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.

项目摘要/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10亿儿童居住在下面 全球贫困线。儿童生命的早期构成了所有后来发展的基础。 对综合儿童发展计划（ECD）计划的投资对于打破 代际贫困周期。关于如何实施和整合ECD干预措施仍然缺乏证据 在贫困环境中，有许多竞争优先级。具体来说，未知哪种途径 推动ECD程序的实施以及是否将ECD程序组件集成到现有 针对贫困儿童的国家计划可以改善发展成果。最近，巴西滚动 响应2016年巴西国家ECD法律框架，OUTCRIANçaFelizECD计划 计划主要侧重于培养护士护理育儿技能以缓解贫困的负面影响 在3岁以下的儿童及其家人参加BolsaFamília的家人，这是最大的有条件现金转移 （CCT）世界上的计划。巴西ECD和CCT计划缺乏整合。填补这一空白至关重要 改善嵌入到最脆弱的现有计划中的ECD政策和倡议 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 CriançaFeliz的实施和瓶颈途径，以及2）帮助优化Bolsa的影响 Família通过将CriançaFeliz与粮食安全组成部分组成而对ECD的结果进行 程序。该项目将使用基于新颖的复杂自适应中的混合方法方法 以前用于了解潜水员母乳喂养和ECD计划的框架 国家，但不在巴西。分析将基于计划影响途径流程评估和 程序优化计算建模方法由上下文和程序特定数据告知。 调查结果将在巴西的决策者中广泛传播，并与一名决策者结合 工具箱使他们能够将来继续应用优化方法继续 通过BolsaFamília改善ECD结果。调查结果有很大的潜力被翻译成其他CCT 全球计划。该提案非常符合候选人的长期研究兴趣，成为 ECD领域的实施科学研究人员，特别是计划和政策评估。这 该项目的完成将为随后的R01赠款申请提供数据，以检查 优化粮食安全和ECD计划的成本效益整合，以改善ECD结果 现实世界中的条件。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ECD，将能够过渡到独立的学术地位。