Évaluation de l'espace de croissance pour les enfants (RTG)
Soutiens complets aux parents pour la petite enfance et santé et développement des enfants
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
L'objectif du programme innovant de RtG est d'aider les parents à augmenter la probabilité que leurs enfants entrent à l'école prêts à apprendre et continuent à atteindre leur plein potentiel dans les domaines de l'éducation, du travail et de la citoyenneté. L'approche thérapeutique psychodynamique et la relation solide de trois ans avec les familles sont conçues pour agir comme catalyseur d'un changement durable et à long terme des méthodes parentales et de la stabilité du système familial. Surtout, et contrairement à d'autres programmes visant à améliorer la parentalité et le développement de l'enfant, RtG estime que fournir une aide matérielle concrète améliore l'efficacité du conseil et de l'orientation vers les familles à faible revenu en réduisant le stress économique et en libérant des ressources rares. Le programme s'appuie sur des décennies de recherche sur l'importance des soutiens parentaux pour les familles à faible revenu et leurs enfants, l'importance d'un soutien matériel concret et de la réduction de la pauvreté pour améliorer la santé et le développement des enfants, et la reconnaissance que les premières années sont un moment efficace pour fournir des soutiens essentiels qui influencent les résultats à long terme. De nombreux programmes, tels que les modèles de visites à domicile qui offrent un soutien parental aux nouvelles mères à faible revenu, ont donné des résultats prometteurs. Après des décennies de recherche corrélationnelle établissant des relations entre le revenu, la pauvreté et la santé et le développement des enfants, il existe une littérature émergente fournissant des preuves causales convaincantes que le revenu est important pour les résultats des enfants. Les deux souches de cette recherche s'appuient sur des recherches supplémentaires qui suggèrent clairement que la petite enfance est une période clé de vulnérabilité où les interventions peuvent faire une différence durable dans la fortune des enfants à faible revenu et de leurs familles. La recherche s'appuiera sur cette littérature, en testant une intervention qui combine à la fois des soutiens parentaux et une fourniture significative de soutien matériel - essentiellement, en évaluant si une approche combinée peut s'avérer potentiellement plus puissante que la somme de ses parties.
L'évaluation de RtG offre l'occasion sans précédent de tester la valeur combinée de l'éducation parentale avec les soutiens sociaux et matériels. Le projet s'appuie sur une approche novatrice qui combine le soutien du revenu, l'éducation parentale et la connexion aux services communautaires pour promouvoir la santé et le développement précoces des jeunes enfants. Les programmes de parentalité et de soutien du revenu visent chacun à promouvoir la santé et le développement positifs des familles à revenu faible et moyen, mais trop souvent, ils fonctionnent de manière isolée, ce qui limite potentiellement leur capacité à réduire les disparités dans la santé et le développement des parents et des enfants. Le modèle innovant de RtG offre la possibilité de tester l'effet combiné de ces services et de fournir des informations précieuses aux praticiens et aux décideurs sur les effets synergiques de ces composantes du programme. La recherche proposée peut faciliter le changement dans le domaine de la petite enfance en démontrant des preuves préliminaires que ce modèle innovant peut produire des effets démontrables sur les principaux résultats proximaux au cours de la première année de vie et fournir une première étape vers la constitution de preuves pour des approches à plusieurs volets pour répondre aux besoins des familles à faible revenu. Les résultats de cette étude peuvent guider le domaine vers des approches plus intégrées qui combinent le soutien matériel, la connexion aux ressources et l'aide parentale pour avoir des impacts réels sur la santé et le développement des jeunes enfants. Room to Grow et son évaluation apporteront des contributions claires au développement d'une culture de la santé et de politiques pertinentes dans le domaine de la petite enfance. Il s'agira du premier ECR qui offre une combinaison de soutiens parentaux et communautaires avec un soutien matériel substantiel et autonomisant. De nombreux programmes parentaux fournissent des livres ou des jouets adaptés au développement, mais il est incroyablement rare de fournir l'équivalent au détail d'environ 10 000 $ en soutien au cours des trois premières années de la vie. Cela permettra d'établir si un modèle tel que celui de RtG est prometteur pour transformer les programmes de parentalité de la petite enfance en aidant à construire une culture de la santé et à réduire les disparités en matière de santé parmi les enfants issus de milieux différents. L'organisation et sa direction attendent avec impatience d'apprendre du projet d'évaluation afin de mieux comprendre ce qui fonctionne bien et ce qui pourrait être amélioré dans la prestation du programme et le curriculum. L'équipe de RtG a délibérément créé une culture qui utilise les données pour éclairer la prise de décision et attend avec impatience de comprendre toute l'étendue des résultats de l'ECR. RtG élabore actuellement des plans d'expansion au cours des cinq prochaines années dans le cadre d'un processus formel de planification stratégique. L'organisation espère éventuellement desservir le double ou plus du nombre de familles dans chaque ville où elle opère, New York et Boston. À ce jour, les conclusions des évaluations internes sont extrêmement encourageantes. Les chercheurs espèrent que d'autres fondations et agences gouvernementales (ou donateurs privés) seront ravies de s'appuyer sur le soutien de la Fondation Robert Wood Johnson et que les chercheurs pourront prolonger l'élan initial généré par ce projet au fil du temps.
Le projet est conçu pour étudier les résultats proximaux. À long terme, l'équipe de recherche espère s'appuyer sur ces résultats proximaux et éventuellement suivre les enfants jusqu'à l'âge scolaire, ainsi qu'augmenter considérablement le nombre d'enfants inclus dans le projet ECR.
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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New York
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New York, New York, États-Unis, 10032
- Columbia University - Columbia Population Research Center (CPRC)
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
La description
Critère d'intégration:
- Femme
- Doit avoir au moins 16 ans
- Au troisième trimestre (semaines 28 à 34) de la grossesse
- Répondre aux critères du programme Room to Grow
- Faible revenu
- Besoin de services
Critère d'exclusion:
- Ne sait pas lire/écrire l'anglais et/ou l'espagnol
- Homme
- Troisième trimestre passé
- Déjà accouché
- Revenu moyen à élevé
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Autre
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: Intervention Group
The treatment group will consist of mothers who were randomly selected to receive Room to Grow services, which include three years of social and practical support for the mother and baby through a combination of one-on-one sessions with an expert clinical social worker in-person every three months and provision of essential baby items and equipment.
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Le groupe de traitement sera composé de mères sélectionnées au hasard pour recevoir les services Room to Grow, qui comprennent trois ans de soutien social et pratique pour la mère et le bébé.
Le modèle de programme fondé sur la recherche combine des séances individuelles sur mesure avec un travailleur social clinicien expert en personne tous les trois mois, la fourniture d'articles essentiels pour bébé, notamment des livres, des jouets, des vêtements et de l'équipement (valeur au détail des articles en nature sur trois ans s'élève en moyenne à 10 000 $) et les connexions aux ressources communautaires vitales (par exemple, le logement, les droits, la garde d'enfants, les services sociaux).
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Aucune intervention: Control Group
The control group will consist of mothers who will not receive Room to Grow services.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
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Mean Score of Depressive Symptoms Using the CES-D Scale
Délai: At Baseline (weeks 28-34 of pregnancy); 10.5 months after birth of child; 25 months after birth of child
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The Center for Epidemiological Studies-Depression (CES-D), is a 20-item measure that asks caregivers to rate how often over the past week they experienced symptoms associated with depression, such as restless sleep, poor appetite, and feeling lonely. Response options range from 0 to 3 for each item (0 = Rarely or None of the Time, 1 = Some or Little of the Time, 2 = Moderately or Much of the time, 3 = Most or Almost All the Time). Scores range from 0 to 60, with high scores indicating greater depressive symptoms. The Baseline and 25-month surveys included 12 items from the scale, and the 10.5-month survey included 7 items. The subscale scores range from 0 - 21 and 0 - 36, respectively. Higher scores indicate greater depressive symptoms. |
At Baseline (weeks 28-34 of pregnancy); 10.5 months after birth of child; 25 months after birth of child
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Mean Score of Perceived Stress Scale (PSS)
Délai: At Baseline (weeks 28-34 of pregnancy); 10.5 months after birth of child; 25 months after birth of child
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The Perceived Stress Scale (PSS) is a widely used instrument for measuring the perception of general stress. This 14-item scale measures how stressful or uncontrollable participants find their lives. Respondents rate the frequency of their feelings and thoughts related to events and situations that occurred in the last month. Individual scores on the PSS can range from 0-40 with higher scores indicating higher perceived stress. Scores ranging from 0-13 would be considered low stress. Scores ranging from 14-26 would be considered moderate stress. Scores ranging from 27-40 would be considered high perceived stress. The Baseline and 10.5-month surveys included 4 items from the scale. The 25-month survey included 6 items. Scores ranged from 0 - 16 and 0 - 24, respectively. Higher scores indicate higher perceived stress levels. |
At Baseline (weeks 28-34 of pregnancy); 10.5 months after birth of child; 25 months after birth of child
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Mean Score of Parental Sense of Competence Using PSOC Scale
Délai: At Baseline (weeks 28-34 of pregnancy); 10.5 months after birth of child; 25 months after birth of child
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The Parenting Sense of Competence Scale (PSOC). The PSOC measures parental competence on two dimensions: Satisfaction and Efficacy. It is a 17-item Likert-scale questionnaire (on a 6-point scale ranging from strongly agree [1] to strongly disagree [6]), with nine questions under Satisfaction and eight under Efficacy. Satisfaction section examines the parents' anxiety, motivation and frustration, while the Efficacy section looks at the parents' competence, capability levels, and problem-solving abilities in their parental role. Scores range from 17-102. A higher score indicates a higher parenting sense of competency. The Baseline and the 10.5-month surveys included 5 items from the scale with a modified 4-point scale ranging from strongly agree [1] to strongly disagree [4]. The 25-month survey included 8 items with the modified 4-point scale. Scores ranged from 4 - 20 and 4 - 32, respectively, with higher scores indicating a higher parenting sense of competency. |
At Baseline (weeks 28-34 of pregnancy); 10.5 months after birth of child; 25 months after birth of child
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Mean Score of the Confusion, Hubbub, and Order Scale (CHAOS)
Délai: At Baseline (weeks 28-34 of pregnancy); 10.5 months after birth of child; 25 months after birth of child
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The Confusion, Hubbub, and Order Scale (CHAOS) is a questionnaire filled out by parents that is designed to assess the level of confusion and disorganization in the child's home environment. The statements are scored using a 4-point scoring system. The questionnaire consists of 15 statements, to each of which a parent or caregiver responds (1) True, or (0) False (scoring was adjusted for items that required reverse coding). Scores ranged from 0-15. The Baseline and the 10.5-month surveys included 2 items from the scale with a modified 4-point scale ranging from 0 - 3: 0 = Not at all like your own home; 1 = A little bit like your own home; 2 = Somewhat like your own home; 3 = Very much like your own home. The 25-month survey included 5 items from the scale. Item scores were averaged and ranged from 0 - 3. A higher score represents characteristics of a more chaotic, disorganized, and hurried home. |
At Baseline (weeks 28-34 of pregnancy); 10.5 months after birth of child; 25 months after birth of child
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Mean Score of Cognitive Stimulation in the Home (STIMQ)
Délai: 10.5 months after birth of child; 25 months after birth of child
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STIMQ is a measure of cognitive stimulation in the home consisting of 4 subscales: Availability of Learning Materials (ALM), Reading, Parental Involvement in Developmental Advance (PIDA), and Parental Verbal Responsivity (PVR). The 10-month & 25-month surveys contained 4 of the 7 items in the PVR scale to measure cognitive stimulation. Respondents reported on the frequency of verbal responsiveness during everyday routines with their child. The full PVR scale uses an 8-point response scale ranging from 0 (never) - 7 (every day) and total scores range from 0 - 49 for preschool-age children. A modified 4-point response scale ranging from 1 (not at all) - 4 (every day). The average score of the four items was used and total scores ranged from 1-4. A higher score represents more responsivity and reflects greater stimulation in the home (a more favorable outcome). |
10.5 months after birth of child; 25 months after birth of child
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Mean Score of Aggravation in Parenting Scale
Délai: 10.5 months after birth of child; 25 months after birth of child
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A measurement of stress experienced by parents associated with caring for children.
It measures the amount of parenting stress brought on by changes in employment, income or other factors in the parent's life.
Research has shown that high levels of aggravation in parenting are related to mothers' employment status and to child behavior problems.
High stress and aggravation in parents are associated with poor cognitive and socioemotional development of young children.
6 of the 9 items in the scale were included in the surveys.
Response categories being (0) Strongly agree, (1) Somewhat agree, (2) Somewhat disagree, (3) Strongly disagree.
This 0-3 score is reverse coded, and items are averaged to create an overall score with higher scores indicating more stress.
Total scores ranged from 0-3.
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10.5 months after birth of child; 25 months after birth of child
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Number of Toys and Goods in the Home
Délai: 10.5 months after birth of child; 25 months after birth of child
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Subjects are asked if they have certain types of developmentally appropriate toys and games in the categories of symbolic play (doll, toy pots, small car), art (crayons, Play-Doh, paint), adaptive/fine motor toys (puzzle, shape sorter, pop-up toy), language (toy letters or numbers, toys that make animal sounds) and life-size toys (toy car or animal for child to ride).
Respondents can answer yes/no for each (1=yes, 0=no).
Subjects were asked about 13 items in the 10-month survey and 16 items in the 25-month survey.
Items were replaced or supplemented for age-appropriateness at each wave.
Item responses were tallied resulting in scores ranging from 0-13 and 0-16, respectively.
A higher score or number of developmentally appropriate toys and goods in the home reflects a more favorable outcome for the child.
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10.5 months after birth of child; 25 months after birth of child
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Worry Enough Money for Baby Scale Score
Délai: At Baseline (weeks 28-34 of pregnancy); 10.5 months after birth of child; 25 months after birth of child
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Subjects are asked to rate (on a scale of 1-10) how worried they are about having enough money to cover their baby's expenses with 1 being "Not at all worried" and 10 being "Very worried".
A lower score indicates less concern and is therefore favorable.
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At Baseline (weeks 28-34 of pregnancy); 10.5 months after birth of child; 25 months after birth of child
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Mean Score of Parent Supportiveness Using the 3-bag Task
Délai: At follow-up in-person meeting (42-72 months after birth of child)
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The 3-bag task utilizes a semi-structured play protocol in which the parent-child dyad is instructed to play with the toys in each of three bags in a predetermined sequence.
The semi-structured play interactions are videotaped and the parent-child behaviors scored in accordance with the 3-bag task coding scales used in the National Institute of Child Health and Human Development Study of Early Child Care.
Parent supportiveness is the average of three measures: maternal sensitivity, positive affect, and the extent to which the parent provides cognitive stimulation while interacting with their child.
Scoring for all three considers both the quantity and quality or intensity of behavioral indicators observed for each; a score of 1 represents virtually no evidence of the particular behavior and a score of 7 indicates very high levels of the behavior.
As an average of the three, parent supportiveness follows the same scoring scheme and higher scores represent a more favorable outcome.
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At follow-up in-person meeting (42-72 months after birth of child)
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Mean Score of Parent Detachment Using 3 Bag-task
Délai: At follow-up in-person meeting (42-72 months after birth of child)
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The 3-bag task utilizes a semi-structured play protocol in which the parent-child dyad is instructed to play with the toys in each of three bags in a predetermined sequence.
The semi-structured play interactions are videotaped and the parent-child behaviors scored in accordance with the 3-bag task coding scales used in the NICHD Study of Early Child Care.
The parent detachment scale is based on observations of the parent's awareness of, attention to, and engagement with the child.
Behavioral indicators of detachment include being consistently inattentive, being inconsistently attentive, and/or interacting with the child in a perfunctory or indifferent manner.
Scoring considers both the quantity of behavioral indicators observed and the quality or intensity of the behaviors.
A score of 1 represents very low detachment and score of 7 indicates very high detachment.
A lower score represents a more favorable outcome.
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At follow-up in-person meeting (42-72 months after birth of child)
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Mean Proportion Correct Score on Working Memory Span Performance
Délai: At follow-up in-person meeting (42- 72 months after birth of child)
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This task measures working memory.
Working memory involves holding information in short-term storage and attending to one item (i.e., a house) while overcoming interference from the other (i.e., an animal or color).
The task requires children to perform the operation of naming and holding in mind two pieces of information simultaneously and to activate one while overcoming interference occurring from the other.
The task becomes more difficult as the number of houses increases.
In the pretest phase, it is established that children can name both the colors and the animals in the task.
Children then receive three 1-house trials, three 2-house trials, and three 3-house trials.
There are 18 items.
Individually, incorrect items receive a score of 0 and correct items receive a score of 1. Item scores are averaged and the total score on this activity is a proportion correct score of all items which ranges from 0 to 1.
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At follow-up in-person meeting (42- 72 months after birth of child)
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Mean Proportion Correct Score on Inhibitory Motor Control Performance
Délai: At follow-up in-person meeting (42-72 months after birth of child)
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This task measures inhibitory motor control and is a standard go no-go task.
Children are presented with a large green button on the screen that makes a "popping" sound when it is touched.
Children are instructed to touch the button every time that they see an animal (the 'go' response) except when that animal is a pig (the 'no-go' response).
No-go responses vary in difficulty depending on how many go responses preceded them.
In the pretest phase, children are asked to identify all of the animals.
During administration items, the task is presented in varying numbers of go trials prior to each no-go trial, including, in standard order, 1-go, 3-go, 3-go, 5-go, 1-go, 5-go, 7-go and 7-go.
There are 40 items.
Individually, incorrect items receive a score of 0 and correct items receive a score of 1. Item scores are averaged and the total score on this activity is a proportion correct score of all items ranging from 0 to 1.
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At follow-up in-person meeting (42-72 months after birth of child)
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Mean Proportion Correct Score on Attention Shifting Performance
Délai: At follow-up in-person meeting (42-72 months after birth of child)
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This task measures attention shifting and requires children to use flexible thinking.
For the initial trials in the task, children are presented with two pictures (animals, flowers, etc.) that are similar along a single dimension of color, shape, or size.
Initially, the child is explicitly told how two of the pictures are the same in some way.
Then, the child is presented with a third picture alongside the original two and asked to state how the new picture is similar to one of the original pictures.
This task requires the child to shift his/her attention from the initial dimension of similarity to a new dimension of similarity.
In the most difficult, items all of the pictures are presented at once and children are prompted to identify both dimensions of similarity.
There are 30 items.
Incorrect items receive a score of 0 and correct items receive a score of 1. Item scores are averaged and the total score on this activity is a proportion correct score of all items ranging from 0 to 1.
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At follow-up in-person meeting (42-72 months after birth of child)
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Mean Language Total Standard Score
Délai: At follow-up in-person meeting (42-72 months after birth of child)
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The Receptive One-Word Picture Vocabulary Test, Fourth Edition (ROWPVT-4) is a norm-referenced assessment that tests an individual's ability to match a spoken word with an image of an object, action, or concept.
The test targets the ability to understand the meaning of words spoken and name what is depicted on a test plate without context.
Scores range from 55 - 145.
This is a standardized language assessment based on a mean of 100 and a standard deviation of 15.
Scores of 85-115 are considered to be within the average range of functioning.
Scores above 115 are considered above average and scores below 85 are considered below average.
Scores from this measure indicate that a child's receptive vocabulary is above average, below average, or equivalent to their peers of the same age.
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At follow-up in-person meeting (42-72 months after birth of child)
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Christopher Wimer, PhD, Senior Research Scientist at CPRC, School of Social Work
Publications et liens utiles
Publications générales
- Peacock S, Konrad S, Watson E, Nickel D, Muhajarine N. Effectiveness of home visiting programs on child outcomes: a systematic review. BMC Public Health. 2013 Jan 9;13:17. doi: 10.1186/1471-2458-13-17.
- Duncan GJ, Morris PA, Rodrigues C. Does money really matter? Estimating impacts of family income on young children's achievement with data from random-assignment experiments. Dev Psychol. 2011 Sep;47(5):1263-79. doi: 10.1037/a0023875.
- Chaudry A, Wimer C. Poverty is Not Just an Indicator: The Relationship Between Income, Poverty, and Child Well-Being. Acad Pediatr. 2016 Apr;16(3 Suppl):S23-9. doi: 10.1016/j.acap.2015.12.010.
- Duncan, G.J., Magnuson, K., Kalil, A. et al. Soc Indic Res (2012) 108: 87. https://doi.org/10.1007/s11205-011-9867-9
- Cates CB, Weisleder A, Mendelsohn AL. Mitigating the Effects of Family Poverty on Early Child Development through Parenting Interventions in Primary Care. Acad Pediatr. 2016 Apr;16(3 Suppl):S112-20. doi: 10.1016/j.acap.2015.12.015.
- Wimer C, Marti M, Brooks-Gunn J, Waldfogel J. Early Impacts of Room to Grow: A Multifaceted Intervention Supporting Parents and Children Age Zero to Three. Child Youth Serv Rev. 2021 Jul;126:106041. doi: 10.1016/j.childyouth.2021.106041. Epub 2021 Apr 30.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- AAAR1340
- P2CHD058486 (Subvention/contrat des NIH des États-Unis)
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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produit fabriqué et exporté des États-Unis.
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