ABSTRACT Research suggests that it is important to establish regular physical activity and healthy eating patterns during the early years (0-5 years). Engaging in healthy behaviours during this stage of life supports growth and development and lays the foundation for a lifetime of health and wellbeing. Despite these benefits, research indicates that children in Canada are not meeting the daily recommended physical activity guidelines for early years. Moreover, their diets are lacking in fruits and vegetables and are high in processed foods. As many early years children spend a large part of their day in childcare centres, educators can have a large influence on their physical activity and healthy eating behaviours. In the Canadian Prairie Provinces many childcare centres are located in rural communities. Previous research suggests that rural educators are influenced by unique factors associated with geographic local (e.g., access to resources to promote physical activity and year round access to variety of healthy foods) when attempting to provide healthy opportunities for children. In order to address the specific factors identified by rural educators and support healthier behaviours among rural early year’s children, a multilevel physical activity and healthy eating intervention (Healthy Start) was developed using McLeroy’s ecological model and a population health approach. Healthy Start was pilot tested in three rural childcare centres. Purpose: The primary purpose of this dissertation study was to evaluate Healthy Start, a multilevel community-based physical activity and healthy eating intervention, in rural childcare centres throughout Saskatchewan. In order to achieve this primary purpose, the specific dissertation objectives were addressed as follows. Paper 1: a) Determine if over the course of the intervention, Healthy Start contributed to increases in physical activity levels and improvements in motor skill development among early years children aged 3 to 5 years; b) Determine if Healthy Start supported educators in providing children with more opportunities for physical activity; c) Describe educators’ experiences and perceptions of Healthy Start and its influence on physical activity within the childcare centre environment. Paper 2: a) Assess to what extent, Healthy Start contributed to healthier eating behaviours among early years children aged 3 to 5 years over the course of the intervention; b) Determine if Healthy Start supported childcare staff (educators and cooks) in providing children with more opportunities for healthy eating; c) Describe educators ‘experiences and perceptions of Healthy Start and its influence on healthy eating within the childcare centre environment. Paper 3: To pilot a pulse crop intervention study in one of the intervention childcare centres in order to: a) Increase knowledge and awareness about the nutritional value and health benefits of pulse crops among childcare staff (educators and cooks); b) Support childcare staff in providing children with more opportunities for pulse crop consumption; c) Expand the variety of healthy foods consumed by early years children by incorporating locally grown pulse crops into the childcare centre meals. Methods: A population health controlled intervention study using a wait-list control design (48 weeks delayed-intervention) was used to evaluate the impact of the intervention. Mixed methods were employed to determine the intervention’s influence on children and educator behaviours and on the childcare centre environment. Results: Overall, increases in children’s physical activity levels and improvements in healthy eating behaviours were observed in the intervention group. Moreover, educators felt the intervention was effective in supporting them to increase physical activity and healthy eating opportunities provided to rural early years children. Lastly, improvements to childcare centre environments were made to promote healthy behaviours among the children. Conclusion: Collectively, the pilot study provided insight into the complexities and feasibility of promoting physical activity and healthy eating among early years children in childcare centres, particularly in rural communities. This was an innovative intervention which addressed critical factors at multiple levels contributing to the development of healthy behaviours among rural early years children. The lessons learned in this dissertation study can be used to improve the Healthy Start intervention so its implementation can be effectively expanded to childcare centres within and outside of Saskatchewan. Additionally, the findings can contribute to the limited body of literature on implementing and evaluating interventions aimed at increasing both physical activity and healthy eating in Canadian childcare centres. In turn, supporting the healthy development of early years children in the province and beyond.

Thesis to Changes in attitudes in education and care in early child development is the analysis of current attitudes and opinions in the concept of motherhood in the generation of mothers and daughters. The theoretical part deals with the educational and developmental aspects of early stages of child development, reflects a shift from authoritarian educational orientation to the humanist conception of education. The empirical part presents results of research probes obtained by questionnaire survey, which was attended by 40 pairs of mothers and their daughters.

Economics

Thesis advisor: Theresa Betancourt / Families in low- and middle-income countries (LMICs) face significant mental health and psychosocial care gaps. In recent years, researchers and practitioners have addressed these gaps by task-sharing evidence-based mental health and psychosocial support (MHPSS) interventions to nonspecialist community providers. Task-shared interventions have demonstrated effectiveness (improvements in MHPSS outcomes of intervention participants); however, quality of delivery (fidelity and competence) has rarely been examined as a factor associated with effectiveness despite implementation science models suggesting a causal link between quality of delivery and effectiveness. In this study, I apply a mixed methods approach to examine the quality of delivery by nonspecialists who are facilitating an evidence-based, early childhood development and family violence prevention program, known as Sugira Muryango, in Rwanda. Currently, Sugira Muryango is being expanded and implemented through the Promoting Lasting Anthropometric Change and Young Children’s Development (PLAY) Collaborative, which scales up Sugira Muryango to 10,000 households living in extreme poverty in Ngoma, Nyanza, and Rubavu districts. The program has strong ties to the Rwanda National Government and their social protection and policy goals. I find that nonspecialist age is significantly associated with higher initial fidelity and competence scores and smaller improvements in fidelity and competence over time. In addition, nonspecialists in Nyanza district were more likely to have higher initial fidelity and competence scores but also see smaller changes over time. Fidelity and competence were found to significantly co-vary. Multi-level growth models revealed that fidelity was not a significant predictor of changes in any child discipline outcomes or of any responsive caregiving outcomes. However, competence significantly predicted changes in some responsive caregiving practices, specifically acceptance and learning materials, and it predicted decreases in physical punishment. In semi-structured interviews, the nonspecialists provided examples of using skills such as rapport-building, empathy, and active listening to deliver Sugira Muryango effectively. Nonspecialists also provided examples of barriers to quality of delivery, including compensation and technology issues. Overall, this dissertation contributes empirical evidence to what we understand theoretically and moves towards development of best practices for monitoring and supervising nonspecialists in task-shared MHPSS interventions. / Thesis (PhD) — Boston College, 2024. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

The goal of this international study was to gain insight into a little-known approach to family home visiting: programs that make use of both volunteer and paid visitors. Using a qualitative embedded multiple case study design, I interviewed volunteers and staff at three such programs regarding the development of the service, and the strengths and challenges of this approach. Key findings suggest that this approach allows programs to provide preventative, universally available services; and to serve a greater number and broader range of families. These were important features given the local targeted, reactive service delivery systems. Common challenges included funding difficulties and some limited communication and workload issues. This approach shows promise as a way to increase program accessibility and impact. Considerations for program planners include the costs of qualified staff to coordinate volunteers and do home visiting, and organizational readiness to deploy volunteers effectively in home visiting roles. / A preliminary exploratory study of three family home visiting programs involving volunteer and paid home visitors.

Disertacijoje tirtas vaizdo analizės metodu pagrįstos, trumpalaikės, nukreiptos į motinos ir kūdikio sąveiką, prieraišumo santykius koreguojančios intervencijos (VIPP, Juffer, Bakermans-Kranenburg, & Van IJzendoorn, 2008) poveikis motinų jautrumui kūdikio signalams bei kūdikių prieraišumo saugumui. Tiriamieji buvo (N = 54) nepakankamai jautrios kūdikio signalams, klinikinių sutrikimų neturinčios, viduriniosios klasės motinos ir kūdikiai. Motinos jautrumas kūdikio signalams buvo vertinamas klasikine Ainsworth skale pagal nufilmuotą motinos ir kūdikio laisvą žaidimą, o kūdikių prieraišumo saugumas vertintas Waters‘o „Prieraišumo Q-rūšiavimo metodika“ (stebint kūdikį ir motiną namuose). Ilgalaikį dalyvavimo korekcijos programoje poveikį vaikų elgesio sunkumams vertinome CBCL metodika. Nustatyta, kad dalyvavimas korekcijos programoje reikšmingai padidino motinų jautrumą kūdikių signalams, net kai buvo kontroliuojamas motinos amžius, išsilavinimas, kasdienis stresas, saviveiksmingumas, kūdikių lytis ir temperamentas. Kūdikių prieraišumo saugumas eksperimentinėje grupėje nepadidėjo, kai eksperimentinės grupės tiriamieji baigė dalyvauti programoje, lyginant su kontroline grupe. Aukštesniu ir žemesniu neigiamu emocionalumu pasižymintys kūdikiai gavo tiek pat naudos iš dalyvavimo programoje. Eksperimentinės, kontrolinės grupių ir pakankamai jautrių motinų vaikai patyrė panašiai tiek pat elgesio sunkumų dviejų metų amžiuje. Disertacijoje analizuojami veiksniai, susiję su motinų... [toliau žr. visą tekstą] / The randomized control trial examined the effects of a short-term, interaction focused and attachment-based video-feedback intervention (VIPP, Juffer, Bakermans-Kranenburg, & Van IJzendoorn, 2008) on mothers’ sensitive responsiveness and infant-mother attachment security in a sample (N = 54) of low sensitive, non-clinical, middle class Lithuanian mothers. Maternal sensitivity was assessed in a free play session with the Ainsworth sensitivity scale, and attachment security was observed using the Attachment Q sort for home observations. The long-term intervention effect on children behavior problems was assessed with CBCL. We found that the intervention mothers indeed significantly improved their sensitive responsiveness through participation in the intervention. VIPP enhanced maternal sensitive responsiveness even when maternal age, educational level, daily hassles, efficacy, infant gender, and infant negative and positive affect were controlled for. However, attachment security in the intervention group infants was not enhanced after the intervention, compared to the control infants, and the infants did not seem to differential susceptible to the increase in maternal sensitivity. Experimental, control groups children and sensitive mothers’ children experienced the same level of behavior problems at two years. Factors associated with maternal sensitivity and children behavior problems were analyzed.

The measurement of reliable and valid indicators of early child development is necessary for assessing phenomena and is useful in the monitoring of ongoing efforts to eradicate inequalities in the social determinants of health. There is an increasing awareness of the contextual, cultural, and developmental influences on constructs used in early child development (ECD) research. Using a measurement perspective, this dissertation examined the issue of measurement invariance and psychometric validity in early child development research. A construct violates the principle of invariance when two persons from different populations who are theoretically identical on the construct being measured have different scores on it. This dissertation consists of three journal-style manuscripts (published or under review) that were used as examples to address the importance of the issue of measurement invariance and psychometric validity in ECD research using data from two unique areas: autism and executive functioning. The three data sets were collected on pre-school children with parents and or teachers as informants and were chosen to represent different levels of data collection – clinical, community, and population. These data sets allowed for the examination of measurement invariance by type of informant, sex, and age of child. The results from the three studies illustrate the importance of assessing measurement invariance in ECD and whether or not the instruments examined can be used to assess sub-group differences with confidence. A lack of measurement invariance found for two of the studies, suggests that observed group differences in latent constructs could be attributed, in part, to measurement bias. More importantly, bias in the measurement of the constructs of severity of social impairment symptoms in autism, and executive functioning across groups could have an impact on services such as patient treatment. These biases could also influence public policy development, particularly when there may be an underlying need for a cross-group approach where belief systems may affect the meaning and structure of constructs. In summary, measurement invariance should be a prerequisite for making any meaningful comparisons across groups. A requirement of establishing measurement invariance should be included in the guidelines for comparative research studies as a necessary first step before an instrument is adopted for use.

The measurement of reliable and valid indicators of early child development is necessary for assessing phenomena and is useful in the monitoring of ongoing efforts to eradicate inequalities in the social determinants of health. There is an increasing awareness of the contextual, cultural, and developmental influences on constructs used in early child development (ECD) research. Using a measurement perspective, this dissertation examined the issue of measurement invariance and psychometric validity in early child development research. A construct violates the principle of invariance when two persons from different populations who are theoretically identical on the construct being measured have different scores on it. This dissertation consists of three journal-style manuscripts (published or under review) that were used as examples to address the importance of the issue of measurement invariance and psychometric validity in ECD research using data from two unique areas: autism and executive functioning. The three data sets were collected on pre-school children with parents and or teachers as informants and were chosen to represent different levels of data collection – clinical, community, and population. These data sets allowed for the examination of measurement invariance by type of informant, sex, and age of child. The results from the three studies illustrate the importance of assessing measurement invariance in ECD and whether or not the instruments examined can be used to assess sub-group differences with confidence. A lack of measurement invariance found for two of the studies, suggests that observed group differences in latent constructs could be attributed, in part, to measurement bias. More importantly, bias in the measurement of the constructs of severity of social impairment symptoms in autism, and executive functioning across groups could have an impact on services such as patient treatment. These biases could also influence public policy development, particularly when there may be an underlying need for a cross-group approach where belief systems may affect the meaning and structure of constructs. In summary, measurement invariance should be a prerequisite for making any meaningful comparisons across groups. A requirement of establishing measurement invariance should be included in the guidelines for comparative research studies as a necessary first step before an instrument is adopted for use.