Family responsive care mediating the home visiting effects on left-behind children's early development in rural China

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development Pub Date : 2024-01-19 DOI:10.1111/cch.13226

Mengshi Li, Yufeng Du, Chunxia Zhao, Huifeng Shi, Xiaoli Wang, Jingxu Zhang

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引用次数: 0

Abstract

Background

The early development of left-behind children requires great concern and improvement. Yet, current interventions for left-behind children are mainly focussed on children older than 3. This study aims to assess the effectiveness of a home visiting programme on family responsive care and early development of rural left-behind children and examine whether family responsive care mediates the effects of intervention on child development.

Methods

A quasi-experimental study design was utilized in this study. A stratified clustered sampling was employed to choose villages in programme towns into intervention group. A control village was matched with every intervention village. All of the left-behind children and their caregivers meeting the inclusion criteria in the chosen villages were enrolled in the survey. The outcomes included child development, caregiver's early stimulation, parent–child communication, and learning materials. Baseline assessments were conducted in 2018, and endline assessments were conducted in 2020.

Results

In the endline survey, we enrolled 608 children with 258 in the intervention group and 350 in the control group. Left-behind children in the intervention group were less likely to have development delay compared with the control group (odds ratio [OR] = 0.59, 95% confidence interval [CI]: 0.36, 0.96). Migrant parents of children in the intervention group showed higher proportion of expressing emotional support to their children when communicating (OR = 1.69, 95% CI: 1.05, 2.72). Children who received home visits more than once per 2 months had lower level of suspected development delay than children in the control group (OR = 0.34, 95% CI: 0.18, 0.68). Caregiver's early stimulation and migrant parents' emotional support to left-behind children mediated the intervention dose and left-behind children's development.

Conclusion

Caregiver's early stimulation mediates the intervention and child's development. The findings suggest a promising future for scaling similar early childhood development interventions for left-behind children in rural settings.

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中国农村留守儿童早期发展的家访效应--家庭响应式照料的中介作用

背景留守儿童的早期发展需要得到高度关注和改善。然而，目前针对留守儿童的干预措施主要针对 3 岁以上的儿童。本研究旨在评估家访计划对农村留守儿童的家庭回应性照料和早期发展的效果，并探讨家庭回应性照料是否会对干预措施对儿童发展的影响产生中介作用。方法本研究采用准实验研究设计。研究采用分层聚类抽样的方法，在计划实施乡镇中选择村庄进入干预组。每个干预村都有一个对照村。所选村庄中所有符合纳入标准的留守儿童及其看护人都被纳入调查。调查结果包括儿童发展、照顾者的早期刺激、亲子沟通和学习材料。基线评估于 2018 年进行，终点评估于 2020 年进行。结果在终点调查中，我们共招募了 608 名儿童，其中干预组 258 名，对照组 350 名。与对照组相比，干预组的留守儿童出现发育迟缓的可能性较低（几率比[OR] = 0.59，95%置信区间[CI]：0.36，0.96）。干预组儿童的外来务工父母在与子女交流时表达情感支持的比例较高（OR = 1.69，95% 置信区间 [CI]：1.05, 2.72）。与对照组儿童相比，每两个月接受一次以上家访的儿童疑似发育迟缓的程度较低（OR = 0.34，95% CI：0.18，0.68）。照顾者的早期刺激和外来务工父母对留守儿童的情感支持对干预剂量和留守儿童的发展有中介作用。结论照料者的早期刺激对干预和留守儿童的发展具有中介作用。研究结果表明，在农村地区推广类似的留守儿童早期发展干预措施前景广阔。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child Care Health and Development 医学-小儿科

CiteScore

3.40

自引率

5.30%

发文量

136

审稿时长

4-8 weeks

期刊介绍： Child: care, health and development is an international, peer-reviewed journal which publishes papers dealing with all aspects of the health and development of children and young people. We aim to attract quantitative and qualitative research papers relevant to people from all disciplines working in child health. We welcome studies which examine the effects of social and environmental factors on health and development as well as those dealing with clinical issues, the organization of services and health policy. We particularly encourage the submission of studies related to those who are disadvantaged by physical, developmental, emotional and social problems. The journal also aims to collate important research findings and to provide a forum for discussion of global child health issues.