有从 PCF 获得母乳喂养、产妇心理健康和纪律处分等问题的支持。总之，PCF 增强了家庭提供的养育照护环境的组成部分。然而，他们的脆弱性和实施环境障碍可能会阻止家庭从 PCF 活动中充分受益。
