Scaling up of Brazil's Criança Feliz early childhood development program: an implementation science analysis.
Scaling up of Brazil's Criança Feliz early childhood development program: an implementation science analysis.
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DOI：
10.1111/nyas.14589
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发表时间：
2021-08
影响因子：
5.2
通讯作者：
Pérez-Escamilla R
中科院分区：
文献类型：
--
作者：
Buccini G;Venancio SI;Pérez-Escamilla R
为了解决阻碍社会经济弱势儿童充分发挥其发展潜力的不平等现象，巴西在5570个城市中的2934个实施了“快乐儿童”早期儿童发展方案。在对过去或现在的国家和州协调小组的22名关键举报人进行深入访谈的基础上，采用有目的的抽样进行了定性案例研究。主题分析遵循RE-AIM框架，复杂的自适应系统构建映射了障碍和推动因素如何影响规模扩大。在重新目标内确定了一个与PCF出现有关的总主题和18个次级主题。有利的国家政治环境有利于PCF通过自上而下的方法出现，这导致了治理方面的挑战。家庭登记标准的改变促进了覆盖范围，基于证据的方法有利于家访的设计。但是，部门间行动的实施仍然是效率的障碍，而部门内各级的阻力又推迟了通过。WhatsApp促进了网络、能力建设和应用。仓促扩大规模为高质量交付带来了障碍，并导致各城市的实施途径不同。法律制度化是确保永久资金和维持的关键。PCF加强了巴西的幼儿服务，但为了有效的可持续性，需要解决强烈的负反馈循环。
To address inequities that prevent socioeconomically vulnerable young children from reaching their full developmental potential, Brazil implemented the Programa Criança Feliz (PCF) (“Happy Child” early childhood development program) in 2934 of the 5570 municipalities. A qualitative case study was carried out based on in-depth interviews with 22 key informants, employing purposive sampling, from past or current national and state coordination teams. Thematic analysis followed the RE-AIM framework and complex adaptive system constructs mapped how barriers and enablers influenced scale-up. One overarching theme related to PCF emergence and eighteen subthemes were identified within the RE-AIM. An enabling national political environment favored PCF emergence through a top-down approach that led to governance challenges. Changes in the enrollment criteria for families facilitated reach, and evidence-based methodology favored the designing of the home visits. However, operationalizing the intersectoral actions remains a barrier for effectiveness, while intrasectoral resistance across levels delayed adoption. WhatsApp facilitated networking, capacity building, and adoption. Rushed scale-up generated barriers for quality delivery and led to different implementation pathways across municipalities. Legal institutionalization is critical to assure permanent funding and maintenance. PCF has enhanced early childhood services in Brazil, but strong negative feedback loops need to be addressed for effective sustainability.
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影响因子：
12.7
作者：
Glasgow, RE;Vogt, TM;Boles, SM
通讯作者：
Boles, SM
DOI：
10.1016/s0140-6736(16)31389-7
发表时间：
2017-01-07
期刊：
Lancet (London, England)
影响因子：
--
作者：
Black MM;Walker SP;Fernald LCH;Andersen CT;DiGirolamo AM;Lu C;McCoy DC;Fink G;Shawar YR;Shiffman J;Devercelli AE;Wodon QT;Vargas-Barón E;Grantham-McGregor S;Lancet Early Childhood Development Series Steering Committee
通讯作者：
Lancet Early Childhood Development Series Steering Committee
影响因子：
5.2
作者：
Cavallera, Vanessa;Tomlinson, Mark;Dua, Tarun
通讯作者：
Dua, Tarun
影响因子：
5.7
作者：
Jolles, Monica Perez;Lengnick-Hall, Rebecca;Mittman, Brian S.
通讯作者：
Mittman, Brian S.
影响因子：
5.2
作者：
Milner, Kate M.;Bhopal, Sunil;Lawn, Joy E.
通讯作者：
Lawn, Joy E.