Implementation Quality of an Early Childhood Parenting Program in Colombia and Child Development.

OBJECTIVES: We conducted a cluster-randomized trial of an enhancement to an existing parenting program in rural Colombia (called the Family, Women, and Infancy Program [FAMI]), and found benefits to parenting practices and child development. In this study, we examine the effects of the enhancement on the quality of intervention implementation and examine associations between quality and child and maternal outcomes. METHODS: In Colombia, 340 FAMI mothers in 87 towns were randomly assigned to quality enhancement through the provision of structured curricula, play materials, and training and supervision from professional tutors, or to control (no enhancement). Children aged <12 months were enrolled (N = 1460). A subsample of 150 FAMI mothers (83 intervention, 67 control) in 29 towns (17 intervention, 12 control) participated in the assessment of the quality of group parenting sessions through independent observation. Child development and parenting practices were measured at endline (10.5 months after baseline). RESULTS: In intention-to-treat analyses, we found significant benefits of intervention for the observed quality of group sessions (1.67 SD [95% confidence interval, 1.23-2.11]). An SD increase in session quality predicted an increase in treatment mothers' attendance of 4.68 sessions (95% confidence interval, 1.37-7.98). Session quality partially mediated the effect of the intervention on parental practices and child development. CONCLUSIONS: Enhancing an existing parenting program led to large benefits to the observed quality of intervention implementation. Quality was associated with increased maternal engagement, parenting practices, and child development. The observational measure of quality has potential to promote and maintain quality at scale.

Early Stimulation and Nutrition: The Impacts of a Scalable Intervention.

Early childhood development is becoming the focus of policy worldwide. However, the evidence on the effectiveness of scalable models is scant, particularly when it comes to infants in developing countries. In this paper, we describe and evaluate with a cluster-Randomized Controlled Trial an intervention designed to improve the quality of child stimulation within the context of an existing parenting program in Colombia, known as FAMI. The intervention improved children's development by 0.16 of a standard deviation (SD) and children's nutritional status, as reflected in a reduction of 5.8 percentage points of children whose height-for-age is below -1 SD.

Social Capital and Lifestyle Impacts on Mental Health in University Students in Colombia: An Observational Study.

Introduction: For young adults, the first year of higher education represents a transition period into adulthood associated with an increased risk of developing depression, anxiety, and stress, contributing to deteriorating physical and mental health. The present study aimed to analyze the relationship between depressive symptoms and social capital and lifestyles among Colombian university students. Methods: In 2020, a longitudinal repeated measures study was conducted on first year students at Universidad de los Andes in Bogota, Colombia. The study was conceptualized and approved by the university before the COVID-19 pandemic appeared. Each student completed a self-administered questionnaire including questions on sociodemographic characteristics, depressive symptoms, perceived stress, social capital, and lifestyles. The study's pilot was conducted in November 2019, and the two measurement points were in January 2020 (wave 1, before the COVID-19 pandemic was declared) and in August 2020 (wave 2, during the COVID-19 pandemic). A binary logistic regression analysis was performed to assess the relationship between depressive symptoms, perceived stress, social capital, and lifestyles. Findings: A total of 609 first year students (response rate = 58.11%) participated in wave 1, and 42% of the participants showed signs of clinically relevant depressive symptoms. In wave 2, despite the difficulties encountered in collecting data due to the COVID-19 pandemic, 216 students from wave 1 participated (35.47%). An increase in a sedentary lifestyle was observed (31.49%). We found that cognitive and behavioral social capital levels decreased by 12.03 and 24.54%, respectively. In addition, we observed a 6.5% increase in students with clinically relevant depressive symptoms compared to wave 1. A low level of behavioral [OR: 1.88; 95% CI (1.16, 3.04)] social capital was associated with clinically relevant depressive symptoms. Conclusion: The health of university students continues to be a public health concern. The study suggests that social capital may play an important role in preventing depressive symptoms. Therefore, universities should put effort into programs that bring students together and promote the creation of social capital.

Understanding how socioeconomic inequalities drive inequalities in COVID-19 infections.

Across the world, the COVID-19 pandemic has disproportionately affected economically disadvantaged groups. This differential impact has numerous possible explanations, each with significantly different policy implications. We examine, for the first time in a low- or middle-income country, which mechanisms best explain the disproportionate impact of the virus on the poor. Combining an epidemiological model with rich data from Bogotá, Colombia, we show that total infections and inequalities in infections are largely driven by inequalities in the ability to work remotely and in within-home secondary attack rates. Inequalities in isolation behavior are less important but non-negligible, while access to testing and contract-tracing plays practically no role because it is too slow to contain the virus. Interventions that mitigate transmission are often more effective when targeted on socioeconomically disadvantaged groups.

SARS-CoV-2 Drive/Walk-Thru screening centers in Colombia: The CoVIDA Project / Centros de tamizaje masivo para SARS COV-2 en Colombia: Proyecto CoVIDA

Abstract Objective: The CoVIDA project is a public-private collaboration led by Universidad de los Andes that contributed to the SARS-CoV-2 epidemiological surveillance in Bogotá and nearby municipalities. We aimed to describe the development and performance of the Drive/Walk-through free RT- PCR for SARS-CoV-2 testing strategy implemented by CoVIDA. Material and method: We performed a descriptive analysis of the characteristics and performance of the CoVIDA Drive/Walk-through testing centers. The model and the process indicators to assess the model's performance were based on international experiences and scientific literature. Two screening centers were imple mented in shopping centers in the north and south of Bogotá. We reported the number of tests taken, the number of positive tests, and the number of participants that used the model by the type of occupations. Results: In total, 36,689 nasopharyngeal RT-PCR tests for SARS-CoV-2 were performed with a 5.75% cumulative positivity. Process indicators showed an excellent performance and an important contribution in reducing barriers to access to testing. Conclusions: the CoVIDA Drive/Walk-through testing centers supported the epidemiological surveillance in asymptomatic or mild-symptomatic population in Bo gotá. Low and middle-income countries can use this model as a cost-effective and innovative solution strategy to intensify testing and help mitigate the pandemic.

Resumen Objetivo: El proyecto CoVIDA es una colaboración público-privada liderada por la Universidad de los Andes que contribuyó a la vigilancia epidemiológica del SARS-CoV-2 en Bogotá y municipios cercanos. Nuestro objetivo fue describir el desarrollo y rendimiento de la estrategia de tamizaje gratuito con RT-PCR mediante un modelo Drive/Walk through para SARS-CoV-2 implementado por CoVIDA. Materiales y métodos: Realizamos un análisis descriptivo de las características y desempeño de los centros de tamizaje Drive/Walk through de CoVIDA. El modelo y los indicadores de proceso para evaluar el desempeño del modelo se basaron en experiencias internacionales y la literatura científica. Se implementaron dos cen tros de tamizaje en centros comerciales del norte y sur de Bogotá. Se reportó la cantidad de pruebas tomadas, pruebas positivas y de participantes que utilizaron el modelo de acuerdo con el tipo de ocupaciones. Resultados : En total, se realizaron 36,689 pruebas RT-PCR nasofaríngeas para SARS-CoV-2 con una positividad acumulada del 5,75%. Los indicadores de proceso mostraron un excelente desempeño y una contribución importante en la reducción de las barreras de acceso a las pruebas. Conclusiones: los centros de tamizaje con modelo Drive/Walk through de CoVIDA apoyaron la vigilancia epidemiológica en población asintomática o con síntomas leves en Bogotá. Los países de ingresos bajos y medianos pueden utilizar este modelo como una estrategia innovadora y rentable para aumentar la realización de las pruebas y ayudar a mitigar la pandemia.

Qualitative evaluation of a scalable early childhood parenting programme in rural Colombia.

BACKGROUND: Integrating early childhood parenting programmes into existing government services is a key strategy for reducing the loss of children's developmental potential in low- and middle-income countries. There is limited evidence of participants' perceptions of these programmes, especially when implemented at scale. We integrated an intervention into an existing government programme targeting pregnant women and mothers of children up to 2 years of age and their families in rural Colombia. METHODS: As part of a cluster randomized trial, 171 government workers (facilitators) implemented the intervention. The intervention included four components: (1) structured curricula, (2) play materials, (3) nutrition and (4) training and supervision. In this qualitative evaluation of the programme, we conducted semi-structured interviews with beneficiary mothers (n = 62), facilitators (n = 40) and supervisors (n = 8). Topic guides were developed to collect information on participants' perspectives of the acceptability, feasibility and effectiveness of the intervention and the enablers and barriers to implementation. All interviews were audiotaped and transcribed, and data were analysed using the framework approach. RESULTS: Participants' responses indicated that the intervention was acceptable, feasible and effective. Key enablers to implementation were (1) the use of evidence-based behaviour change techniques leading to interactive, fun and participatory sessions; (2) structured curricula with easy to use, simple activities and materials; (3) the focus on positive, supportive relationships; and (4) the perceived benefits of the programme to the beneficiary mothers, children and families, facilitators and programme supervisors. The main barriers were (1) facilitators took time to become comfortable and competent in using the new participatory methodology and (2) the logistics related to making and distributing the play materials. CONCLUSION: Providing structured curricula and play materials with training and ongoing supervision to enhance an existing programme targeting mothers, families and children was reported as acceptable, feasible and effective by beneficiary mothers and programme staff.

Factors Associated With SARS-CoV-2 Infection in Bogotá, Colombia: Results From a Large Epidemiological Surveillance Study.

BACKGROUND: Epidemiologic surveillance of COVID-19 is essential to collect and analyse data to improve public health decision making during the pandemic. There are few initiatives led by public-private alliances in Colombia and Latin America. The CoVIDA project contributed with RT-PCR tests for SARS-CoV-2 in mild or asymptomatic populations in Bogotá. The present study aimed to determine the factors associated with SARS-CoV-2 infection in working adults. METHODS: COVID-19 intensified sentinel epidemiological surveillance study, from April 18, 2020, to March 29, 2021. The study included people aged 18 years or older without a history of COVID-19. Two main occupational groups were included: healthcare and essential services workers with high mobility in the city. Social, demographic, and health-related factors were collected via phone survey. Afterwards, the molecular test was conducted to detect SARS-CoV-2 infection. FINDINGS: From the 58,638 participants included in the study, 3,310 (5·6%) had a positive result. A positive result was associated with the age group (18-29 years) compared with participants aged 60 or older, participants living with more than three cohabitants, living with a confirmed case, having no affiliation to the health system compared to those with social health security, reporting a very low socioeconomic status compared to those with higher socioeconomic status, and having essential occupations compared to healthcare workers. INTERPRETATION: The CoVIDA study showed the importance of intensified epidemiological surveillance to identify groups with increased risk of infection. These groups should be prioritised in the screening, contact tracing, and vaccination strategies to mitigate the pandemic. FUNDING: The CoVIDA study was funded through donors managed by the philanthropy department of Universidad de los Andes.

COVID-19 spread, detection, and dynamics in Bogota, Colombia.

Latin America has been severely affected by the COVID-19 pandemic but estimations of rates of infections are very limited and lack the level of detail required to guide policy decisions. We implemented a COVID-19 sentinel surveillance study with 59,770 RT-PCR tests on mostly asymptomatic individuals and combine this data with administrative records on all detected cases to capture the spread and dynamics of the COVID-19 pandemic in Bogota from June 2020 to early March 2021. We describe various features of the pandemic that appear to be specific to a middle income countries. We find that, by March 2021, slightly more than half of the population in Bogota has been infected, despite only a small fraction of this population being detected. The initial buildup of immunity contributed to the containment of the pandemic in the first and second waves. We also show that the share of the population infected by March 2021 varies widely by occupation, socio-economic stratum, and location. This, in turn, has affected the dynamics of the spread with different groups being infected in the two waves.

Análisis de género de clases de la autodeterminación del rendimiento y la motivación en clase de Educación Física / Gender analysis of motivation and performance self-assessment in physical education class

Introducción: En la actualidad los estudiantes no se motivan para realizar actividad física en la clase de Educación Física y esto se agrava en el género femenino, dado que tienen mayores índices de obesidad y desmotivación, es un tema contingente en la actualidad de la educación chilena que debe ser abordado. Objetivo: Analizar los factores que inciden en la escasa motivación de estudiantes de género femenino de octavo grado básico en Educación Física. Métodos: El diseño de investigación fue de carácter mixto, ya que estuvo basado en la combinación de metodologías y técnicas de recolección de información cuantitativas y cualitativas. Resultados: Se realizaron análisis y evaluación de diagnóstico rendimiento mujeres y hombres de octavo grado básico en Educación Física. Análisis multivariados de las variables: práctica educativa, metodología y motivación de resultados validados que mostraron una tendencia en sus resultados. Conclusiones: El análisis confirma que las alumnas de octavo básico no se motivan y tampoco participan de forma regular en la clase de Educación Física, porque las actividades no se vinculan a sus intereses e inquietudes propias de una adolescente. Además, presentan desgano en realizar actividades deportivas aludiendo a las exigencias del profesor y actividades que están orientadas hacia los intereses del sexo masculino en desmedro del sexo femenino(AU)

Introduction: Current lack of motivation by students to actively engage in physical activity during physical education class is more marked among girls, given their higher obesity and disinterest indices. This urgent problem of Chilean education requires immediate analysis. Objective: Analyze the teaching and methodological factors affecting the scant motivation of female 8th grade junior high school students for physical education classes, as well as their variability and dispersion. Methods: A mixed research design was used based on a combination of quantitative and qualitative data collection methodologies and techniques. Results: Diagnostic analysis and evaluation were conducted of the performance of 8 th grade junior high school male and female students in physical education. Multivariate analysis was performed of the variables educational practice, methodology and motivation of validated results showing a trend in their values. Conclusions: Analysis confirmed that female 8th grade students lack motivation and do not attend physical education class regularly, since those activities have little to do with the likes and interests of adolescents. The students stated that their reluctance to participate in sport activities is due to the demands of teachers and the activities themselves, geared as they are to the interests of the male sex at the expense of female students(AU)

The effects of the transition from home-based childcare to childcare centers on children's health and development in Colombia.

Colombia's national early childhood strategy launched in 2011 aimed at improving the quality of childcare services offered to socio-economically vulnerable children, and included the possibility that children and their childcare providers could transfer from non-parental family daycare units to large childcare centers in urban areas. This study seeks to understand whether the offer to transfer and the actual transfer from one program to the other had an impact on child cognitive and socioemotional development, and nutrition, using a cluster-randomized control trial with a sample of 2767 children between the ages of 6 and 60 months located in 14 cities in Colombia. The results indicate a negative effect of this initiative on cognitive development, a positive effect on nutrition, and no statistically significant effect of the intervention on socioemotional development. We also explored the extent to which these impacts might be explained by differences in the quality of both services during the transition, and report that quality indicators are low in both programs but are significantly worse in centers compared to community nurseries.

Implementing aeioTU: quality improvement alongside an efficacy study-learning while growing.

Effectiveness trials of increasing childhood development interventions across low- and middle-income countries have shown significant variability. The strength and consistency of benefits for children are dependent on program quality, and this requires paying attention to program implementation. In this paper, we summarize findings on program quality and teacher practices and perceptions for the aeioTU program, a center-based Reggio-inspired program in Colombia, now serving more than 13,000 children. The research found engaged, committed staff who valued the emergent approach and understood the children as requiring opportunities to express themselves, being the source for the curriculum, and having relationships with the materials around them. Although the average classroom quality was low in 2011, it increased significantly by 2014, particularly in the language and reasoning and interactions items. Indicator-level analyses showed that higher-order interactions and language processes were observed in a large proportion of classrooms by 2014. Teachers' self-reports on the environment and their teaching and learning showed high levels of quality by 2013. These findings illustrate the significance of process data for program improvement, especially when a program is young. Program quality can be raised after teachers improve their skills, have experience enacting a curriculum, and after training has been strengthened in response to information, while simultaneously scaling up the program.

Wealth gradients in early childhood cognitive development in five Latin American countries.

Research from the United States shows that gaps in early cognitive and non-cognitive ability appear early in the life cycle. Little is known about this important question for developing countries. This paper provides new evidence of sharp differences in cognitive development by socioeconomic status in early childhood for five Latin American countries. To help with comparability, we use the same measure of receptive language ability for all five countries. We find important differences in development in early childhood across countries, and steep socioeconomic gradients within every country. For the three countries where we can follow children over time, there are few substantive changes in scores once children enter school. Our results are robust to different ways of defining socioeconomic status, to different ways of standardizing outcomes, and to selective non-response on our measure of cognitive development.

Subsidized childcare and child development in Colombia: effects of Hogares Comunitarios de Bienestar as a function of timing and length of exposure.

Rigorous evidence regarding the impact of early care and education on children's development comes primarily from high-income nations. A few studies from Latin America and the Caribbean have identified benefits of conditional cash transfer and home visiting programs on children's development. However, there is still controversy around the impact and cost-effectiveness of childcare approaches. Further research is needed to understand how scaled-up childcare settings may support the development of low-income children in Latin America. To that end, the present study sought to identify the effects of exposure to a subsidized childcare program in Colombia on children's nutritional status, cognitive and socioemotional development. This community-based program, known as Hogares Comunitarios de Bienestar (HCB), serves 800 thousand low-income children under age 6, delivering home-based childcare, supplementary nutrition, and psychosocial stimulation. We analyzed data on 10,173 program beneficiary children (ages 3-6) collected in 2007. We compared beneficiary children who had been in the program for a long time with beneficiary children who had been in the program for a month or less, by age group, to estimate program exposure effects. We used a matching estimator to correct for self-selection into different exposure levels. Results indicated that cognitive development improved 0.15 to 0.3 of a standard deviation (SD) after at least 15 months of exposure for children between 3 and 6 years of age. Socioemotional skills improved 0.12 to 0.3 SD for children older than 3 after at least 15 months of program exposure. No significant gains were found for nutritional status. The estimated benefit-cost ratio ranged from 1.0 to 2.7, depending upon varying discount rates. Findings lend support for a potentially effective strategy to promote the development of low-income children in Colombia and other developing nations.