Microenterprise to Improve Child Development in Households Exposed to HIV

微型企业改善感染艾滋病毒家庭的儿童发展

• 批准号: 9244065
• 负责人: Atheendar S. Venkataramani
• 金额: $ 18.32万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-08 至 2017-07-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9244065
• 关键词: AIDS/HIV problem; Address; Adolescence; Adult; Affect; Africa South of the Sahara; Age; Almond Nut; Applications Grants; Area; Automobile Driving; Award; Behavior; Caregiver Burden; Caregivers; Child; Child Development; Child Nutrition; Child Rearing; Cognitive; Collaborations; Complement; Consequences of HIV; Data; Development; Developmental Process; Disadvantaged; Doctor of Medicine; Economics; Emotional Stress; Exposure to; Female; Food; Foundations; Funding; Future; Goals; Grant; Growth; HIV; HIV Infections; Health; Household; Income; Internal Medicine; International; Intervention; Investments; Journals; Lead; Life; Life Cycle Stages; Link; Literature; Measures; Mentors; Mentorship; Modeling; Morbidity - disease rate; Outcome; Parents; Peer Review; Performance; Pilot Projects; Policies; Population; Positioning Attribute; Poverty; Psychosocial Stress; Public Health; Qualitative Methods; Qualitative Research; Randomized; Research; Research Infrastructure; Research Personnel; Resources; Risk; Risk Factors; Role; Rural; Sampling; Social Mobility; Stress; Surveys; Testing; Training; Uganda; Vulnerable Populations; Work; base; career; caregiving; child mental development; cognitive development; cognitive skill; cognitive testing; cohort; design; developmental psychology; early childhood; executive function; experience; experimental study; health economics; high risk; human capital; improved; innovation; mental development; mortality; nutrition; programs; psychosocial development; public health relevance; skills; socioeconomics; theories

 DESCRIPTION (provided by applicant): HIV infection of an adult caregiver places children at great risk for poor cognitive and psychosocial development. The increased financial insecurity, food insecurity, and emotional stress that result from caregiver HIV infection may lead to inadequate child nutrition, cognitive stimulation, and educational investment, all of which result in poor child developmental outcomes. These early disadvantages are further compounded over the life-course, leading to poverty, ill-health, and reduced social mobility in adulthood. Economic interventions, particularly those targeting poor households, may help break the link between caregiver HIV infection and poor life chances for children by bolstering child nutrition and educational investment and allowing for more effective caregiving. However, this has not been explored in the literature. My long-term career goal is to become an independent investigator with specific expertise in understanding the adult health and socioeconomic consequences of HIV-related early life-course adversity in sub-Saharan Africa. To achieve this goal, I will need additional mentorship and training in developmental psychology, qualitative methods, field experiment and household survey design, specifically as they relate to HIV-affected populations. I will draw upon this training and leverage the resources of my primary mentor David Bangsberg's extensive research infrastructure to achieve my scientific objective, which is to examine the impacts of a randomized household-level microenterprise intervention on cognitive and psychosocial development among children living in households exposed to HIV in rural Uganda and elucidate the key mechanisms behind these effects. My primary mentor's already funded longitudinal microenterprise trial provides the experimental platform for my proposed research. My central hypothesis, which follows from human capital theory, is that the microenterprise intervention will improve child cognitive and psychosocial development. I will test this hypothesis by pursuing 3 specific research aims: (1) identify key mechanisms linking household economic status and child cognitive and psychosocial development in households with HIV-infected caregivers using qualitative methods; (2) assess the impacts of the microenterprise intervention on key early childhood developmental outcomes; and (3) investigate the mechanisms underlying the developmental impacts of the intervention. I am well positioned to achieve these aims given the extensive infrastructure already in place for the parent microenterprise trial and my internationally-renowned team of mentors and advisors with expertise in HIV (Dr. Bangsberg), developmental psychology (Dr. Charles Nelson), field experiments (Dr. Bangsberg and Dr. Alexander Tsai), qualitative methods (Dr. Norma Ware), and microenterprise (Mr. Bernard Kakuhikire). The proposed research is innovative and significant: the results will provide a rich picture of how economic interventions can bolster the developmental potential of children with HIV-infected caregivers, thus informing future policy.

 描述（由申请人提供）：成年照顾者感染艾滋病毒会使儿童面临认知和心理社会发育不良的巨大风险。由于照顾者感染艾滋病毒而导致的经济不安全、粮食不安全和情绪压力的增加可能导致儿童营养不足、认知刺激和教育投资不足，所有这些都导致儿童发育不良。这些早期的不利条件在一生中进一步加剧，导致贫穷、健康不良和成年后社会流动性降低。经济 干预措施，特别是那些针对贫困家庭的干预措施，通过加强儿童营养和教育投资，并允许更有效的教育，可能有助于打破照顾者感染艾滋病毒与儿童生活机会差之间的联系。然而，这在文献中没有被探讨过。我的长期职业目标是成为一名独立调查员，在了解撒哈拉以南非洲艾滋病毒相关的早期生命历程逆境的成人健康和社会经济后果方面具有特定的专业知识。为实现这一目标，我将需要在发展心理学、定性方法、实地实验和住户调查设计方面，特别是在与受艾滋病毒影响的人口有关的方面，提供更多的指导和培训。我将利用这一培训，并利用我的主要导师大卫邦斯伯格的广泛的研究基础设施的资源，以实现我的科学目标，这是研究的影响，随机家庭层面的微型企业干预对认知和心理社会发展的儿童生活在家庭暴露于艾滋病毒在乌干达农村和阐明这些影响背后的关键机制。我的主要导师已经资助的纵向微型企业试验为我提出的研究提供了实验平台。我的中心假设，从人力资本理论，是微型企业的干预将改善儿童的认知和心理社会发展。我将通过追求3个具体的研究目标来验证这一假设：（1）使用定性方法确定家庭经济状况与艾滋病毒感染的照顾者家庭中儿童认知和心理社会发展之间的关键机制;（2）评估微型企业干预对关键幼儿发展结果的影响;（3）调查干预对发展影响的潜在机制。我有能力实现这些目标，因为母公司微型企业试验已经有了广泛的基础设施，我的国际知名导师和顾问团队在艾滋病毒（Bangsberg博士）、发展心理学（Charles纳尔逊博士）、实地实验（Bangsberg博士和亚历山大蔡博士）、定性方法（Norma Ware博士）和微型企业（Bernard Kakuhikire先生）方面都有专长。拟议的研究是创新和重要的：结果将提供一个丰富的图片如何经济干预措施可以加强与艾滋病毒感染的照顾者的儿童的发展潜力，从而为未来的政策。