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About this paper symposium
| Panel information |
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| Panel 27. Solicited Content: Global South |
| Paper #1 | |
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| Apapacho, A Violence Prevention Parenting Program: Feasibility Study and Lessons from a Research-Practice-Partnership in Colombia | |
| Author information | Role |
| Dr. Jorge Cuartas, New York University & Colombia, United States & Universidad de los Andes | Presenting author |
| Juliana Borbón, Fundación Apapacho, Colombia | Non-presenting author |
| Luciana Beccassino, Bangor University & Fundación Apapacho, UK and Colombia | Non-presenting author |
| Helen Baker-Henningham, Bangor University & University of the West Indies, UK and Jamaica | Non-presenting author |
| Abstract | |
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Violence against children (VAC) is a prevalent global issue that threatens children's health and developmental trajectories (McLaughlin et al., 2019; Nelson & Gabard-Durnam, 2020). Evidence from randomized trials demonstrates that parenting programs may effectively prevent VAC (Backhaus et al., 2023; Cuartas et al., 2024), even in humanitarian settings (Backhaus et al., 2024). Nevertheless, very few parenting programs have been scaled, and only a minority of parents around the world, particularly in resourced-constrained countries, receive these essential supports (Britto et al., 2022; Shenderovich et al., 2021; van Tuyll van Serooskereken Rakotomalala et al., 2023). This policy gap is salient in Colombia, a country where children have suffered extensively due to a protracted civil conflict and a high prevalence of violent punishment in the home (Cuartas, 2018). In response, the National Government recently launched a national strategy to end VAC and made a call for "[…] designing services, programs, and strategies aimed at preventing physical punishment […] in all settings" (author's translation; Gobierno de Colombia, 2021, p. 51). In the present study, we responded to these recent policy calls and broader knowledge gaps in developmental science by conducting a feasibility study and documenting lessons from a research-practice partnership (RPP) to develop Apapacho, a developmental, scalable, violence prevention parenting program. We established a RPP with the ICBF (Colombian institute in charge of child and family policy) to integrate (1) developmental insights (e.g., ecological perspectives and considering the developing needs and challenges children and parents face across the developmental course), (2) empirical evidence on the core components (i.e., content and delivery approaches) of evidence-based violence-prevention programs, and (3) qualitative data from policymakers, parents, and program facilitators (N=68) (see Figure 1 for an integrative model that summarizes findings from this stage of work). We document the stages and decisions that led to the program theory of change (Figure 2), structure, activities, and manuals, ensuring that Apapacho will be embedded into the existing service infrastructure. In addition, we report results from the mixed-methods feasibility study of Apapacho. We randomly selected nine service units from Modalidad Familiar (ICBF's community-based service modality) to receive Apapacho (N=136 dyads) and seven units to serve as a comparison group (N=136). We collected quantitative baseline data in July 2024 and will collect follow-up data in November 2024 after implementing 11 in-person group sessions. We will employ a propensity score matching combined with a difference-in-differences approach to assess the effects of Apapacho on (1) parents' attitudes and beliefs, (2) mental health and parenting stress, (3) behaviors, including discipline and engagement in early stimulation activities, and (4) child behavioral problems and cognitive, social, and emotional development. Moreover, we will collect endline qualitative data from focus groups and interviews with parents (N=20) and program facilitators (N=4) to understand facilitators and barriers to implementing Apapacho. The evidence presented in this study informs the scalability of Apapacho and future research and practice aimed at leveraging developmental insights using RPP to protect children from violence and promote their healthy development. |
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| Paper #2 | |
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| Take-Up and Impact of a Digital Parenting Intervention within Brazil’s National Home Visiting Program | |
| Author information | Role |
| Dr. Dana Charles McCoy, Ph.D., Harvard University, United States | Presenting author |
| Kenji Kitamura, Harvard University, United States | Non-presenting author |
| Andreana Castellanos, Afinidata, United States | Non-presenting author |
| Benone Pedrosa, Governo do Estado do Ceará, Brazil | Non-presenting author |
| Jimmy Oliveira, Instituto de Pesquisa e Estratégia Econômica do Ceará, Brazil | Non-presenting author |
| Julieta Trias, World Bank, United States | Non-presenting author |
| Abstract | |
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Research has shown that parenting programs have can improve caregiver and child outcomes in low- and middle-income countries (Jeong, Pitchik, & Yousafzai, 2018). Nevertheless, these programs are difficult to bring to scale and often show only small effects when implemented at the national level (Britto et al., 2022; Santos et al., 2022). This study uses a multifactorial randomized trial to examine the effectiveness of embedding an artificial intelligence (AI) driven digital intervention for parents within Brazil’s national home visiting program for low-income families, Programa Criança Feliz (PCF; “Happy Child Program”). In this presentation, we examine the sociodemographic characteristics that predict parents’ take-up of the digital intervention, as well as evidence for whether higher levels of take-up are predictive of greater impacts on parent well-being, the home learning environment, and child development outcomes. This study includes 1,599 young children (0-3 years) whose family were participating in PCF across 41 municipalities in Ceará, Brazil. Children’s home visitors (N = 281) were randomized to deliver the digital intervention alongside normal PCF services (60%) or a business-as-usual PCF control condition (40%). Parents reported on their families’ sociodemographic characteristics, their own well-being (mental health using the Depression, Anxiety, and Stress Scale – 21; self-efficacy using the Self-Efficacy for Parenting Tasks Index Toddler Scale), their household learning environment (stimulation using an extended version of the Family Care Indicators; physical punishment using the Conflict Tactics Scales), and their child’s development (using the Caregiver-Reported Early Development Instruments) at baseline in February, 2023 and endline in May, 2024. All measures were locally adapted and pilot tested prior to baseline and endline, and demonstrated adequate psychometric properties (alphas, factor loadings). PCF home visitors in the intervention condition were asked to enroll families in the digital intervention and then to encourage its use during the 15-month implementation period. Parents’ take-up of the digital intervention was tracked automatically in the app. Results suggest that 659 of the 940 families (70.1%) in the intervention condition enrolled in the digital intervention. The most-used intervention feature was recommendations for activities that parents could complete with children to support specific dimensions of child development. Amongst enrolled families, 92% opened at least one activity and 55.5% opened at least 10. Other features were used less frequently: 75.1% of enrolled families tracked their children’s developmental milestones, and only 20.3% opened any articles about child development. Results of Poisson regression analyses predicting take-up of these features (Table 1) suggest that families with younger children, boys, older and more educated caregivers, contact with home visitors, more books in the home, and lower levels of caregiver stress and depression (but higher levels of anxiety) were more likely to take up all three intervention features (activities, articles, and milestone tracking). In sum, these results support prior studies showing somewhat limited take-up of digital parenting interventions, and confirm that take-up is non-randomly distributed. The final presentation will include results of treatment-on-treated analyses documenting the implications of this differential take-up for intervention impacts on parent and child outcomes. Policy implications will also be discussed. |
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| Paper #3 | |
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| Evaluation of financial incentives on paternal engagement and outcomes within a fatherhood program in Tanzania | |
| Author information | Role |
| Joshua Jeong, Ph.D., Emory University, United States | Presenting author |
| Juliet K. McCann, Emory University, United States | Non-presenting author |
| Gabriel K. Sangarara, Tanzania Home Economics Organization-Mwanza, Tanzania | Non-presenting author |
| Julieth Joseph, Tanzania Home Economics Organization-Mwanza, Tanzania | Non-presenting author |
| Damas Joachim, Tanzania Home Economics Organization-Mwanza, Tanzania | Non-presenting author |
| Abstract | |
| Fathers can positively influence child development through men’s caregiving roles as parents and partners. However, few parenting interventions have deliberately engaged fathers and with varying degrees of success. One persistent challenge limiting the feasibility and effectiveness of community-based fatherhood programs has been fathers’ low program attendance often due to opportunity costs and men’s primary perceived roles as financial providers. This study explored the role of financial incentives on fathers’ attendance and changes in program impacts on paternal caregiving outcomes. After an extensive community-engaged intervention development process, we piloted a weekly 15-session, group-based parenting program aimed at enhancing fathers’ relationships with their children and partners to ultimately improve early child development across six communities in Mwanza, Tanzania. In each community, 10 couples with a child under 2 years of age were enrolled (N=60 fathers and 60 mothers). The six study communities were randomly assigned to receive different types of incentives, which were introduced into the program starting the 6th session: 5,000 TSH ($1.85 USD) for each session they attended thereafter, 10,000 TSH ($3.70 USD) for each session they attended thereafter, or no financial incentives throughout. We conducted a baseline survey with enrolled fathers in July 2024. Fathers reported on their parenting knowledge and attitudes, stimulation, discipline practices, mental wellbeing, marital relationships, and gender attitudes. Program facilitators tracked participants’ attendance at each session. We will reassess these paternal measures at endline in November 2024 and estimate pre-post intervention changes in outcomes. We are also conducting a qualitative implementation evaluation to broadly assess quality of program delivery, but also more specifically to understand participants’ perceptions of the financial incentives in relation to their attendance and any changes in outcomes. In Aug 2024 after the introduction of the financial incentives, we conducted qualitative interviews with male and female participants, parenting group leaders, and program facilitators (N=36) to obtain their initial impressions. We will conduct interviews again in Nov 2024 to gain a more comprehensive picture of the role of financial incentives after the completion of the program. In our presentation, we will share the quantitative results on whether average participation rates among fathers and pre-post changes in paternal outcomes differ by financial incentive type and complement these results with the qualitative findings regarding stakeholders’ perceptions about the incentives and the potential mechanisms of change. This study will provide new insights into the role of financial incentives with respect to program uptake and impacts among fathers specifically in Tanzania. Implications of these findings for policy and practice especially in low-resource settings will be discussed. | |
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Improving the Scalability, Implementation Outcomes, and Inclusivity of Parenting Programs in Low- and- Middle-Income Countries
Submission Type
Paper Symposium
Description
| Session Title | Improving the Scalability, Implementation Outcomes, and Inclusivity of Parenting Programs in Low- and- Middle-Income Countries |