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Edwards RC, Planalp EM, Bosquet Enlow M, Akshoomoff N, Bodison SC, Brennan MB, Ciciolla L, Eiden RD, Fillipi CA, Gustafsson HC, McKelvey LM, Morris AS, Peralta-Carcelén M, Poehlmann J, Wakschlag LS, Wilson S. Capturing the complexity of child behavior and caregiver-child interactions in the HEALthy Brain and Child Development (HBCD) Study using a rigorous and equitable approach. Dev Cogn Neurosci 2024; 69:101422. [PMID: 39126821 DOI: 10.1016/j.dcn.2024.101422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 07/19/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024] Open
Abstract
The HEALthy Brain and Child Development (HBCD) Study, a multi-site prospective longitudinal cohort study, will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood. This article outlines methodological considerations and the decision-making process for measurement selection for child behavior, parenting/caregiver-child interactions, and the family/home environment for HBCD. The decision-making process is detailed, including formation of a national workgroup (WG-BEH) that focused on developmentally appropriate measures that take a rigorous and equitable approach and aligned with HBCD objectives. Multi-level-observational and caregiver-report measures were deemed necessary for capturing the desired constructs across multiple contexts while balancing the nuance of observational data with pragmatic considerations. WG-BEH prioritized developmentally sensitive, validated assessments with psychometrics supporting use in diverse populations and focused on mechanistic linkages and prediction of desired constructs. Other considerations included participant burden and retention, staff training needs, and cultural sensitivity. Innovation was permitted when it was grounded in evidence and filled key gaps. Finally, this article describes the rationale for the selected constructs (e.g., temperament, social-emotional development, parenting behaviors, family organization) and corresponding measures chosen for HBCD visits from early infancy through 17 months of age.
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Affiliation(s)
- Renee C Edwards
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA.
| | - Elizabeth M Planalp
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Michelle Bosquet Enlow
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Natacha Akshoomoff
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Stefanie C Bodison
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Marianne B Brennan
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Lucia Ciciolla
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Rina D Eiden
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Courtney A Fillipi
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Hanna C Gustafsson
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Lorraine M McKelvey
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Amanda S Morris
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Myriam Peralta-Carcelén
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Julie Poehlmann
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Lauren S Wakschlag
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Sylia Wilson
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
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Hartinger Pena SM, Mäusezahl D, Jäggi L, Aguilar L, Alvarado Llatance M, Castellanos A, Huaylinos Bustamante ML, Hinckley K, Charles McCoy D, Zhang C, Fink G. Digital Support Systems to Improve Child Health and Development in Peru: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e50371. [PMID: 38096020 PMCID: PMC10755649 DOI: 10.2196/50371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Children living in low and middle-income countries (LMICs) are at greater risk for experiencing adversities that can undermine their health and early development. Recently launched digital early childhood development (ECD) programs attempt to support families with young children in their home environments using digital technologies. However, relatively little is known regarding the effectiveness of these new technologies. OBJECTIVE The goal of this study is to rigorously assess the reach, effectiveness, and cost-effectiveness of a newly developed digital ECD platform called Afini. The Afini platform was designed to support parents of young children in low-resource settings to improve ECD and interact with caregivers through messenger services and a chatbot. METHODS This is a 3-arm cluster randomized controlled trial. In total, 2471 caregivers and their 3- to 9-month-old children were enrolled in the study across 164 study clusters in the San Marcos, Cajabamba, and Cajamarca provinces of Peru. Clusters of participants were randomly assigned to 1 of 3 groups: a control group (72 community clusters and 980 caregiver-child dyads), a home visit intervention group (20 community clusters and 316 caregiver-child dyads), and an Afini intervention group (72 community clusters and 1175 caregiver-child dyads). Families in the control group receive no focused ECD intervention. The home visit group is receiving biweekly home visits by a trained field staff following the national ECD program (Programa Nacional Cuna Más) curriculum and training guidelines. Caregivers in the Afini group are receiving ECD activities and advice through the digital platform. The primary study outcome is children's overall development at the age of 2.5 years, using the internationally validated long form of the Global Scales for Early Development. Secondary outcomes include caregiver engagement; caregiver mental health; screen time; as well as caregiver reports of children's motor, cognitive, language, and socioemotional development measured through locally piloted and validated tools. RESULTS Enrollment started in September 2021 and ended in March 2023. Endline assessments will take place between August 2023 and September 2024. CONCLUSIONS This study is, to our knowledge, the first to rigorously assess the effectiveness and cost-effectiveness of digital ECD technologies in LMICs. Given the large number of children in LMICs currently receiving only limited external support, the evaluated platform has the potential to improve the short- and long-term well-being of millions of children and their parents globally. TRIAL REGISTRATION ClinicalTrials.gov NCT05202106; https://clinicaltrials.gov/ct2/show/NCT05202106. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50371.
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Affiliation(s)
- Stella Maria Hartinger Pena
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Daniel Mäusezahl
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Lena Jäggi
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Leonel Aguilar
- Institute for Computing Platforms, Federal Institute of Technology Zurich, Zürich, Switzerland
| | | | | | | | - Kristen Hinckley
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Ce Zhang
- Institute for Computing Platforms, Federal Institute of Technology Zurich, Zürich, Switzerland
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Spruit A, Colonnesi C, Wissink I, Uittenbogaard R, Willems L, Stams GJ, Noom M. Development and validation of the Attachment Relationship Inventory-Caregiver Perception 2-5 years (ARI-CP 2-5): Psychometric structure, external validity, and norms. Infant Ment Health J 2021; 42:188-205. [PMID: 33455023 PMCID: PMC8048982 DOI: 10.1002/imhj.21909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There is a lack of instruments assessing child–caregiver attachment relationships in early childhood to be used in attachment‐based practice, in particular from a caregiver's perception, which is an important factor of clinical importance to take into account in parenting interventions targeting young children. Therefore, the 48‐item Attachment Relationship Inventory—Caregiver Perception 2–5 years (ARI‐CP 2–5) was developed. Survey data of 446 caregivers of 2‐ to 5‐year‐old children were collected, and a subsample of 83 caregivers participated in an observation study. Confirmatory factor analysis confirmed a four‐factor structure of secure, avoidant, ambivalent, and disorganized attachment relationship. Indications of configural, metric, and scalar invariance were found for caregivers’ and children's sex, children's age, and population (clinical vs. general population). The four scales showed sufficient internal consistency and significant associations with children's psychopathology, caregivers’ general attachment representations, caregivers’ mind‐mindedness, and population type. Moreover, preliminary evidence for convergent validity with observational attachment measures was found. It is concluded that the ARI‐CP 2–5 is a valid instrument that can be used as part of the screening and assessment of insecure attachment relationships.
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Affiliation(s)
- Anouk Spruit
- Research Institute of, Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands.,Basic Trust, Dordrecht, The Netherlands
| | - Cristina Colonnesi
- Research Institute of, Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Inge Wissink
- Research Institute of, Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Lucia Willems
- Research Institute of, Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Geert-Jan Stams
- Research Institute of, Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Marc Noom
- Research Institute of, Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
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