Healthy Early Childhood Research Articles

Gondoskodási tőke, egészség-egyenlőtlenségek - a gondoskodás fogalom szerepe az egészség társadalmi determinánsainak elemzésében

Care is a key concept in different interpretations of health, illness and cure, and it has a major influence on various fields of research in medical and health sociology. Nevertheless it has yet to evolve into a well-established conceptual framework in these areas. Therefore in this paper we explore how care as a social determinant of health impacts health outcomes, and how concepts of social determinants of care enhance our understanding of the underlying mechanisms and pathways. We place TEAM-ECD framework at the centre of our analysis, because care is conceived of neither as a factor of inequality its own right, nor as a source of health inequalities by other frameworks that are in use in this field. We aim to fill these gaps by incorporating few approaches of care inequalities into the above-mentioned framework for the social determinants of healthy early childhood development.

Process evaluation of the initial implementation of the Moments that Matter parenting program in Kenya.

The Moments that Matter® parenting program aims to promote nurturing care and healthy early childhood development (ECD) through monthly home visits and monthly community group meetings that are delivered by ECD promoters and coordinated with faith leaders in rural Western Kenya. We designed a process evaluation in August 2023 during the first quarter of program implementation. We conducted in-depth interviews and focus group discussions with caregivers, ECD promoters, faith leaders, and program staff to capture their program experiences, assess program quality, and explore the implementation barriers and facilitators during this early stage of program roll-out. Although ECD promoters delivered the program with fidelity, the roles and responsibilities of faith leaders were relatively weaker and inconsistent. Key facilitators of quality implementation included visual aids of key messages and supportive supervision. Barriers included a lack of clarity about faith leaders' roles and relatively long group session duration. We highlight several key recommendations for improving fidelity, quality, and eventual program effects with respect to enhancingnurturing care and early child development. Overall, our study showcases how a process evaluation conducted during the early phase of program implementation can reveal practical insights that can be used to inform program adaptations and quality improvement.

Psychological hardiness as a mediator variable between workplace bullying and job anxiety among early childhood teachers: implications for healthcare

PurposeEarly childhood teachers play a significant role in building children’s success in their first years of school. Therefore, a healthy early childhood workforce in a healthy working environment is an essential aspect of effective early childhood services. This paper aims to explore the extent to which psychological hardiness can be considered as a mediator variable between exposure to workplace bullying and job anxiety among early childhood teachers.Design/methodology/approachA homogeneous sample comprised of 200 early childhood teachers. For data collection, the researcher used the workplace bullying scale, the psychological hardiness scale and the job anxiety scale among early childhood teachers (prepared by the researcher).FindingsThe findings indicated that psychological hardiness mediates the relationship between exposure to workplace bullying and job anxiety among early childhood teachers.Originality/valueThe research result highlighted the necessity of providing counseling programs for early childhood teachers helping them eliminate work stress that affects their job performance. In addition, the kindergarten administration must concentrate on how to effectively communicate and cooperate with early childhood teachers in light of regulations, policies and laws to defeat the spread of workplace bullying. The results of this research contributed to the existing literature by examining the relationship between the research variables, particularly in the early childhood education context.

Associations between the well-being of the early childhood education workforce and caregiver-child relationships in centre- and home-based settings

ABSTRACT The purpose of this study was to (1) explore demands and resources among centre-based and Family, Friend and Neighbor (FFN) early childhood education (ECE) caregivers, and (2) investigate how these factors are associated with the quality of caregiver-child relationships. ECE caregivers (n = 257) completed a survey that assessed demands, resources, and the quality of caregiver-child relationships. Analyses included univariate and bivariate analyses and hierarchical linear regression modelling. Centre-based caregivers (n = 173) reported higher stress, less knowledge related to wellness, and lower confidence related to self-care practices compared to FFN caregivers (n = 84) (all p < .05). Mindfulness was associated with higher reported closeness with children in their care (p < .05). Centre-based caregivers may experience more demands and less resources compared to FFN caregivers which could impact the quality of care. Mindfulness strategies may help to mitigate demands and bolster the well-being of ECE caregivers and healthy early childhood development.

The Use of Graphic Facilitation to Support Adherence to OCAP® Principles in Research With Indigenous Communities

Graphic facilitation is a creative, robust visual communication process and tool that can be used by researchers for several benefits including improving data integrity; mitigating barriers between researchers and participants; promoting participants’ ownership of data, decision-making, and creativity; and, co-creating knowledge, which is of particular interest among certain cultures and in some contexts. For Indigenous Peoples who traditionally use visual, oral, and narrative modalities as primary forms of communication, graphic facilitation is a methodology that aligns well with these modes of communicating. In this article, we describe our use of graphic facilitation in a community-led project exploring Indigenous parents’ perceptions of community strengths, needs and priorities related to healthy early childhood development and optimal parenting. In collaboration with the Indigenous Friendship Centre in Hamilton, Canada, we held a Community Gathering that was facilitated by a graphic artist experienced in working with the Indigenous community; the findings resulting from the Gathering are presented. We discuss how researchers can use graphic facilitation as a tool to ensure adherence to the OCAP® principles of data ownership, control, access, and possession for the Indigenous community and describe the potential for mitigating power imbalances. Finally, considerations for researchers contemplating using graphic facilitation as a tool for research projects with Indigenous people and communities are presented.

User Experience Co-Design of a Mobile Application to Support Childrearing in Low- and Middle-Income Countries.

The widespread adoption of mobile phones and increasing mobile connectivity globally create opportunities to access remote and disadvantaged populations. Mobile health interventions in low- and middle-income countries have substantial reach and potential to promote the socio-emotional and cognitive development of children. This study presents co-design workshop findings relating to the user experience of a mobile application - Thrive by Five - which intends to promote healthy early childhood development globally, particularly in low- and middle-income countries. Here, findings from workshops conducted in 11 countries in Asia, Africa, and Oceania are presented. Key feedback on the mobile application user experience indicated several necessary changes, such as simplifying and localising the language, incorporating short videos or animations, adding more bright colours and illustrations, and making numerous improvements and additions to the app features and functionality. The findings contribute to advancing mobile health, context-sensitive technologies, user experience design, and low-resource setting technology co-design.

How to make healthy early childhood development more likely in marginalized Roma communities: a concept mapping approach

BackgroundThis study aims to assess which measures could improve the healthy early childhood development of children from marginalized Roma communities and to identify priority measures.MethodsConcept mapping approach was used, using mixed methods. In total 54 professionals, including social workers, educators, health care providers, municipality representatives, and project managers participated in our study.ResultsFour distinct clusters of measures targeting living conditions, public resources, healthcare and community interventions, and 27 individual priority measures of highest urgency and feasibility were identified. The cluster ‘Targeting living conditions’, was rated as the most urgent but least feasible, whereas the cluster ‘Targeting health care’, was considered least urgent but most feasible. Among the 27 priority measures, ‘Planning parenthood’ and ‘Scaling up existing projects’ had the highest priority.ConclusionOur results reflect the public and political discourse and indicate significant barriers to implementation. Reducing inequalities in early childhood needs to be addressed through coordinated efforts.

Rethinking Payment and Incentives for a Healthy Early Childhood.

If there were such a thing as a magic wand to pass policies to improve the health of young children, pediatricians would make great use of it. Taken to scale, interventions such as universal pre-K, universal home visiting, quality child care, and family support services could help millions of children thrive. Absent a magic wand, however, the real-world challenge is that investments in prevention are often unconscionably small.

Let Us Be Vigilant: COVID-19 Is Poised to Obliterate Gains in Healthy Child Development Globally

In this issue of Pediatrics , McCormick et al1 report on a multicountry observational cohort study in which children and parents were assessed multiple times from children’s age 6 months to 6 years, collecting information on measures of socioeconomic status, infection, illness, maternal depression, positive parenting, and the home environment, with the outcome being child development as measured by the Bayley Scales of Infant Development at early ages and the Wechsler Preschool and Primary Scale of Intelligence at 60 months. Five trajectories of cognitive development were determined by statistical analysis. Not surprisingly, variables that represented a supportive and nurturing environment, such as emotional-verbal responsiveness of the parents, behaviors and/or environment to support learning, and environmental safety, were most strongly able to differentiate the most and least positive trajectories. Of course, other important variables were adequate nutrition and less respiratory and diarrheal illness. There is a large literature on the relationship of interventions to support and enhance nurturing parenting as well as to improve the learning environment with better early childhood outcomes in both high-income countries and low- and middle-income countries.2–5 We also know that children living in … Address correspondence to Benard P. Dreyer, MD, FAAP, Department of Pediatrics, NYU Grossman School of Medicine, New York University, 550 First Ave, New York, NY 10016. E-mail: benard.dreyer{at}nyulangone.org

Monitoring Progress Toward Meeting the United Nations SDG on Pre-primary Education: An Important Step Towards More Equitable and Sustainable Economies

Despite widespread agreement among international organizations on the importance of healthy early childhood development, monitoring of national action on the provision of pre-primary education has been limited. This paper presents a quantitative approach to monitoring the world’s progress on the United Nations (UN) sustainable development goal (SDG) target 4.2 to “ensure that all girls and boys have access to quality early childhood development, care and pre-primary education.” A rigorous approach was used to create a new quantitative globally comparable database of indicators for policies that mandate the provision of national pre-primary education for 86% of UN member states. This dataset was analyzed to examine global inequalities in the provision of universal pre-primary education and revealed that 43% of countries, and only 3% of low-income countries, provide tuition-free pre-primary education. Just under 25% of countries offer tuition-free pre-primary education for two or more years. This contrasts sharply with primary education, which is provided tuition-free in 96% of countries. To illustrate how this data can contribute to the examination of the relationship between policy and outcome, it is used in a regression analysis. Additional global data collection on the quality of pre-primary education would further enhance efforts to monitor policies that play key roles in the fulfillment of target 4.2, and support the achievement of the United Nations sustainable development goal on education.

Status of Breastfeeding and Child Immunization Outcomes in Clients of the Nurse-Family Partnership.

Background The Nurse-Family Partnership (NFP) is a home visiting program serving first-time, low-income mothers, with an area of focus on healthy early childhood development. Previous foundational trials of program effect on breastfeeding and immunizations have shown a mix of neutral and positive results. The present evaluation investigates these effects following program scale-up, using a large contemporary cohort of clients. Methods Nurse-Family Partnership client breastfeeding and immunization status were compared to National Survey of Children's Health data and National Immunization Survey data, respectively. Sample differences in demographic covariates were adjusted using logistic regression. Results Nurse-Family Partnership clients were significantly more likely to have ever breastfed (adjusted prevalence ratio [aPR: 1.20 (1.17, 1.23)] and maintain breastfeeding at 6 [aPR: 1.17 (1.10, 1.24)] and 12 [aPR: 1.39 (1.25, 1.53)] months, but less likely to exclusively breastfeed at 6months [aPR: 0.84 (0.70, 0.95)] NFP clients were significantly more likely to be up-to-date on immunizations at 6 [aPR: 1.23 (1.22, 1.25)], 18 [aPR: 1.33 (1.30,1.35)], and 24 [aPR: 1.15 (1.14, 1.16)] months of age than the reference cohort, with no significant difference at 12months. Discussion Nurse-Family Partnership clients had more beneficial breastfeeding and immunization outcomes than children of mothers with demographically similar profiles. However, exclusive breastfeeding at 6months lags behind the reference sample and represents a potential area for further improvement.

Early life determinants of low IQ at age 6 in children from the 2004 Pelotas Birth Cohort: a predictive approach.

BackgroundChildhood intelligence is an important determinant of health outcomes in adulthood. The first years of life are critical to child development. This study aimed to identify early life (perinatal and during the first year of life) predictors of low cognitive performance at age 6.MethodsA birth cohort study started in the city of Pelotas, southern Brazil, in 2004 and children were followed from birth to age six. Information on a broad set of biological and social predictors was collected. Cognitive ability—the study outcome—was assessed using the Wechsler Intelligence Scale for Children (WISC). IQ scores were standardized into z-scores and low IQ defined as z < −1. We applied bootstrapping methods for internal validation with a multivariate logistic regression model and carried out external validation using a second study from the 1993 Pelotas Birth Cohort.ResultsThe proportion of children with IQ z-score < −1 was 16.9% (95% CI 15.6–18.1). The final model included the following early life variables: child’s gender; parents’ skin color; number of siblings; father’s and mother’s employment status; household income; maternal education; number of persons per room; duration of breastfeeding; height-for-age deficit; head circumference-for-age deficit; parental smoking during pregnancy; and maternal perception of the child’s health status. The area under the ROC curve for our final model was 0.8, with sensitivity of 72% and specificity of 74%. Similar results were found when testing external validation by using data from the 1993 Pelotas Birth Cohort.ConclusionsThe study results suggest that a child’s and her/his family’s social conditions are strong predictors of cognitive ability in childhood. Interventions for promoting a healthy early childhood development are needed targeting children at risk of low IQ so that they can reach their full cognitive potential.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-014-0308-1) contains supplementary material, which is available to authorized users.

L'activité des médecins des structures d'accueil régulier d'enfants de moins de 6 ans : attentes des responsables de structures

This work aims to describe the activities of nurseries' medical practitioners and the expectations of the nurseries' supervisors. It is based on the analysis of 139 questionnaires received from nursery schools' managers from the Pays de Loire region in 2005. Ninety percent of the nurseries that accommodate children less than six years-old, do employ a medical practitioner. She or he is often a salaried paediatrician with a full-time job or clinical practice, who consults twice a month for two hours and forty minutes in each nursery which employs him/her. Her/his main activity consists of conducting standard medical examinations when children are admitted into the nursery and on-going follow-up of their adaptation and healthy early childhood development. She or he also ensures that hygienic preventive measures are respected in case of an epidemic or other potentially hazardous health situations. Moreover, two-thirds of the establishments offer prevention follow-up for the children, whereas health promotion programmes and interventions are only carried out in just over half of them. Emergency medical procedures are conducted in a quarter of them only. Most of the nursery directors are satisfied with the medical services provided, despite some criticism. They mainly wish that practitioners were more available and more regularly present on-site in order to supply further preventive care, to develop training programmes for other staff members, and to participate in thematic meetings. Encouraging improved synergy between the professionals working in the nurseries, placing child psychologists to work in the facilities and fostering better relationships with the independent medical practitioners would all help the process of development and the evolution of the operational function of the medical practitioners in these structures.

Spirometry in Early Childhood in Cystic Fibrosis Patients

Background:Spirometry data in cystic fibrosis (CF) patients in early childhood is scarce, and the ability of spirometry to detect airways obstruction is debatable.Objective:To evaluate the ability of spirometry to detect airflow obstruction in CF patients in early childhood.Methods:CF children (age range, 2.5 to 6.9 years) in stable clinical condition were recruited from five CF centers. The children performed guided spirometry (SpiroGame; patented by Dr. Vilzone, 2003). Spirometry indices were compared to values of a healthy early childhood population, and were analyzed with relation to age, gender, and clinical parameters (genotype, pancreatic status, and presence of Pseudomonas in sputum or oropharyngeal cultures).Results:Seventy-six of 93 children tested performed acceptable spirometry. FVC, FEV1, forced expiratory flow in 0.5 s (FEV0.5), and forced expiratory flow at 50% of vital capacity (FEF50) were significantly lower than healthy (z scores, mean ± SD: − 0.36 ± 0.58, − 0.36 ± 0.72, − 1.20 ± 0.87; and − 1.80 ± 1.47, respectively; p < 0.01); z scores for FEV1and FVC were similar over the age ranges studied. However, z scores for FEV0.5and forced expiratory flow at 25 to 75% of vital capacity were significantly lower in older children compared to younger children (p < 0.001), and a higher proportion of 6-year-old than 3-year-old children had z scores that were > 2 SDs below the mean (65% vs 5%, p < 0.03). Girls demonstrated lower FEF50than boys (z scores: − 2.42 ± 1.91 vs − 1.56 ± 1.23; p < 0.001). Clinical parameters evaluated were not found to influence spirometric indices.Conclusions:Spirometry elicited by CF patients in early childhood can serve as an important noninvasive tool for monitoring pulmonary status. FEV0.5and flow-related volumes might be more sensitive than the traditional FEV1in detecting and portraying changes in lung function during early childhood.

Overlapping agendas or serendipitous synergism

Overlapping agendas or serendipitous synergism