Impact of COVID-19 on maternal health and child care behavior: Evidence from a quasi-experimental study of vulnerable communities in Boa Vista, Brazil.

BACKGROUND: COVID-19 related distress has been shown to have negative associations with family well-being. OBJECTIVES: To determine the immediate impact of acute COVID-19 infection on maternal well-being and parenting practices among Brazilian families. PARTICIPANTS AND SETTING: We studied 2'579 mothers (29'913 observations) of young children from vulnerable neighborhoods in Boa Vista, Brazil over 12 months. METHODS: We monitored family health and caregiving behavior including the incidence of COVID-19 infections in the surveyed households through bi-weekly phone interviews over 50 weeks, from June 2020 to May 2021. Primary outcomes were home-based child stimulation, positive parenting behavior, and parenting stress. We used fixed effects panel regressions to estimate the impact of household COVID-19 infections on parenting outcomes. RESULTS: Over the study period, 441 participants (17.1%; 831 (3.0%) observations) reported at least 1 positive COVID-19 infection in their household. Household COVID-19 infections significantly reduced home-based stimulation by 0.10 SDs (95%CI: -0.18, -0.01), positive parenting behaviors by 0.14 SDs (-0.21, -0.01), and increased parenting stress by 0.07 SDs (0.02, 0.12). The impact on home-based stimulation was most pronounced when the mother herself had a COVID-19 infection (-0.16; -0.29, -0.04). Parenting stress responded most strongly to mother or child COVID-19 infections. Effects were relatively short-lived, only children's infections' on parental stress was still detectable 2 weeks after initial infection. CONCLUSION: Our findings suggest that COVID-19 infections cause substantial disruptions in children's home environments - additional short-term support for families with acute infections could attenuate the negative impact on children's home environment during the pandemic.

Survive and Thrive in Brazil: The Boa Vista Early Childhood Program: study protocol of a stepped-wedge, randomized controlled trial.

BACKGROUND: A growing body of evidence suggests that early life health and developmental outcomes can be improved through parental support programs. The objective of this project was to test the feasibility, impact, and relative cost-effectiveness of an adapted "Reach Up and Learn" program delivered through home-visiting programs as well as through center-based parenting groups on child health and development in the municipality of Boa Vista, Brazil. METHODS: A randomized, stepped-wedge design was used to roll out and evaluate the two parenting platforms in Boa Vista municipality. A total of 39 neighborhoods with a high Neighborhood Vulnerability Index were selected for the study. For the first phase of the program, nine neighborhoods were randomly selected for home visits, and two were randomly selected for the center-based parenting groups. In the second phase of the program, 10 neighborhoods were added to the home-visiting program, and eight were added to the center-based program. In the final phase of the program, the remaining 10 control areas will also be assigned to treatment. Study eligibility will be assessed through a baseline survey completed by all pregnant women in the 39 study areas. Pregnant women will be eligible to participate in the study if they are either classified as poor, were under age 20 years when they became pregnant, or if they indicate to have been exposed to domestic or sexual violence. To assess program impact, an endline survey will be conducted when children reach age 2 years. The primary study outcome is child development at age 2 years as measured by the PRIDI instrument. Secondary outcome will be infant mortality, which will be assessed linking municipal vital registration systems to the program rollout. DISCUSSION: This trial will assess the feasibility and impact of parenting programs rolled out at medium scale. The results from the trial should create evidence urgently needed for guiding Brazil's national Criança Feliz program as well as similar efforts in other countries. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03386747. Registered on 13 December 2017. All items of the World Health Organization Trial Registration Data Set are available in this record.

Comparison of the Emotional Indicators of the Pfister Test between Boys and Girls from Ceará-Brazil / Comparação dos Indicadores Emocionais do Teste de Pfister entre Meninos e Meninas Cearenses / La Comparación de los Indicadores Emocionales del Test de Pfister entre Niños y Niñas Cearenses

Abstract The increasing need for psychological instruments characterized by scientific rigor, with their psychometric qualities confirmed, drives the development of studies that seek evidence of validity for psychological tests. The aim of this study was to seek evidence of validity for the Pfister Test by comparing the sexes. The study was carried out with 197 children from the city of Ceará, 46% male and 54% female, using the Pfister Colored Pyramids Test as the main instrument and the Raven Colored Progressive Matrices Test as an instrument to screen the intellectual performance of the participants. After statistical analysis and interpretation of the data, predominance in the choice of blue, green and black colors was observed in the boys, especially regarding darker tones, which may indicate emotion-related control. The girls made more frequent use of the colors violet and red, both in the lightest tones, which culturally refers to femininity and may suggest impulsivity. It was concluded that there are statistically significant differences in color choices between boys and girls, which can be comprehended as a contribution to the evidence of validity studies of the Pfister Test.

Resumo A necessidade, cada vez mais emergente, de instrumentos psicológicos que se caracterizem pelo rigor científico, atestado por meio de suas qualidades psicométricas, impulsiona o desenvolvimento de estudos que busquem evidências de validade de testes psicológicos. Neste estudo objetivou-se buscar por evidências de validade para o Teste de Pfister por meio da comparação entre sexos. O presente estudo foi realizado com 197 crianças da capital cearense, sendo 46% do sexo masculino e 54% do sexo feminino, utilizando o Teste das Pirâmides Coloridas de Pfister, como instrumento principal, e o Teste das Matrizes Progressivas Coloridas de Raven, como instrumento de rastreio do desempenho intelectual dos participantes. Após análises estatísticas e interpretação dos dados, verificou-se uma predominância na escolha das cores azul, verde e preto por parte dos meninos, especialmente em tons mais escurecidos, o que pode indicar controle relacionado às emoções, enquanto as meninas fizeram uso mais frequente das cores violeta e vermelho, ambas no tom mais claro, o que se remete culturalmente à feminilidade e pode sugerir impulsividade. Conclui-se que há diferenças estatisticamente significativas nas escolhas das cores entre meninos e meninas, o que pode ser compreendido como uma contribuição aos estudos de evidências de validade do Teste de Pfister.

Resumen La necesidad de instrumentos psicológicos que se caractericen por el rigor científico, atestado a través de sus calidades psicométricas, impulsa el desarrollo de estudios que busquen evidencias de validez de pruebas psicológicas. En este estudio se objetivó buscar evidencias de validez para el Test de Pfister por medio de la comparación entre sexos. Este estudio fue realizado con 197 niños de la capital cearense, siendo 46% del sexo masculino y 54% del sexo femenino, utilizando el Test de Pfister. El Test de las Matrices Progresivas Coloridas de Raven se utilizó como rastreo del desempeño intelectual de los participantes. Se verifico una predominancia en la elección de los colores azul, verde y negro por parte de los niños en tonos más oscurecidos, o que puede indicar control relacionado a las emociones, mientras las niñas optaron más significativamente por los colores violeta y rojo, ambas en el tono más claro, lo que se remite culturalmente a la femineidad y puede sugerir impulsividad. A partir de los resultados, se concluye que hay diferencias significativas en las elecciones de los colores entre niños y niñas, lo que puede ser comprendido como una contribución para estudios de evidencias de validez en el Test de Pfister.