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.

项目总结/摘要 贫困对儿童发展的影响是一个关键的公共卫生问题。近10亿儿童生活在 全球贫困线。儿童生命的最初几年是以后所有发展的基础。 对儿童早期综合发展（ECD）计划的投资对于打破贫困至关重要。 贫穷的世代循环。关于如何执行和纳入幼儿发展干预措施的证据仍然缺乏 在贫穷的环境中，有许多相互竞争的优先事项。具体而言，尚不清楚哪些途径 推动幼儿发展计划的实施，以及是否将幼儿发展计划的组成部分纳入现有的 针对贫困儿童的国家计划可以改善发展成果。最近，巴西卷 根据2016年巴西国家幼儿发展法律的框架， 该计划主要侧重于培养养育子女的技能，以缓冲贫困的负面影响 3岁以下儿童及其家庭参加Bolsa Família，这是最大的有条件现金转移， (CCT)世界上的节目。巴西的幼儿发展和有条件现金援助方案缺乏一体化。填补这一空白至关重要 改善幼儿发展政策和现有针对最弱势群体的计划中的举措 孩子这个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，以及2）帮助优化Bolsa的影响 通过将Criança Feliz与《儿童权利公约》的粮食安全组成部分相结合， 程序.该项目将使用一种基于新的复杂自适应方法的混合方法 以前用于了解在不同地区扩大母乳喂养和幼儿发展计划的框架 但不是在巴西。分析将基于计划影响途径过程评估和 由上下文和程序特定数据通知的程序优化计算建模方法。 调查结果将与一位决策者一起在巴西的决策者中广泛传播 工具箱，使他们能够在未来继续应用优化方法， 通过家庭补助金改善幼儿发展成果。研究结果有很大的潜力被转化为其他CCT 世界各地的节目。这一建议非常符合候选人的长期研究兴趣，成为一个 儿童发展领域的执行科学研究员，特别是在方案和政策评估方面。的 该项目的完成将为随后的R 01赠款申请提供数据， 优化粮食安全和幼儿发展方案的成本效益整合，以改善幼儿发展成果， 真实世界的条件。通过这个项目，候选人将接受实施科学的培训 方法，卫生经济学和幼儿发展，并将能够过渡到一个独立的学术地位。