Grandmother Caregiving, Family Dynamics, and Child Development in Rural Pakistan: a Mixed Methods Approach

项目摘要。实现最佳的儿童社会情感和认知发展（SECD）是一个全球性的问题。 公共卫生优先。发展不佳与教育程度低、工资收入低以及 成人健康不佳。促进最佳的儿童SECD结果需要让关键的照顾者参与， 大多数促进儿童SECD的心理社会干预措施针对的是母亲，而不是家庭 系统方法。在不同的文化背景下，祖母往往是关键的顾问或决策者， 妇幼保健问题。尽管祖母的作用很有影响力， 这种排斥可能会导致干预措施的影响减弱。了解祖母的 角色的演变，影响儿童的结果，并在生命早期塑造家庭的做法是必不可少的信息 干预措施。此外，母亲和祖母这两个主要的照顾者之间的冲突可能会导致 不太理想的教育实践，最终，可怜的孩子SECD。研究仅限于祖母- 母亲关系的质量影响到家庭的养育做法，特别是在资源匮乏的情况下。 这个拟议的博士前多样性补充的目标是准备申请人成功的 过渡到博士后奖学金，并最终成为一个独立的研究者的职业生涯，重点是 设计，实施和评估干预措施，以促进最佳的儿童SECD。这将是完成 通过个性化的指导和教学培训：1）发展干预发展的新技能， 实施科学，2）加强专业发展技能，特别是在口头和书面 沟通，传播和赠款写作，3）成功申请并过渡到博士后 奖学金。优秀的导师团队提供互补和跨学科的专业知识，以支持 并为申请人从博士前到博士后培训的过渡做好准备。 本文研究的混合方法的目标是（1）估计 祖母在早期生活中的参与和6岁时的儿童SECD，（2）检查 祖母-母亲关系质量和家庭投资，以促进儿童发展，（3a） 定性地探讨祖母和母亲对抚养角色，家庭动态和祖母的看法 纳入促进经济合作和发展干预措施，以及（3b）综合研究结果并利用执行工作 科学原则，提供新的见解，祖母纳入心理社会，促进SECD 干预措施。Bachpan队列，巴基斯坦农村的纵向出生队列，作为母研究。 将对来自Bachpan队列的祖母和母亲进行单独的深入访谈， 7岁。这个混合方法的项目将产生新的见解，祖母抚养，家庭动态， 对儿童的影响。研究结果将用于突出执行差距和机会 并确定将祖母纳入巴基斯坦现有干预措施的实施战略。

PROJECT SUMMARY. Achieving optimal child socioemotional and cognitive development (SECD) is a global public health priority. Poor development has been linked to low educational attainment, low wage earnings, and poor adult health. Promoting optimal child SECD outcomes necessitates engaging key caregivers, but the majority of psychosocial interventions to promote child SECD target mothers and fail to incorporate a family systems approach. Across cultural contexts, grandmothers are often key advisors or decision-makers on maternal and child health issues. Despite their influential roles, grandmothers are often omitted from interventions and this exclusion can lead to diminished intervention impacts. Understanding how grandmothers’ roles evolve, impact child outcomes, and shape household practices in early life is essential to informing interventions. Further, conflicts between mothers and grandmothers, two key caregivers in early life, may lead to suboptimal caregiving practices and ultimately, poor child SECD. Research is limited on how the grandmother- mother relationship quality affects household caregiving practices, especially in low-resource contexts. The goal of this proposed predoctoral Diversity Supplement is to prepare the applicant for a successful transition to a postdoctoral fellowship, and ultimately an independent investigator career, with a focus on designing, implementing, and evaluating interventions to promote optimal child SECD. This will be accomplished by individualized mentorship and didactic training to: 1) develop new skills in intervention development and implementation science, 2) strengthen professional development skills, specifically in oral and written communication, dissemination, and grant-writing, and 3) successfully apply and transition into a postdoctoral fellowship. The outstanding mentorship team provides complementary and interdisciplinary expertise to support and prepare the applicant for transition from predoctoral to postdoctoral training. The goals of the proposed mixed methods dissertation research are to (1) estimate associations between grandmother involvement across early life and child SECD at age 6, (2) examine associations between grandmother-mother relationship quality and household investments to promote child development, (3a) qualitatively explore grandmother and mother views on caregiving roles, family dynamics, and grandmother inclusion in SECD-promoting interventions, and (3b) synthesize research findings and use implementation science principles to provide new insights on grandmother inclusion in psychosocial, SECD-promoting interventions. The Bachpan Cohort, a longitudinal birth cohort in rural Pakistan, serves as the parent study. Separate in-depth interviews of grandmothers and mothers from the Bachpan Cohort will be conducted at child age 7. This mixed methods project will generate new insights on grandmother caregiving, family dynamics, and impacts on child SECD. The research findings will be used to highlight implementation gaps and opportunities and identify implementation strategies for grandmother inclusion in existing interventions in Pakistan.