Intervenciones educativas en el desarrollo infantil y los supuestos de la alfabetización en salud: revisión integrativa

Luz, Rayara Medeiros Duarte; Marinho, Dayana Cecília de Brito; Lima, Ana Paula Esmeraldo; Coriolano-Marinus, Maria Wanderleya Lavor

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Revista Brasileira de Enfermagem

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Sumário

REVIEW • Rev. Bras. Enferm. 76 (1) • 2023 • https://doi.org/10.1590/0034-7167-2022-0116 copiar

Intervenciones educativas en el desarrollo infantil y los supuestos de la alfabetización en salud: revisión integrativa

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivos:

analizar la evidencia científica en la literatura que aborda intervenciones educativas realizadas por profesionales de la salud sobre el desarrollo infantil temprano en un contexto comunitario e identificar qué supuestos de alfabetización en salud están presentes durante la implementación de las intervenciones.

Método:

revisión integradora en las bases de datos PubMed, CINAHL y Web of Science. De 300 estudios encontrados, 11 fueron seleccionados para la muestra.

Resultados:

los profesionales de la salud están capacitados para implementar intervenciones con padres/madres/cuidadores para promover el desarrollo infantil en entornos comunitarios. Se alienta a los padres a desarrollar un entorno estimulante y propicio para el desarrollo de sus hijos. Las principales dimensiones de alfabetización en salud encontradas fueron acceso y aplicación.

Conclusión:

se confirma la importancia de formar profesionales de la salud, con competencias y habilidades comunicativas para orientar a los padres/madres/cuidadores a incentivar el desarrollo de sus hijos en su entorno familiar con actividades lúdicas e interactivas.

Descriptores:
Educación en Salud; Alfabetización en Salud; Desarrollo Infantil; Personal de Salud; Atención Primaria de Salud

DATABASE	SEARCH STRATEGY	FILTERS APPLIED	PUBLICATIONS FOUND (INITIAL SAMPLE)	SELECTED ARTICLES (FINAL SAMPLE)
MEDLINE	((“Health Education” [Mesh]) OR “Education, Public Health Professional” [Mesh])) AND “child Development” [MeSH]	- Clinical trial; - Period of last the 10 years (2012-2021).	83	8
Web of Science	((ALL=(“Health Education” OR “Education, Public Health Professional”)) AND ALL=(“Child Development”))	- Period of last the 10 years (2012-2021).	111	2
CINAHL	TX (“Health Education” OR “Education, Public Health Professional”) AND TX “Child Development” AND TX ( “Health Workers” OR “Health Personnel”)	- Period of last the 10 years (2012-2021).	106	1
TOTAL			300	11

Study code/database	Year/ country	Article title	Level of evidence
A1: MEDLINE	2021/ Kenya	Group-based parenting interventions to promote child development in rural Kenya: a multi-arm, cluster-randomised community effectiveness trial(¹²12 Luoto JE, Lopez Garcia I, Aboud FE, Singla DR, Fernald LCH, Pitchik HO, et al. Group-based parenting interventions to promote child development in rural Kenya: a multi-arm, cluster-randomised community effectiveness trial. Lancet Glob Health. 2021;9(3):1-22. https://doi.org/10.1016/S2214-109X(20)30469-1 https://doi.org/10.1016/S2214-109X(20)30... )	I
A2: MEDLINE	2020/ China	The Effectiveness and Cost-effectiveness of a Parenting Intervention Integrated with Primary Health Care on Early Childhood Development: a Cluster-Randomized Controlled Trial(¹³13 Shi H, Li X, Fang H, Zhang J, Wang X. The effectiveness and cost-effectiveness of a parenting intervention integrated with primary health care on early childhood development: a cluster-randomized controlled trial. Prev Sci. 2020;21(5):661-71. https://doi.org/10.1007/s11121-020-01126-2 https://doi.org/10.1007/s11121-020-01126... )	I
A3: MEDLINE	2020/ Turkey	Effects of providing nursing care with web-based program on maternal self-efficacy and infant health(¹⁴14 Sari C, Altay N. Effects of providing nursing care with web-based program on maternal self-efficacy and infant health. Public Health Nurs. 2020;37(3):380-92. https://doi.org/10.1111/fn.12712 https://doi.org/10.1111/fn.12712... )	I
A4: CINAHL	2020/ United States	Encouraging Parenting Behaviors That Promote Early Childhood Development Among Caregivers From Low-Income Urban Communities: A Randomized Static Group Comparison Trial of a Primary Care-Based Parenting Program(¹⁵15 Shah R, Isaías A, Schwartz A, Atkins M. Encouraging parenting behaviors that promote early childhood development among caregivers from low-income urban communities: a randomized static group comparison trial of a primary care-based parenting program. Matern Child Health J. 2019;23(1):39-46. https://doi.org/10.1007/s10995-018-2589-8 https://doi.org/10.1007/s10995-018-2589-... )	I
A5: MEDLINE	2019/ China	Using community health workers to deliver a scalable integrated parenting program in rural China: A cluster-randomized controlled trial(¹⁶16 Luo R, Emmers D, Warrinnier N, Rozelle S, Sylvia S. Using community health workers to deliver a scalable integrated parenting program in rural China: a cluster-randomized controlled trial. Soc Sci Med. 2019;239:112545. https://doi.org/10.1016/j.socscimed.2019.112545 https://doi.org/10.1016/j.socscimed.2019... )	I
A6: MEDLINE	2018/ China	Effects of early comprehensive interventions on child neurodevelopment in poor rural areas of China: a moderated mediation analysis(¹⁷17 Liu S, Wang Z, Zhao C, Huang X, Liang X, Wang X, et al. Effects of early comprehensive interventions on child neurodevelopment in poor rural areas of China: a moderated mediation analysis. Public Health. 2018;159:116-122. https://doi.org/10.1016/j.puhe.2018.02.010 https://doi.org/10.1016/j.puhe.2018.02.0... )	IV
A7: MEDLINE	2018/ Uganda	Nutrition, hygiene, and stimulation education to improve growth, cognitive, language, and motor development among infants in Uganda: A cluster-randomized Trial(¹⁸18 Muhoozi GKM, Atukunda P, Diep LM, Mwadime R, Kaaya AN, Skaare AB, et al. Nutrition, hygiene, and stimulation education to improve growth, cognitive, language, and motor development among infants in Uganda: a cluster-randomized trial. Matern Child Nutr. 2018;14(2):1-11. https://doi.org/10.1111/mcn.12527 https://doi.org/10.1111/mcn.12527... )	I
A8: Web of Science	2018/ United States	Comics as a Medium for Parent Health Education: Improving Understanding of Normal 9-Month-Old Developmental Milestones(¹⁹19 Rosas-Blum ED, Granados HM, Mills BW, Leiner M. Comics as a medium for parent health education: improving understanding of normal 9-month-old developmental milestones. Front Pediatr. 2018;6:1-5. https://doi.org/10.3389/fped.2018.00203 https://doi.org/10.3389/fped.2018.00203... )	III
A9: MEDLINE	2016/ Pakistan	Effects of responsive stimulation and nutrition interventions on children’s development and growth at age 4 years in a disadvantaged population in Pakistan: a longitudinal follow-up of a cluster-randomised factorial effectiveness trial(²⁰20 Yousafzai AK, Obradović J, Rasheed MA, Rizvi A, Portilla XA, Tirado-Strayer N, et al. Effects of responsive stimulation and nutrition interventions on children’s development and growth at age 4 years in a disadvantaged population in Pakistan: a longitudinal follow-up of a cluster-randomised factorial effectiveness trial. Lancet Glob Health. 2016;4(8):548-58. https://doi.org/10.1016/S2214-109X(16)30100-0 https://doi.org/10.1016/S2214-109X(16)30... )	I
A10: MEDLINE	2014/ Pakistan	Effect of integrated responsive stimulation and nutrition interventions in the Lady Health Worker programme in Pakistan on child development, growth, and health outcomes: a cluster-randomised factorial effectiveness Trial(²¹21 Yousafzai AK, Rasheed MA, Rizvi A, Armstrong R, Bhutta ZA. Effect of integrated responsive stimulation and nutrition interventions in the Lady Health Worker programme in Pakistan on child development, growth, and health outcomes: a cluster-randomised factorial effectiveness trial. Lancet. 2014;384(9950):1282-93. https://doi.org/10.1016/S0140-6736(14)60455-4 https://doi.org/10.1016/S0140-6736(14)60... )	I
A11: Web of Science	2012/ Banglandesh	Effects of a community-based approach of food and psychosocial stimulation on growth and development of severely malnourished children in Bangladesh: a randomized trial(²²22 Nahar B, Hossain MI, Hamadani JD, Ahmed T, Huda SN, Grantham-McGregor SM, et al. Effects of a community-based approach of food and psychosocial stimulation on growth and development of severely malnourished children in Bangladesh: a randomised trial. Eur J Clin Nutr. 2012;66(6):701-9. https://doi.org/10.1038/ejcn.2012.13 https://doi.org/10.1038/ejcn.2012.13... )	I

Study code	HEALTH LITERACY ASSUMPTIONS
Study code	Access	Understand	Appraise	Apply
A1: MEDLINE	Teaching-learning practices: group work, demonstration, problem-solving. Location: home, community centers or churches. Themes: play, responsive communication, hygiene, nutrition, love and respect.	Self-report from parents.	Self-report of positive appraisal.	Self-report of parental stimulation practices and qualitative interviews.
A2: MEDLINE	Teaching-learning practices: pamphlet and telephone call for parents of children with late signs. Location: childcare. Themes: games and activities to stimulate their children in skill development.	No information.	No information.	No information.
A3: MEDLINE	Teaching-learning practices: site prepared by nurses for primiparous mothers. Videos, motivational messages, possible situations that mothers may come across and how to solve them, in addition to a tab to ask questions of mothers to nurses through the site itself. Location: digital. Themes: nutrition, bathing and care, sleep and safety, and communication with the baby.	Knowledge appraisal with open-ended questions.	No information.	Form before and after the intervention.
A4: CINAHL	Teaching-learning practices: demonstration of examples for using age-specific toys and interactions with children. Feedbacks, with praise and reinforcement of positive behaviors. Location: waiting room and after childcare consultation. Themes: a toy was given to each parent along with a handout with suggestions for recreational activities. Comparison with control group (Centers for Disease Control and Prevention leaflet - CPD 9-Month-Old Developmental Milestones).	No information.	No information.	Self-report of parents, telephone questions about cognitive interactions with children and scales of self-efficacy and confidence in raising children.
A5: MEDLINE	Teaching-learning practices: CHWs trained caregivers in interactive activities with their children and provided guidance on child nutrition. Location: waiting room and, after childcare consultation, home. Themes: CD, food, immunization, hygiene, sleep, among others.	No information.	Telephone interviews so that caregivers can give their feedback on the quality of home visits.	Questionnaire to collect measures of parenting practices and parental beliefs, health promotion and measures of health-promoting eating practices.
A6: MEDLINE	Practical of teach-learning: check-up of child health, monitoring of CD, guidance on food and advice to develop recreational activities to encourage children’s learning. Location: home. Themes: food, development, recreational activities for stimulation and forms of communication.	No information.	No information.	Infant-Toddler Home Observation for Measurement of the Environment (IT-HOME).
A7: MEDLINE	Teaching-learning practices: providing immediate information and demonstrations (practice) of how to play with children. Location: home. Themes: CD (cognition, language, songs, gross motor and fine motor).	Questionnaire for knowledge appraisal.	No information.	No information.
A8: Web of Science	Teaching-learning practices: comic books. Location: childcare. Themes: CD milestones.	Pre- and post-intervention questionnaire, with eight questions aimed at understanding the CD milestones at 9 months in relation to children’s motor, language and social skills.	No information.	Parents reported the use of information obtained through the comic book; told a friend about CD; called the pediatrician to discuss possible delays in their child; and shared the material with relatives.
A9: MEDLINE	Teaching-learning practices: home visits. Location: home. Themes: responsive stimulation, CD and food.	Maternal self-report.	No information.	Observation of Mother-Child Interaction (OMCI) measure.
A10: MEDLINE	Teaching-learning practices: home visits, feedback. Location: home. Themes: feeding (control group), responsive stimulation, CD promotion (intervention group).	No information.	No information.	No information.
A11: Web of Science	Teaching-learning practices: five groups to receive intervention: (1) psychosocial stimulation (PS); (2) food supplementation (FS); (3) PS + FS; (4) clinical control (CC); and (5) hospital control (HC). Location: community clinics, home. Themes: toys, readings, CD milestones, nutritional supplementation.	No information.	No information.	No information.

Article	Cognition/personal-social	Language	Socioemotional	Fine motor	Gross motor	Health literacy
E1	✓(+)	✓(+)	✓(+)			(1)(2)(3)(4)
E2		✓(+)	✓ (=)	✓(+)		(1)
E3	✓	✓	✓	✓	✓	(1)(2)(4)
E4	✓					(1)(4)
E5	✓(+)	✓(=)	✓(=)	✓(=)	✓(=)	(1)(3)(4)
E6	✓(+)	✓(=)	✓(+)	✓(+)	✓(=)	(1)(4)
E7	✓(+)	✓(+)	✓(=)	✓(+)	✓(=)	(1)(2)
E8						(1)(2)(4)
E9	✓(+)	✓(+)	✓(+)	✓(+)	✓(+)	(1)(2)(4)
E10	✓(+)	✓(+)	✓(+)	✓(+)	✓(+)	(1)
E11					✓(=)	(1)

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[1] Corresponding author: Rayara Medeiros Duarte Luz, E-mail: rayara.luz@ufpe.br