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Predictors of Attendance in Reading Aloud Programs in Brazil: Results from Two RCTs

Wed, April 7, 2:45 to 4:15pm EDT (2:45 to 4:15pm EDT), Virtual

Abstract

Introduction. Parenting programs may be an effective strategy to prevent socioeconomic disparities in child development. Studies on reading-aloud programs have shown positive impacts on parenting and child outcomes in high-income countries (HIC) and low- and middle-income countries (LMICs). Research on psychosocial predictors of attendance in parenting programs in LMIC is critical to understand the effectiveness of these interventions in reaching families at risk for socioeconomic-related adversities. However, results from studies in HIC and LMIC are inconsistent. Some studies reported high psychosocial risk associated with high attendance, while others showed low risk associated with high attendance.

Aim. This study aimed to 1) determine sociodemographic and psychosocial predictors of attendance in parenting programs targeting low-income families in an LMIC, and 2) whether these predictors differ between two cities in Brazil where randomized control trials (RCTs) of a community-based reading aloud program were conducted.

Hypotheses. High socioeconomic and psychosocial vulnerabilities likely reduce attendance in parenting interventions. Due to differences in the settings and child age, some predictors may vary by city.

Methods. One RCT was conducted in educational centers targeting families of toddlers and preschoolers in Boa Vista (BV), northern Brazil. The second RCT was conducted in community centers targeting pregnant women and families with children up to 24 months in Arcoverde, northeastern Brazil. Both cities have high poverty rates, but participating families in Arcoverde had lower incomes than BV. In both RCTs, families were randomized to control and intervention groups. At baseline, 566 families in BV (279 intervention) and 399 families in Arcoverde (199 intervention) contributed with data at child’s age 37.4 (6.5) and 11.6 (6.7) months, respectively. The intervention was developed by researchers in Brazil and the US. Group sessions (led by a Psychologist) aimed to encourage parents to read with their children and share experiences and barriers related to reading aloud at home. A book-lending library complemented the workshops. At baseline, parents responded to sociodemographic and psychosocial measures including child’s age, gender, and birth order; maternal age, education, marital status, family income, food security, financial hardship, and scores on Confusion, Hubbub, and Order Scale (CHAOS), Edinburgh Postnatal Depression Scale (EPDS), Self-efficacy, and Parent Reading Belief Scores (PRBI). Sociodemographic and psychosocial measures were used as predictors of attendance in the programs and were analyzed by cities and combined through bivariate and hierarchical regression models.

Results. There was no difference in the median number of workshops attended between the two cities (Table 1). Parents attended a median of 5 (out of 9) workshops in BV and 4 (out of 7) in Arcoverde, with 97% in BV and 80% in Arcoverde attending at least one. Combining analyses showed that families with first-born children, parents married, less financial hardship, less chaos at home, and high scores in PRBI were more likely to participate in the workshops (Table 2). Mothers with fewer depression symptoms in BV and parents with less education in Arcoverde attended more workshops. Families exposed to several socioeconomic-related adversities in LMIC may need additional psychosocial support and resources to attend parenting interventions.

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