Microenterprise to Improve Child Development in Households Exposed to HIV

 描述(由申请人提供)：成人照顾者感染艾滋病毒使儿童处于认知和心理社会发育不良的极大风险中。由照料者艾滋病毒感染引起的经济不安全、食品不安全和情绪压力的增加可能会导致儿童营养、认知刺激和教育投资不足，所有这些都会导致儿童发展成果不佳。这些早期的劣势在一生中进一步加剧，导致成年后贫困、健康状况不佳和社会流动性降低。经济上的 干预措施，特别是针对贫困家庭的干预措施，可能有助于通过加强儿童营养和教育投资并提供更有效的照料，帮助打破照料者艾滋病毒感染与儿童生活机会不佳之间的联系。然而，这在文献中还没有被探讨过。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与艾滋病毒相关的早期生活逆境对成人健康和社会经济影响方面具有特定的专业知识。为了实现这一目标，我将需要在发展心理学、定性方法、实地试验和家庭调查设计方面，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·邦斯伯格广泛的研究基础设施的资源来实现我的科学目标，即审查随机的家庭一级微型企业干预对生活在乌干达农村地区感染艾滋病毒家庭的儿童的认知和心理社会发展的影响，并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。我的中心假设源于人力资本理论，即微型企业干预将改善儿童的认知和心理社会发展。我将通过追求三个具体的研究目标来检验这一假设：(1)使用定性方法确定家庭经济状况与有艾滋病毒感染照顾者的家庭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儿童早期发展结果的影响；以及(3)调查干预对发展影响的潜在机制。鉴于母公司微型企业试验的广泛基础设施已经到位，以及我的国际知名的导师和顾问团队，他们在艾滋病毒(邦斯伯格博士)、发展心理学(Charles Nelson博士)、实地实验(邦斯伯格博士和Alexander Tsai博士)、定性方法(Norma Ware博士)和微型企业(Bernard Kakuhikire先生)方面的专业知识，我处于有利地位，能够实现这些目标。这项拟议的研究具有创新性和重大意义：研究结果将提供一幅丰富的图景，说明经济干预如何提高有艾滋病毒感染照顾者的儿童的发展潜力，从而为未来的政策提供参考。

 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.