Pathways to scale up integrated early childhood development programs

扩大综合幼儿发展计划的途径

• 批准号: 10404624
• 负责人: Gabriela Buccini
• 金额: $ 19.64万
• 依托单位: UNIVERSITY OF NEVADA LAS VEGAS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-12 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10404624
• 关键词: Accounting; Applications Grants; Area; Attention; Brazil; Breast Feeding; Buffers; Caring; Child; Child Development; Child Rearing; Complex; Computer Models; Country; Critical Pathways; Data; Development; Effectiveness; Effectiveness of Interventions; Elements; Enrollment; Evaluation; Family; Fostering; Foundations; Future; Goals; Government; Healthcare; Household; Individual; Investments; Legal; Life; Link; Low income; Measures; Methodology; Methods; Modeling; Municipalities; Nature; Outcome; Pathway Analysis; Pathway interactions; Policies; Positioning Attribute; Poverty; Process; Program Development; Public Health; Quality Control; Readiness; Recommendation; Research; Research Personnel; System; Testing; Training; Translating; Variant; base; contextual factors; cost effective; cost effectiveness; design; development policy; early childhood; early life adversity; evidence base; food insecurity; food security; health economics; implementation barriers; implementation science; improved; interest; intergenerational; low and middle-income countries; novel; process evaluation; programs; response; scale up; skill acquisition; skills; socioeconomics; theories; therapy development; tool

PROJECT SUMMARY/ABSTRACT The impact of poverty on child development is a critical public health issue. Nearly 1 billion children live below the poverty line worldwide. The early years of a child's life form the foundation for all later development. Investments in Integrated Early Childhood Development (ECD) programs are critical for breaking the intergenerational poverty cycle. Evidence is still lacking on how to implement and integrate ECD interventions in poverty setting where many competing priorities are in place. Specifically, it is unknown which pathways drive the implementation of ECD programs and whether integrating ECD program components into an existing national program targeting impoverished children can improve development outcomes. Recently, Brazil rolled out the Criança Feliz ECD program in response to the 2016 Brazilian National ECD legal framework This program focuses primarily on fostering nurturing care parenting skills to buffer the negative effects of poverty on children under 3 years and their families enrolled in Bolsa Família, the largest conditional cash transfer (CCT) program in the world. The Brazilian ECD and CCT programs lack integration. Filling in this gap is vital to improving ECD policies and initiatives embedded within existing programs targeting the most vulnerable children. This implementation science project takes a systems approach to achieve two goals: 1) identify pathways of implementation and bottlenecks of Criança Feliz, and 2) help optimize the impact of Bolsa Família on ECD outcomes through the integration of Criança Feliz with the food security components of the program. This project will use a mixed-methods approach grounded within a novel complex adaptive framework previously used for understanding the scaling up of breastfeeding and ECD programs in diverse countries but not in Brazil. Analyses will be based on the Program Impact Pathways process evaluation and a program optimization computational modelling approach informed by context and program specific data. Findings will be widely disseminated among decision makers in Brazil in conjunction with a policymaker toolbox to empower them to continue applying the optimization methodology in the future to continue improving ECD outcomes through Bolsa Família. Findings have great potential to be translated to other CCT programs worldwide. This proposal fits well with the candidate's long-term research interest to become an implementation science researcher in the field of ECD, specifically in program and policy evaluation. The completion of this project will provide data for a subsequent R01 grant application examining the impact of the optimized cost-effectiveness integration of food security and ECD programs to improve ECD outcomes under real-world conditions. Through this project the candidate will receive training in implementation science methods, health economics and ECD and will be able to transition to an independent academic position.

项目概要/摘要 贫困对儿童发展的影响是一个重要的公共卫生问题。近10亿儿童生活在地下 全世界的贫困线。儿童生命的早期阶段为以后的所有发展奠定了基础。 对儿童早期综合发展 (ECD) 计划的投资对于打破 代际贫困循环。关于如何实施和整合 ECD 干预措施仍缺乏证据 在贫困环境中，存在许多相互竞争的优先事项。具体来说，尚不清楚哪些途径 推动 ECD 计划的实施以及是否将 ECD 计划组件集成到现有的 针对贫困儿童的国家计划可以改善发展成果。近日，巴西推出了 响应 2016 年巴西国家 ECD 法律框架，推出 Criança Feliz ECD 计划 该计划主要侧重于培养养育子女技能，以缓冲贫困的负面影响 针对加入 Bolsa Família 的 3 岁以下儿童及其家人，这是最大的有条件现金转移 (CCT) 计划在世界范围内。巴西的 ECD 和 CCT 计划缺乏整合。填补这一空白至关重要 改进嵌入针对最弱势群体的现有计划中的儿童早期发展政策和举措 孩子们。该实施科学项目采用系统方法来实现两个目标：1）确定 Criança Feliz 的实施途径和瓶颈，2) 帮助优化 Bolsa 的影响 Família 通过将 Criança Feliz 与粮食安全组成部分相结合，了解儿童早期发展 (ECD) 成果 程序。该项目将使用基于新颖的复杂自适应的混合方法 以前用于理解在不同地区扩大母乳喂养和幼儿早期发展计划的框架 国家，但不包括巴西。分析将基于计划影响路径流程评估和 由上下文和程序特定数据通知的程序优化计算建模方法。 研究结果将与政策制定者一起在巴西决策者中广泛传播 工具箱使他们能够在未来继续应用优化方法以继续 通过 Bolsa Família 改善早期儿童发展 (ECD) 成果。研究结果具有转化为其他 CCT 的巨大潜力 世界各地的计划。该提案非常符合候选人成为一名长期研究兴趣 ECD 领域的实施科学研究人员，特别是计划和政策评估。这 该项目的完成将为后续 R01 拨款申请提供数据，以审查该项目的影响 优化粮食安全和儿童早期发展计划的成本效益整合，以改善儿童早期发展成果 现实世界的条件。通过该项目，候选人将接受实施科学方面的培训 方法、卫生经济学和 ECD，并将能够过渡到独立的学术职位。