Low- and middle-income countries around the world are expanding investments in early childhood development (ECD) programs, but few evaluations of ECD programs measure impacts on maternal mental ...health as well as on other, closely associated psychosocial domains. One reason may be a lack of familiarity with appropriate survey instruments for measuring different aspects of maternal psychosocial well-being among ECD-focused researchers. We identified 478 empirical studies of ECD programs in low- and middle-income countries; 55 of them measure impacts on maternal mental health and related domains. In this article, we identify 22 instruments used to measure maternal depression, stress, anxiety, and other aspects of psychosocial well-being. We provide guidance on the uses of each instrument and examples of country contexts where each has been implemented.
The purpose of the study was to examine whether access to an at-scale, group-based parenting education program (“Educación Inicial”) had differential effects on parenting behaviors and child ...cognitive development according to mother's age at the birth of her first child, with a focus on adolescent mothers in rural Mexico.
This was a secondary analysis of a cluster-randomized controlled trial (n = 728 households, n = 106 communities). We conducted intent-to-treat analyses and examined the interaction between treatment group and mother's age at first birth. The primary outcomes were parenting behaviors (Family Care Indicators) and children's cognitive development (McCarthy Scales of Children's Abilities) at ages 3–5 years.
We found that children of mothers who began childbearing in adulthood (20–30 years) scored higher on tests of cognitive development when randomized to weekly parenting support than their counterparts in the comparison group. Whereas, the children of mothers who began childbearing in adolescence (≤16 years) did not have higher scores associated with the parenting program (difference in magnitude of associations: Verbal = −8.19; 95% CI = −15.50 to −.88; p = .03; Memory = −7.22; 95% CI = −14.31 to −.14; p = .05). The higher scores among the children of mothers who began childbearing in adulthood were only significant when Educación Inical was supported by Prospera, the conditional cash transfer program.
Our study results suggest that the Educación Inicial parenting intervention did not adequately address the needs of women who began childbearing in adolescence. One reason may be that adolescent mothers are more socially marginalized and less able to benefit from parenting programs.
Conditional cash transfer programs (CCTs) have shown mixed effects on child development outcomes in the context of poverty. Direct parenting support integrated with CCTs may improve the effectiveness ...of CCTs for children’s development, and benefits could occur via improvements in parenting practices or the home environment. Here, we use data from a randomized effectiveness trial to examine the pathways connecting parenting support and child development. The parenting program (EI: Educación Inicial) was implemented at scale among beneficiaries of Prospera (a CCT, previously Oportunidades and Progresa). Participants included children between the ages of 3 and 5 years old (n = 1,362) from 91 rural communities in three Mexican states. Communities were stratified by indigenous classification and randomized to one of three arms: (T0) Comparison group (CCT benefits only); (T1) CCT benefits plus availability of EI in the community; or (T2) CCT benefits plus promotion and encouragement by the CCT program to participate in EI. Findings were that participation in the T2 arm of the study was associated with a 13% increase in the number of play activities that parents engaged in with their children, particularly shared storybook reading and singing. Parents in T2 showed nearly two times greater odds of reading daily to their children. In mediation analyses, the amount of play activities and shared book reading explained up to 32% of the effects of the EI parenting program on child development outcomes. In this study, collaboration and integration of two social programs was critical for program impact, which occurred through pathways relating to parental engagement in reading and play.
•Low parenting quality at any point in early childhood negatively affects development.•Parental warmth and responsiveness drove parenting quality in infancy.•Stimulating and supportive parenting ...behaviors drove quality in prekindergarten.
Parenting quality—a child’s milieu of warmth, responsiveness, and stimulation—promotes a young child’s cognitive, social, and emotional development. An unanswered question, however, is about the relative contributions of parenting quality in infancy and in early childhood to disparities in child cognitive and socioemotional development by age five, in low- and middle-income countries (LMICs). Understanding these relationships could inform better targeting of parenting programs in LMICs to yield greater effect size and consistency in improvements in early childhood development. This longitudinal study examines parenting quality and early childhood development among 603 children from poor, rural communities in Mexico who were assessed during infancy (4–18 months) and prekindergarten (3–5 years). Parenting quality (low, moderate, or high) was measured using the HOME Inventory in infancy and the Family Care Indicators (FCI) during prekindergarten. Child development was assessed in infancy using the Extended Ages and Stages Questionnaire (EASQ) and the ASQ Socioemotional scale, and during prekindergarten with the McCarthy Scales of Children’s Abilities. We found that parenting quality measures above the 25th percentile during infancy and prekindergarten were independently and significantly associated with a 0.26–0.30 SD increase in McCarthy scores at ages 3–5 years in adjusted analyses. Parental warmth and responsiveness in infancy were significant predictors of child development at ages 3–5 years, but parental stimulating practices and availability of learning materials in the home were not. Conversely, during the prekindergarten period, parental stimulating practices were significant predictors of concurrent child development. Our findings support the importance parenting quality throughout early childhood, and that the effect of aspects of parenting may vary from infancy to prekindergarten. Programs targeting parents of young children should tailor their curriculum to the specific ages of the targeted children.
Conditional cash transfer programs (CCTs) have shown mixed effects on child development outcomes in the context of poverty. Direct parenting support integrated with CCTs may improve the effectiveness ...of CCTs for children's development, and benefits could occur via improvements in parenting practices or the home environment. Here, we use data from a randomized effectiveness trial to examine the pathways connecting parenting support and child development. The parenting program (EI: Educación Inicial ) was implemented at scale among beneficiaries of Prospera (a CCT, previously Oportunidades and Progresa ). Participants included children between the ages of 3 and 5 years old (n = 1,362) from 91 rural communities in three Mexican states. Communities were stratified by indigenous classification and randomized to one of three arms: (T0 ) Comparison group (CCT benefits only); (T1 ) CCT benefits plus availability of EI in the community; or (T2 ) CCT benefits plus promotion and encouragement by the CCT program to participate in EI . Findings were that participation in the T2 arm of the study was associated with a 13% increase in the number of play activities that parents engaged in with their children, particularly shared storybook reading and singing. Parents in T2 showed nearly two times greater odds of reading daily to their children. In mediation analyses, the amount of play activities and shared book reading explained up to 32% of the effects of the EI parenting program on child development outcomes. In this study, collaboration and integration of two social programs was critical for program impact, which occurred through pathways relating to parental engagement in reading and play.
Many school feeding programs target child hunger, nutritional deficiencies, attendance, and education outcomes but often do not examine their effects on cognitive development. In this ...cluster-randomized controlled trial, we tested the effects of adding a morning snack to a school lunch program on the fluid intelligence of 951 children ages 4 to 6 years. While there were no significant effects on development overall, the morning snack improved short-term memory (STM) and total score on the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) among children from the lowest quartile of household expenditures (STM: 0.35SD, p = 0.020; WPPSI-IV: 0.65SD, p = 0.087), and those whose mothers completed secondary school or less (STM: 0.35SD, p = 0.002; total WPPSI-IV: 0.81SD, p = 0.011). For at risk preschoolers, school snack programs may help meet their developmental needs.
On March 17, 2020 the Association of American Medical Colleges recommended dismissal of medical students from clinical settings due to the COVID-19 pandemic. Third-year (M3) and fourth-year (M4) ...medical students were at home, M4s were interested in teaching, and residents and faculty had fewer clinical responsibilities due to elective surgery cancellations. To continue M3 access to education, we created a virtual surgery elective (VSE) that aimed to broaden students’ exposure to, and elicit interest in, general surgery (GS).
Faculty, surgical residents, and M4s collaborated to create a 2-wk VSE focusing on self-directed learning and direct interactions with surgery faculty. Each day was dedicated to a specific pathology commonly encountered in GS. A variety of teaching methods were employed including self-directed readings and videos, M4 peer lectures, case-based learning and operative video review with surgery faculty, and weekly surgical conferences. A VSE skills lab was also conducted to teach basic suturing and knot-tying. All lectures and skills labs were via Zoom videoconference (Zoom Video Communications Inc). A post-course anonymous survey sent to all participants assessed changes in their understanding of GS and their interest in GS and surgery overall.
Fourteen M3s participated in this elective over two consecutive iterations. The survey response rate was 79%. Ninety-one percent of students believed the course met its learning objectives “well” or “very well.” Prior to the course, 27% reported a “good understanding” and 0% a “very good” understanding of GS. Post-course, 100% reported a “good” or “very good” understanding of GS, a statistically significant increase (P = 0.0003). Eighty-two percent reported increased interest in GS and 64% reported an increase in pursuing GS as a career.
As proof of concept, this online course successfully demonstrated virtual medical student education can increase student understanding of GS topics, increase interest in GS, and increase interest in careers in surgery. To broaden student exposure to GS, we plan to integrate archived portions of this course into the regular third-year surgery clerkship and these can also be used to introduce GS in the preclinical years.
Summary
Atmospheric carbon dioxide concentration (CO2) is increasing, which increases leaf‐scale photosynthesis and intrinsic water‐use efficiency. These direct responses have the potential to ...increase plant growth, vegetation biomass, and soil organic matter; transferring carbon from the atmosphere into terrestrial ecosystems (a carbon sink). A substantial global terrestrial carbon sink would slow the rate of CO2 increase and thus climate change. However, ecosystem CO2 responses are complex or confounded by concurrent changes in multiple agents of global change and evidence for a CO2‐driven terrestrial carbon sink can appear contradictory. Here we synthesize theory and broad, multidisciplinary evidence for the effects of increasing CO2 (iCO2) on the global terrestrial carbon sink. Evidence suggests a substantial increase in global photosynthesis since pre‐industrial times. Established theory, supported by experiments, indicates that iCO2 is likely responsible for about half of the increase. Global carbon budgeting, atmospheric data, and forest inventories indicate a historical carbon sink, and these apparent iCO2 responses are high in comparison to experiments and predictions from theory. Plant mortality and soil carbon iCO2 responses are highly uncertain. In conclusion, a range of evidence supports a positive terrestrial carbon sink in response to iCO2, albeit with uncertain magnitude and strong suggestion of a role for additional agents of global change.
See also the Commentary on this article by Way et al., 229: 2383–2385.
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