Pre-Pandemic Support for Shared Reading Buffers Adverse Parenting Impacts: An RCT in Brazil

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Publication year

2022

study description

Randomized Controlled Trial

core topic(s)

Shared Reading

Population Characteristics

International , Poverty/Low-Income

Exposures, Outcomes, Other

COVID-19 and Pandemic Impact , Disparity/Adversity , Home Language/Literacy/Learning Environment , Home Visitation , Libraries and Public Resources , Mental Health , Parent Behaviors and Skills , Parent-Child Relationships/Interactions , Programs and Interventions (other) , Social-Emotional , Universidade do Bebê

metric(s)

StimQ Cognitive Home Environment Questionnaire (StimQ)

objectives

To examine whether (1) a parent-child reading program (Universidade do Bebê [UBB]), conducted in Brazil pre-pandemic can support parenting and parent-child reading 6 months into the pandemic, (2) cognitive stimulation at pandemic onset mediates effects of UBB on these outcomes, and (3) UBB pre-pandemic buffers associations between COVID-19-related distress and parenting/parent-child reading 6 months into the pandemic.

exposure

Universidade do Bebê (UBB), a parent-child reading program

outcomes evaluated

COVID-19 related adverse impacts on parenting

setting

Community centers in three neighborhoods in a city in northeast Brazil

methods

400 women, either pregnant or with children 0–24 months, were randomized to UBB (n = 200) or control groups. UBB consisted of monthly parent workshops focusing on parent-child reading and a book-lending library. Assessments pre-pandemic (June-2019) and at pandemic onset (April-2020) included cognitive stimulation. Assessments 6 months into the pandemic (October-2020) included COVID-19 exposure/impact/distress, as well as parenting and parent-child reading.

sample size

n=400 (women total); n=200 (women, control); n=200 (women, intervention)

measures

Measure of Parenting Impacts: survey developed called “Parenting in a Pandemic Scale” (PIPS) designed to measure  parenting practices in terms of infection  prevention, socioemotional support, and structured activities, including parent-child reading activities during the COVID-19 pandemic. It consists of 25 items using a 5-point Likert scale ranging from 0 (a lot less than before the pandemic) to 4 (a lot more than before the pandemic). Examples of items include “Read books with my child” and “Ensured that my child has good quality sleep (e.g., regular sleep and wake times, no screens in bed)”. Measure of COVID-19 Exposure: phone interviews using the “COVID-19 Exposure and Family Impact Survey” (CEFIS) to assess  levels of exposure to COVID-19 and its impact on families’ economic and psychosocial factors. Families were asked to respond to survey items considering events since March 2020. Measure of Cognitive Stimulation: StimQ qas used to assess cognitive stimulation in the home through parent-child interactions in play, shared reading, teaching, and daily routines, using the READ, PVR, and PIDA subscales. Measure of Maternal Depression: Edinburgh Postnatal Depression Scale

results

133 families (n = 69 UBB) contributed data 6 months into the pandemic. Participation in UBB pre-pandemic was associated with parent-child reading but not parenting 6 months into the pandemic. Indirect effects of UBB through cognitive stimulation at pandemic onset were observed for both outcomes. Increased COVID-19-related distress was significantly associated with reduced parenting/parent-child reading 6 months into the pandemic in the control group only.

conclusions

Promotion of cognitive stimulation pre-pandemic may have reduced risk for effects of the pandemic on parenting/parent-child reading.

limitations

First, validated measures to evaluate COVID-19 exposure/impacts and parenting practices in the context of the pandemic in Brazil were unavailable. We addressed this limitation by examining psychometric characteristics of the translated scales, which demonstrated good internal consistency. Second, approximately a third of the original cohort was interviewed for the assessment that took place 6 months following pandemic onset. However, comparison of sociodemographic characteristics did not show differences between the analytic and full samples. Further, analyses utilizing data imputation methods had comparable findings, with significant differences retained for all measures. Third, given that perceived pandemic-related distress may vary depending on the timing of the evaluation, interpretations of this study’s results may be restricted to the time-point when the data was collected (October 2020), which is considered the end of the first wave of the COVID-19 pandemic in Brazil. Fourth, further study is needed to determine whether findings generalize to other regions in Brazil, LMICs or high-income countries. Fifth, additional information about siblings (e.g., ages, school grades) was not available. This is an important limitation as older siblings in the household may have influenced parenting and reading routines in the context of homeschooling during the pandemic. To further examine the potential role of siblings, we re-ran all analyses using number of siblings, rather than first-born, as a covariate. Findings were similar in terms of statistical significance and effect sizes. Sixth, we did not use diaries to examine parent-child reading. Instead, we used parent surveys, similar to other studies during the pandemic. Although our prior work has documented comparable findings when using StimQ and diaries, no studies to our knowledge have examined parent-child reading through parents’ diaries during the pandemic. Finally, this study’s results allow only indirect evidence for the potential buffering effect of UBB on children’s COVID-related learning losses.