The Effects of Crianza Positiva E-messaging Program on the Quality and Quantity of Parent-Child Interaction in Uruguay

• In Event: Digital Early Childhood Development Interventions in Latin America

Abstract

Introduction: A caring and protecting environment during the first 1000 days of life has been strongly associated to long-term outcomes such as health, education, and employment. Parenting interventions to improve the childrearing environment are often effective, but expensive. The need to intervene with parents at lower cost has encouraged the surge of behavior change communication interventions that combine behavioral science tools with information and communication technologies. We study the effects of two conceptual replications of "Crianza Positiva," an e-messaging program targeting parents with children below the age of three in Uruguay. The intervention sent 72 messages to parents during 24 weeks via WhatsApp and SMS, and covered topics such as parental sensitivity, expressions of affection and good treatment, home safety, routines, language, free play, and self-caring. The first edition took place in 2018, after families had been exposed to a group-based 8-week parenting workshop; the second one was introduced in 2020 during the pandemic, with similar content and frequency, but a slightly different population and no previous workshop.

Hypotheses: We expected the text and audio intervention to increase parental engagement and the quality of parental-child interaction, with larger effects on families that had participated in a prior parenting workshop.

Study population: Parents of children below the age of three enrolled in Early Childhood and Family Centers (CAIF) in Uruguay during 2017 (N=570) and 2020 (N= 687) of low and middle socioeconomic status. Families in the 2020 sample had higher levels of education and were less likely to receive government assistance.

Methods: We used two experimental designs to assess the effects of each intervention. In both cases, families were randomized at the level of the early childhood center (24 centers in 2018 and 39 centers in 2020) either to receive or not to receive messages. We estimated Intention-to-Treat effects using the randomization of families as a proxy for treatment.

Results: Findings from the 2018 intervention show that the messages increased the frequency of parental involvement and the quality of parenting, with effect sizes of around 0.24 standard deviations. The effects were larger for families who experienced previous negative shocks and with lower sense of parental competence at baseline. We also found that mothers receiving the messages spoke to their infants with a wider range of intonation and increased the duration of their vocalizations. Results from the 2020 intervention, on the other hand, showed no effects on any of the outcomes of interest. We consider various hypotheses behind the lack of results. First, this edition was implemented without a previous workshop, suggesting that messaging programs may work better as a complement to more intensive interventions. Second, families were more stressed during the pandemic, potentially reducing their receptivity to the messages. Third, the 2020 sample was more educated, and may have been less responsive to the interventions. Finally, CAIF centers actively used WhatsApp messages to stay in touch with families during the pandemic, competing for the attention of the families.

Authors

• Ana Balsa
  Presenting Author

• Alejandro Cid, University of Montevideo

• Juanita Bloomfield, University of Montevideo