Engaging and Supporting Fathers: A Parenting Intervention to Improve Early Child Development in Tanzania

在低收入和中等收入国家，估计有2.5亿或43%的5岁以下儿童未能实现其发展潜力。父母干预措施，或主要侧重于提高亲子关系质量的项目，已显示出改善儿童早期发展（ECD）结果的有效性。然而，迄今为止，大多数基于证据的育儿干预措施都是为母亲设计、提供给母亲并在母亲中进行评估的，而将父亲排除在外。在高收入国家进行的观察性研究证实，父亲的养育和夫妻关系是父亲身份的独特方面，它们独立地和相互作用地形成父亲对幼儿发展的影响。虽然有越来越多的跨文化证据支持低收入中国家父亲的这些方面，但在撒哈拉以南非洲，人们对如何通过育儿干预来吸引父亲并解决父亲的这些重要方面知之甚少。K99/R00独立之路奖的目标是为候选人成功过渡到独立干预科学家做好准备，其国际研究重点是通过在中低收入国家支持父亲进行社区干预来促进幼儿发展成果。该目标将通过指导阶段（K99）的培训来实现，以扩大候选人在三个关键领域的知识和技能：1)幼儿发展、父亲和家庭科学的多学科和跨文化培训；2)潜在特征分析；3)干预发展和评估科学。候选人组建了一个优秀的导师团队，在理论、实务和方法技能方面具有互补的专业知识。这些培训目标将通过一种全面的方法来实现，其中包括定期的指导会议、课程、培训、会议和在坦桑尼亚的实地研究经验。K99阶段的具体研究目标是：1)基于父亲的养育方式和夫妻关系的测量来描述父亲的特征，并确定其与后来的ECD结果的关联；2)整合和调整多组件养育干预，以支持父亲在坦桑尼亚文化背景下作为父母和伴侣的角色。K99阶段的指导培训和研究成果将使候选人能够完成独立阶段（R00）的最终研究目标，即：3)对新适应的父亲干预进行混合方法的试点试验，以改善父亲的结果。这项建议将产生第一个以证据为基础的多成分育儿干预措施，从一开始就为坦桑尼亚文化背景下的父亲设计。试点结果将用于确定项目的可行性和可接受性，以及对父亲结果的初步干预效果，以支持随后的R01应用，旨在评估其对坦桑尼亚更大样本的ECD结果的有效性。

An estimated 250 million or 43% of children under age 5 years are failing to reach their developmental potential in low- and middle-income countries (LMICs). Parenting interventions, or programs that primarily focus on enhancing the quality of parent-child relationships, have shown effectiveness for improving early child development (ECD) outcomes. However, the majority of evidence-based parenting interventions to date have been designed for, delivered to, and evaluated among mothers and have excluded fathers. Observational studies in high-income countries have supported that fathers’ parenting and couple’s relationships are unique dimensions of fatherhood that independently and interactively shape the influence of fathers on young children’s development. While there is increasing cross-cultural evidence to support these dimensions of fatherhood in LMICs, very little is known about how to engage fathers and address these important aspects of fatherhood through parenting interventions in sub-Saharan Africa. The goal of this K99/R00 Pathway to Independence Award is to prepare the candidate for a successful transition to an independent intervention scientist with an international research focus on promoting ECD outcomes by supporting fathers through community-based interventions in LMICs. The goal will be accomplished through training during the mentored phase (K99) to broaden the candidate’s knowledge and skills in three critical areas: 1) multidisciplinary and cross-cultural training in ECD, fatherhood, and family science, 2) latent profile analysis, and 3) intervention development and evaluation science. The candidate has assembled an outstanding mentorship team with complementary expertise in theoretical, substantive, and methodological skills. These training objectives will be achieved through a holistic approach that includes regular mentorship meetings, coursework, trainings, conferences, and field-based research experience in Tanzania. The specific research aims of the K99 phase are to: 1) characterize profiles of fatherhood based on measures of fathers’ parenting and couple’s relationships, and determine their associations with later ECD outcomes, and 2) integrate and adapt a multicomponent parenting intervention that supports fathers’ roles as parents and partners in the Tanzanian cultural context. The mentored training and research findings from the K99 phase will enable the candidate to accomplish the final research aim of the independent phase (R00) that is: 3) to conduct a mixed-methods pilot trial of the newly adapted fatherhood intervention for improving paternal outcomes. This proposal will generate the first evidence-based, multicomponent parenting intervention that is designed from the outset for fathers in the Tanzanian cultural context. The pilot trial results will be used to determine program feasibility and acceptability and initial intervention efficacy on paternal outcomes to support a subsequent R01 application that aims to evaluate its effectiveness on ECD outcomes with a larger sample in Tanzania.