TY - JOUR

T1 - Implementation of Reach-Up early childhood parenting programme

T2 - Appropriateness, acceptability and feasibility in Brazil and Zimbabwe

AU - Smith, Joanne A.

AU - Baker-Henningham, Helen

AU - Brentani, Alexandra

AU - Mugweni, Rose

AU - Walker, Susan P.

PY - 2018/5/23

Y1 - 2018/5/23

N2 - Young children need nurturing care, which includes responsive caregiver–child interactions and opportunities to learn. However, there are few extant large‐scale programs that build parents’ abilities to provide this. We have developed an early childhood parenting training package, called Reach Up, with the aim of providing an evidence‐based, adaptable program that is feasible for low‐resource settings. Implementation of Reach Up was evaluated in Brazil and Zimbabwe to inform modifications needed and identify challenges that implementers and delivery agents encountered. Interview guides were developed to collect information on the program's appropriateness, acceptability, and feasibility from mothers, home visitors, and supervisors. Information on adaptation was obtained from country program leads and Reach Up team logs, as well as quality of visits from observations conducted by supervisors. The program was well accepted by mothers and visitors, who perceived benefits for the children; training was viewed as appropriate, and visitors felt well‐prepared to conduct visits. A need for expansion of supervisor training was identified and the program was feasible to implement, although challenges were identified, including staff turnover; implementation was less feasible for staff with other work commitments (in Brazil). However, most aspects of visit quality were high. We conclude that the Reach Up program can expand capacity for parenting programs in low‐ and middle‐income countries.

AB - Young children need nurturing care, which includes responsive caregiver–child interactions and opportunities to learn. However, there are few extant large‐scale programs that build parents’ abilities to provide this. We have developed an early childhood parenting training package, called Reach Up, with the aim of providing an evidence‐based, adaptable program that is feasible for low‐resource settings. Implementation of Reach Up was evaluated in Brazil and Zimbabwe to inform modifications needed and identify challenges that implementers and delivery agents encountered. Interview guides were developed to collect information on the program's appropriateness, acceptability, and feasibility from mothers, home visitors, and supervisors. Information on adaptation was obtained from country program leads and Reach Up team logs, as well as quality of visits from observations conducted by supervisors. The program was well accepted by mothers and visitors, who perceived benefits for the children; training was viewed as appropriate, and visitors felt well‐prepared to conduct visits. A need for expansion of supervisor training was identified and the program was feasible to implement, although challenges were identified, including staff turnover; implementation was less feasible for staff with other work commitments (in Brazil). However, most aspects of visit quality were high. We conclude that the Reach Up program can expand capacity for parenting programs in low‐ and middle‐income countries.

KW - Implementation

KW - low- and middle-income countries

KW - Parenting Programmes

KW - Early childhood

U2 - 10.1111/nyas.13678

DO - 10.1111/nyas.13678

M3 - Article

VL - 1419

SP - 120

EP - 140

JO - Annals of the New York Academy of Sciences

JF - Annals of the New York Academy of Sciences

SN - 0077-8923

IS - 1

ER -