Objective:
to map the characteristics of interventions to promote child development that used the Touchpoints Model.
Method:
this is a scoping review, guided by the recommendations of the JBI Reviewer’s Manual, carried out in nine databases, in the gray literature and in the reference list of the selected studies. The research question was “what are the characteristics of interventions with parents/caregivers and children to promote child development, from pregnancy to six years of age, based on the Touchpoints Model?”. Rayyan was used for the selection of studies and a standard form for data extraction. The analysis was carried out descriptively.
Results:
twelve publications were included in the review. Interventions were heterogeneous; concentrated in the period from pregnancy to three years of age; prioritized the dissemination of Touchpoints content according to age, and parenting aspects; most were performed by nurses, in Primary Health Care, and during home visits. Interventions were related to overall development, greater understanding of development and greater interaction with the child.
Conclusion:
studies have shown potential for favorable outcomes for child development and parenting. The variability of interventions made it difficult to map more effective characteristics.
Descriptors:
Child Development; Parenting; Child; Family; Nursing; Review
Objetivo:
mapear las características de las intervenciones para promover el desarrollo infantil que utilizaron el Modelo Touchpoints.
Método:
se trata de una revisión de alcance, guiada por las recomendaciones del JBI Reviewer’s Manual, realizada en nueve bases de datos, en la literatura gris y en la lista de referencias de los estudios seleccionados. La pregunta de investigación fue "¿cuáles son las características de las intervenciones con padres/cuidadores y niños para promover el desarrollo infantil, desde el embarazo hasta los seis años, con base en el Modelo Touchpoints?". Se utilizó el Rayyan para la selección de los estudios y un guión para la extracción de datos. El análisis se realizó de forma descriptiva.
Resultados:
se incluyeron doce publicaciones. Las intervenciones fueron heterogéneas; concentradas en el período comprendido entre el embarazo y los tres años de edad; priorizó la difusión del contenido de los Touchpoints según la edad y los aspectos de parentalidad; la mayoría fueron realizadas por enfermeros, en la Atención Primaria de Salud y durante las visitas domiciliarias. Las intervenciones se relacionaron con el desarrollo general, una mayor comprensión del desarrollo y una mayor interacción con el niño.
Conclusión:
los estudios han demostrado potencial para obtener resultados favorables para el desarrollo infantil y la parentalidad. La variabilidad de las intervenciones dificultó el mapeo de las características más efectivas.”
Descriptores:
Desarrollo Infantil; Responsabilidad Parental; Niño; Familia; Enfermería; Revisión
Objetivo:
mapear as características das intervenções para a promoção do desenvolvimento infantil que utilizaram o Modelo Touchpoints.
Método:
revisão de escopo, guiada pelas recomendações do JBI Reviewer’s Manual realizada em nove bases de dados, na literatura cinzenta e na lista de referências dos estudos selecionados. A questão de pesquisa foi: quais são as características das intervenções com pais/cuidadores e crianças para promoção do desenvolvimento infantil, da gestação até os seis anos de idade, baseadas no Modelo Touchpoints? Foram utilizados o Rayyan, para a seleção dos estudos, e um roteiro, para a extração de dados. A análise foi realizada de forma descritiva.
Resultados:
foram incluídas doze publicações. As intervenções eram heterogêneas; concentradas no período da gestação até os três anos de idade; priorizaram a disseminação de conteúdo dos Touchpoints segundo idade e aspectos de parentalidade; a maioria foi realizada por enfermeiros na Atenção Primária à Saúde e na visita domiciliar. As intervenções foram relacionadas ao desenvolvimento global, à maior compreensão sobre o desenvolvimento e à maior interação com a criança.
Conclusão:
os estudos evidenciaram potencial para resultados favoráveis ao desenvolvimento infantil e à parentalidade. A variabilidade das intervenções dificultou mapear características mais efetivas.
Descritores:
Desenvolvimento Infantil; Parentalidade; Criança; Família; Enfermagem; Revisão
Highlights:
(1) Interventions in the period of pregnancy until the child’s 3 years of life predominated.
(2) Interventions by nurses in Primary Care and home visits predominated.
(3) The interventions were mostly delivered individually and face-to-face.
(4) The participating parents had a greater understanding of child development.
(5) There was more interaction with the child, use of toys and learning materials.
Introduction
Early childhood is defined as the first six years of a child’s life, and has been recognized as a strategic moment to provide opportunities for the child’s biological, psychological, cognitive and social development ( 11. Daelmans B, Manji SA, Raina N. Nurturing Care for Early Childhood Development: Global Perspective and Guidance. Indian Pediatr [Internet]. 2021 [cited 2023 Jan 27];58(Suppl 1):S11-S15. Available from: https://www.indianpediatrics.net/supplOct2021/S11.pdf
https://www.indianpediatrics.net/supplOc...
). The implementation of interventions to promote development in this period of life has been a national and international priority. The Nurturing Care strategy, launched by the World Health Organization (WHO) in 2018 as a set of global actions aimed at responsive care for children, points to child development (CD) as an important aspect to achieve the Sustainable Development Goals (SDG- 2030) ( 22. Ministério da Saúde (BR), Secretaria de Atenção à Saúde, Departamento de Ações Programáticas Estratégicas. Guia para orientar ações intersetoriais na primeira infância [Internet]. Brasília: Ministério da Saúde; 2018 [cited 2023 Jan 23]. Available from: https://undime.org.br/uploads/documentos/phprjdlba_5e3064022386d.pdf
https://undime.org.br/uploads/documentos...
- 33. World Health Organization. United Nations Children’s Fund, World Bank Group. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential [Internet]. Geneva: World Health Organization; 2018 [cited 2023 Jan 25]. Available from: https://apps.who.int/iris/bitstream/handle/10665/272603/9789241514064-eng.pdf
https://apps.who.int/iris/bitstream/hand...
).
Interventions aimed at CD have expanded knowledge about developmental science, and need to be implemented in a multisectoral way and anchored in nurturing care. The home environment and childcare environments represent a powerful and immediate nurturing context for children to reach their full developmental potential ( 11. Daelmans B, Manji SA, Raina N. Nurturing Care for Early Childhood Development: Global Perspective and Guidance. Indian Pediatr [Internet]. 2021 [cited 2023 Jan 27];58(Suppl 1):S11-S15. Available from: https://www.indianpediatrics.net/supplOct2021/S11.pdf
https://www.indianpediatrics.net/supplOc...
).
In this context, evidence demonstrates that parenting interventions are necessary to promote healthy CD, being able to improve parental knowledge, parenting practices and interactions between parents and children ( 44. Jeong J, Franchett EE, Ramos CV, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Med. 2021;18(5):e1003602. https://doi.org/10.1371/journal.pmed.1003602
https://doi.org/10.1371/journal.pmed.100...
5. Zhang L, Ssewanyana D, Martin MC, Lye S, Moran G, Abubakar A, et al. Supporting Child Development Through Parenting Interventions in Low- to Middle-Income Countries: An Updated Systematic Review. Front Public Health. 2021;9:671988. https://doi.org/10.3389/fpubh.2021.671988
https://doi.org/10.3389/fpubh.2021.67198...
- 66. Li Y, Li S, Tang L, Bai Y. The effect of ECD program on the caregiver’s parenting knowledge, attitudes, and practices: based on a cluster-randomized controlled trial in economically vulnerable areas of China. BMC Public Health. 2022;22(1958). https://doi.org/10.1186/s12889-022-14268-5
https://doi.org/10.1186/s12889-022-14268...
). Parenting interventions also demonstrate positive effects on children’s cognitive, language, motor, socio-emotional and attachment development, results that are seen in low-, middle- and high-income countries ( 44. Jeong J, Franchett EE, Ramos CV, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Med. 2021;18(5):e1003602. https://doi.org/10.1371/journal.pmed.1003602
https://doi.org/10.1371/journal.pmed.100...
).
Programs focused on CD have improved child care, but there is a predominance of vertical interventions and family education, with scarce use of the theoretical framework to support them ( 77. Luz RMD, Marinho DCB, Lima APE, Coriolano-Marinus MWL. Educational interventions in child development and health literacy assumptions: an integrative review. Rev Bras Enferm. 2023;76(1):e20220116. https://doi.org/10.1590/0034-7167-2022-0116pt
https://doi.org/10.1590/0034-7167-2022-0...
).
A theoretical reference that has not yet been tested in the Brazilian reality and that aims at an intersectoral practice and with a focus on parental competence is the Touchpoints Model (TP). Created by Thomas Berry Brazelton, the TP Model is an approach to child development that is grounded in cultural sensitivity, reflective practice, and systems theory ( 88. Sparrow J. Reflective practice in organizational learning, cultural self-understanding, and community self-strengthening. Infant Ment Health J. 2016;37(6). https://doi.org/10.1002/imhj.21602
https://doi.org/10.1002/imhj.21602...
). This model establishes a way of caring for families by understanding the development and supporting family relationships. By adopting a new concept of child development - as non-linear, characterized by regressions, spurts and pauses - it understands that child behavior regressions can generate disorganization in the family system and be disruptive ( 99. Brazelton TB, Sparrow J. The Touchpoints Model of Development [Internet]. Boston: Brazelton Touchpoints Center; 2015 [cited 2022 Dec 20]. Available from: https://www.brazeltontouchpoints.org/wp-content/uploads/2011/09/Touchpoints-Model-of-Development-April-2015.pdf
https://www.brazeltontouchpoints.org/wp-...
). The model addresses 15 Touchpoints, from prenatal care to 6 years old, which are periods of regression and disorganization of the child who is learning a new skill ( 99. Brazelton TB, Sparrow J. The Touchpoints Model of Development [Internet]. Boston: Brazelton Touchpoints Center; 2015 [cited 2022 Dec 20]. Available from: https://www.brazeltontouchpoints.org/wp-content/uploads/2011/09/Touchpoints-Model-of-Development-April-2015.pdf
https://www.brazeltontouchpoints.org/wp-...
).
In this approach, the family needs to be supported in a web of intersectoral relationships through an articulated work between health service professionals, educational and social sectors. The model seeks a paradigm shift to respond to the needs of children and their families through an anticipatory, preventive and collaborative orientation based on the experiential learning of parents through observation of their children’s behavior, and is based on eight principles, which are guides for professional work ( 99. Brazelton TB, Sparrow J. The Touchpoints Model of Development [Internet]. Boston: Brazelton Touchpoints Center; 2015 [cited 2022 Dec 20]. Available from: https://www.brazeltontouchpoints.org/wp-content/uploads/2011/09/Touchpoints-Model-of-Development-April-2015.pdf
https://www.brazeltontouchpoints.org/wp-...
).
In the field of interventions aimed at child development with parental emphasis, there is limited evidence, so there is a need to evaluate existing interventions, as well as to develop new interventions to optimize the offer to families ( 1010. Draper CE, Klingberg S, Wrottesley SV, Milner K, Fisher J, Lakes KD, et al. Interventions to promote development in the next 1000 days: A mapping review. Child Care Health Dev. 2022. https://doi.org/10.1111/cch.13084
https://doi.org/10.1111/cch.13084...
).
With the need to explore this model and raise aspects that contribute to the proposition of new interventions, this study aimed to map the characteristics of interventions for the promotion of child development that used the TP Model, due to its potential to foster a care practice advanced in different care contexts for Brazilian children and families. No review on the subject was found in a previous search in the JBI database, the International Prospective Register of Systematic Reviews (Prospero), Cochrane Database of Systematic Reviews and the Open Science Framework (OSF) platform.
Method
Study type
This is a scoping review. This study was developed and structured according to the recommendations the JBI ( 1111. Aromataris E, Munn Z. JBI Manual for Evidence Synthesis. Adelaide: JBI; 2020. https://doi.org/10.46658/JBIMES-20-01
https://doi.org/10.46658/JBIMES-20-01...
) and the checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) ( 1212. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac, D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467-73. https://doi.org/10.7326/M18-0850
https://doi.org/10.7326/M18-0850...
). The review protocol was registered on the OSF platform ( https://doi.org/10.17605/OSF.IO/RBSG4).
For the development of the study, the following methodological steps were taken: formulation of the research question, using the Acronym PCC-Population, Concept and Context; definition of inclusion and exclusion criteria, using the PCC and defining the types of studies and sources; elaboration of a search strategy; identification of databases; search and selection of studies; data extraction and analysis; and construction of the report ( 1111. Aromataris E, Munn Z. JBI Manual for Evidence Synthesis. Adelaide: JBI; 2020. https://doi.org/10.46658/JBIMES-20-01
https://doi.org/10.46658/JBIMES-20-01...
).
Setting
The review was carried out in eight databases: Public MedLars (PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Psychological Information Database (PsycINFO), Latin American and Caribbean Literature in Health Sciences (LILACS), Database in Nursing (BDENF), Excerpta Medica Database (EMBASE), Scopus and Web of Science. It also includes Google Scholar, DART-Europe E-theses Portal, Brazilian Digital Library of Theses and Dissertations of the Brazilian Institute of Information in Science and Technology (IBICT), Theses CAPES, Cybertesis, EthOS and Theses Open Thesis, the Brazelton Touchpoints Center website and the Brazelton/Gomes Pedro Foundation website, as sources of grey literature.
Study period
It was carried out between October 2022 and January 2023.
Selection criteria
The review question was: “what are the characteristics of interventions with parents/caregivers and children to promote child development, from pregnancy to six years of age, based on the Touchpoints Model?” The PCC Acronym ( 1111. Aromataris E, Munn Z. JBI Manual for Evidence Synthesis. Adelaide: JBI; 2020. https://doi.org/10.46658/JBIMES-20-01
https://doi.org/10.46658/JBIMES-20-01...
) was defined as: P- Parents/caregivers and children; C- Interventions to promote child development that use the Touchpoints Model; C- All contexts of child care.
Studies that responded to the research objective and the review question were included, reporting on an intervention aimed at promoting child development, from pregnancy to the child’s six years of age, and based on the Touchpoints Model. It could be an intervention already applied, or its protocol/design, and in any context of care - health, education, social assistance or home services.
Interventions were defined as activities carried out as planned, with the aim of producing a positive effect ( 44. Jeong J, Franchett EE, Ramos CV, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Med. 2021;18(5):e1003602. https://doi.org/10.1371/journal.pmed.1003602
https://doi.org/10.1371/journal.pmed.100...
, 1313. Ahun MN, Aboud F, Wamboldt C, Yousafzai AK. Implementation of UNICEF and WHO’s care for child development package: Lessons from a global review and key informant interviews. Front Public Health. 2023;11:1140843. https://doi.org/10.3389/fpubh.2023.1140843
https://doi.org/10.3389/fpubh.2023.11408...
), whether policies, programs or individual practices. The gestation period until the child`s 6 years of age has been the focus of programs and policies in Brazil ( 1414. Brasil. Lei 13.557, de 8 de março de 2016. Dispõe sobre as políticas públicas para a primeira infância e dá outras providências [Internet]. Diário Oficial da União. 2016 Mar 09 [cited 2023 Jan 12];46 (seção 1). Available from: http://www.planalto.gov.br/ccivil_03/_ato2015-2018/2016/lei/l13257.htm
http://www.planalto.gov.br/ccivil_03/_at...
) and is the period covered by the TP Model ( 99. Brazelton TB, Sparrow J. The Touchpoints Model of Development [Internet]. Boston: Brazelton Touchpoints Center; 2015 [cited 2022 Dec 20]. Available from: https://www.brazeltontouchpoints.org/wp-content/uploads/2011/09/Touchpoints-Model-of-Development-April-2015.pdf
https://www.brazeltontouchpoints.org/wp-...
).
Studies that did not include the population, concept and context of interest, or that did not report the application of an intervention, such as editorials, letters to the editor and opinion articles, were excluded; in addition to incomplete studies that were not located in full after trying to contact the Brazelton Touchpoints Center and the Brazelton/Gomes-Pedro Foundation. Duplicate documents were considered only once.
There was no time, geographic or language restriction.
Study variables
The study variables were those recommended by the JBI ( 1111. Aromataris E, Munn Z. JBI Manual for Evidence Synthesis. Adelaide: JBI; 2020. https://doi.org/10.46658/JBIMES-20-01
https://doi.org/10.46658/JBIMES-20-01...
): authors; country; year of publication; kind of study; goal; population; context in which the interventions were carried out; plus those recommended by the Template for Intervention Description and Replication (TIDier) ( 1515. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ Open. 2014;348:g1687. https://doi.org/10.1136/bmj.g1687
https://doi.org/10.1136/bmj.g1687...
): theoretical framework used; professional responsible for the intervention; intervention content; materials and strategies used; delivery mode; volume (number of times, duration and period); intervention results/effects.
Instruments used for data collection
The standard form used for data extraction was prepared in Microsoft Word ® software based on the items that must compose the interventions according to the TIDieR ( 1515. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ Open. 2014;348:g1687. https://doi.org/10.1136/bmj.g1687
https://doi.org/10.1136/bmj.g1687...
).
TIDieR aims to improve the complete description of interventions to allow their replicability. It contemplates the following items of an intervention: why (theory); what and which (materials and strategies); who did it (professional); how (in person, via internet or telephone, in groups or individually); where (place where it occurred); when and how much (volume - number of times and what period of time); how well (whether adherence or fidelity was assessed, how and by whom; whether strategies were used to maintain and/or improve the intervention). Fidelity refers to the degree to which an intervention was delivered and received by participants as planned ( 1515. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ Open. 2014;348:g1687. https://doi.org/10.1136/bmj.g1687
https://doi.org/10.1136/bmj.g1687...
).
The form was completed by two reviewers and a consensus was reached between the collected information and the grouping of information in a single table.
Data collection
One of the reviewers was trained by JBI Brazil to conduct reviews and shared the guidelines learned with the other reviewer before starting the study.
Searches in the databases were carried out on October 12, 2022 through registration in the Portal de Periódicos (Journals Portal) of the Coordination for the Improvement of Higher Education Personnel (CAPES), via the Federated Academic Community (CAFe). Thesis databases and institutional websites were accessed on the aforementioned date via Google search engine. The definition of the databases and the search strategy was carried out with the help of a librarian. The selected descriptors were combined according to the characteristics of each database and search engine.
The selected databases and respective search strategies are shown in Figure 1.
The search on the Brazelton Touchpoints Center and Brazelton/Gomes Pedro Foundation sites was carried out without the need for a search strategy, since all publications refer to the model. A hand search of references of the studies selected in the research was also carried out.
The results obtained from all search platforms were exported to Rayyan ® (online software used for selecting studies in knowledge synthesis methods) to exclude duplicate studies and carry out the selection of searches. Two reviewers independently assessed titles and abstracts, and eligible studies were assessed in full. In case of disagreement, a third reviewer was called to settle.
Data processing and analysis
The data extraction form prepared in Microsoft Word ® software allowed the synthesis, interpretation of data and numerical analysis of the distribution of studies, being represented by a narrative summary of the results, which were related to the research objective and question. For the description of the review, PRISMA-ScR was used.
Ethical aspects
There was no need to submit the study to the Research Ethics Committee.
Results
A total of 251 studies were identified, excluding 46 duplicates via Rayyan ®, leaving 205 studies. A total of 190 studies were excluded by reading the title and abstract, and another three exclusion during the full-texts reading, two of them for not having been located and one for not contemplating the study population. Thus, 12 studies were included in this review: five scientific articles, one book chapter, three dissertations, and three theses ( Figure 2).
In three of the included studies, the intervention has not yet been applied ( 1616. Fareleira F, Xavier MR, Velte J, Teixeira A, Martins C. Parenting, child development and primary care-‘Crescer em Grande!’ intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol. BMJ Open. 2021;11:11(5):e042043. https://doi.org/10.1136/bmjopen-2020-042043
https://doi.org/10.1136/bmjopen-2020-042...
17. Martins PAC. Cuidar para a promoção do desenvolvimento infantil [Thesis]. Lisboa: Escola Superior de Enfermagem de Lisboa; 2017 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.26/18990
http://hdl.handle.net/10400.26/18990...
- 1818. DiCero KE. Small Circles: A Parenting Adolescent Prevention and Intervention Program for Young Families in the Teen Parent Shelter Program in Massachusetts [Dissertation]. Newton, MA: William James College; 2018 [cited 2023 Feb 21]. Available from: https://www.proquest.com/docview/2171058719?pq-origsite=gscholar&fromopenview=true
https://www.proquest.com/docview/2171058...
), therefore, there are no results/effects described.
Most interventions have been carried out in the last twenty years in the United States ( 1818. DiCero KE. Small Circles: A Parenting Adolescent Prevention and Intervention Program for Young Families in the Teen Parent Shelter Program in Massachusetts [Dissertation]. Newton, MA: William James College; 2018 [cited 2023 Feb 21]. Available from: https://www.proquest.com/docview/2171058719?pq-origsite=gscholar&fromopenview=true
https://www.proquest.com/docview/2171058...
19. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
20. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
21. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
- 2222. Brandt K, Murphy MEJ. Touchpoints in a nurse home visiting program. In: Lester BM, Sparrow JD. Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton. Nova Jersey, NJ: John Wiley & Sons; 2010. ) and in Portugal ( 1616. Fareleira F, Xavier MR, Velte J, Teixeira A, Martins C. Parenting, child development and primary care-‘Crescer em Grande!’ intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol. BMJ Open. 2021;11:11(5):e042043. https://doi.org/10.1136/bmjopen-2020-042043
https://doi.org/10.1136/bmjopen-2020-042...
- 1717. Martins PAC. Cuidar para a promoção do desenvolvimento infantil [Thesis]. Lisboa: Escola Superior de Enfermagem de Lisboa; 2017 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.26/18990
http://hdl.handle.net/10400.26/18990...
, 2323. Vilaça SPP. Desenvolvimento infantil e capacitação materna como resultado da aplicação do Programa de Empowerment Parental para o Desenvolvimento Infantil (PEPDI) [Dissertation]. Braga: Universidade do Minho; 2013 [cited 2023 Feb 21]. Available from: https://hdl.handle.net/1822/24370
https://hdl.handle.net/1822/24370...
24. Pinto RMP. O impacto do modelo Touchpoints nas representações do educador [Thesis]. Lisboa: Instituto Politécnico de Lisboa; 2013 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.21/3270
http://hdl.handle.net/10400.21/3270...
25. Castelão ASD. A construção de uma parentalidade confiante: influência do Modelo Touchpoints na relação educador-família [Thesis]. Lisboa: Instituto Politécnico de Lisboa; 2013 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.21/3261
http://hdl.handle.net/10400.21/3261...
- 2626. Soares HM. The contribution of nursing intervention in the study of touchpoints model’s efficacy [Dissertation]. Porto: Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto; 2016. ), in Primary Care Services ( 1616. Fareleira F, Xavier MR, Velte J, Teixeira A, Martins C. Parenting, child development and primary care-‘Crescer em Grande!’ intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol. BMJ Open. 2021;11:11(5):e042043. https://doi.org/10.1136/bmjopen-2020-042043
https://doi.org/10.1136/bmjopen-2020-042...
- 1717. Martins PAC. Cuidar para a promoção do desenvolvimento infantil [Thesis]. Lisboa: Escola Superior de Enfermagem de Lisboa; 2017 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.26/18990
http://hdl.handle.net/10400.26/18990...
, 2020. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
- 2121. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
, 2626. Soares HM. The contribution of nursing intervention in the study of touchpoints model’s efficacy [Dissertation]. Porto: Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto; 2016. ), in school ( 1919. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
), in shelters ( 1818. DiCero KE. Small Circles: A Parenting Adolescent Prevention and Intervention Program for Young Families in the Teen Parent Shelter Program in Massachusetts [Dissertation]. Newton, MA: William James College; 2018 [cited 2023 Feb 21]. Available from: https://www.proquest.com/docview/2171058719?pq-origsite=gscholar&fromopenview=true
https://www.proquest.com/docview/2171058...
), in hospitals and maternity ( 2323. Vilaça SPP. Desenvolvimento infantil e capacitação materna como resultado da aplicação do Programa de Empowerment Parental para o Desenvolvimento Infantil (PEPDI) [Dissertation]. Braga: Universidade do Minho; 2013 [cited 2023 Feb 21]. Available from: https://hdl.handle.net/1822/24370
https://hdl.handle.net/1822/24370...
, 2727. Shimpuku Y, Iida M, Hirose N, Tada K, Tsuji T, Kubota A, et al. Prenatal education program decreases postpartum depression and increases maternal confidence: a longitudinal quasi-experimental study in urban Japan. Women Birth. 2022;35(1):e456–e46. https://doi.org/10.1016/j.wombi.2021.11.004
https://doi.org/10.1016/j.wombi.2021.11....
), in the families’ homes ( 2020. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
21. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
- 2222. Brandt K, Murphy MEJ. Touchpoints in a nurse home visiting program. In: Lester BM, Sparrow JD. Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton. Nova Jersey, NJ: John Wiley & Sons; 2010. ) and in daycare centers ( 2424. Pinto RMP. O impacto do modelo Touchpoints nas representações do educador [Thesis]. Lisboa: Instituto Politécnico de Lisboa; 2013 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.21/3270
http://hdl.handle.net/10400.21/3270...
- 2525. Castelão ASD. A construção de uma parentalidade confiante: influência do Modelo Touchpoints na relação educador-família [Thesis]. Lisboa: Instituto Politécnico de Lisboa; 2013 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.21/3261
http://hdl.handle.net/10400.21/3261...
). The identification of the studies is presented in Figure 3.
Flowchart of the article selection process for the adapted scoping review of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). São Paulo, SP, Brazil, 2023
The nurse was the professional who performed the intervention in six studies ( 1919. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
20. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
21. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
22. Brandt K, Murphy MEJ. Touchpoints in a nurse home visiting program. In: Lester BM, Sparrow JD. Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton. Nova Jersey, NJ: John Wiley & Sons; 2010. - 2323. Vilaça SPP. Desenvolvimento infantil e capacitação materna como resultado da aplicação do Programa de Empowerment Parental para o Desenvolvimento Infantil (PEPDI) [Dissertation]. Braga: Universidade do Minho; 2013 [cited 2023 Feb 21]. Available from: https://hdl.handle.net/1822/24370
https://hdl.handle.net/1822/24370...
, 2626. Soares HM. The contribution of nursing intervention in the study of touchpoints model’s efficacy [Dissertation]. Porto: Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto; 2016. ), in one of them together with researchers ( 1919. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
) and, in another, with physicians ( 2121. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
); will also be the professional responsible for two of the interventions not yet carried out ( 1616. Fareleira F, Xavier MR, Velte J, Teixeira A, Martins C. Parenting, child development and primary care-‘Crescer em Grande!’ intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol. BMJ Open. 2021;11:11(5):e042043. https://doi.org/10.1136/bmjopen-2020-042043
https://doi.org/10.1136/bmjopen-2020-042...
- 1717. Martins PAC. Cuidar para a promoção do desenvolvimento infantil [Thesis]. Lisboa: Escola Superior de Enfermagem de Lisboa; 2017 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.26/18990
http://hdl.handle.net/10400.26/18990...
). The other responsible professionals were physicians ( 1616. Fareleira F, Xavier MR, Velte J, Teixeira A, Martins C. Parenting, child development and primary care-‘Crescer em Grande!’ intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol. BMJ Open. 2021;11:11(5):e042043. https://doi.org/10.1136/bmjopen-2020-042043
https://doi.org/10.1136/bmjopen-2020-042...
- 1717. Martins PAC. Cuidar para a promoção do desenvolvimento infantil [Thesis]. Lisboa: Escola Superior de Enfermagem de Lisboa; 2017 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.26/18990
http://hdl.handle.net/10400.26/18990...
, 2121. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
), researchers ( 1616. Fareleira F, Xavier MR, Velte J, Teixeira A, Martins C. Parenting, child development and primary care-‘Crescer em Grande!’ intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol. BMJ Open. 2021;11:11(5):e042043. https://doi.org/10.1136/bmjopen-2020-042043
https://doi.org/10.1136/bmjopen-2020-042...
, 1919. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
, 2727. Shimpuku Y, Iida M, Hirose N, Tada K, Tsuji T, Kubota A, et al. Prenatal education program decreases postpartum depression and increases maternal confidence: a longitudinal quasi-experimental study in urban Japan. Women Birth. 2022;35(1):e456–e46. https://doi.org/10.1016/j.wombi.2021.11.004
https://doi.org/10.1016/j.wombi.2021.11....
), educators ( 2020. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
, 2424. Pinto RMP. O impacto do modelo Touchpoints nas representações do educador [Thesis]. Lisboa: Instituto Politécnico de Lisboa; 2013 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.21/3270
http://hdl.handle.net/10400.21/3270...
- 2525. Castelão ASD. A construção de uma parentalidade confiante: influência do Modelo Touchpoints na relação educador-família [Thesis]. Lisboa: Instituto Politécnico de Lisboa; 2013 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.21/3261
http://hdl.handle.net/10400.21/3261...
) and social worker ( 2020. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
).
The period of the intervention, duration and frequency differed between studies. Two of the studies carried out the intervention in person, in groups ( 1919. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
, 2727. Shimpuku Y, Iida M, Hirose N, Tada K, Tsuji T, Kubota A, et al. Prenatal education program decreases postpartum depression and increases maternal confidence: a longitudinal quasi-experimental study in urban Japan. Women Birth. 2022;35(1):e456–e46. https://doi.org/10.1016/j.wombi.2021.11.004
https://doi.org/10.1016/j.wombi.2021.11....
), six performed face-to-face and individually ( 2121. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
22. Brandt K, Murphy MEJ. Touchpoints in a nurse home visiting program. In: Lester BM, Sparrow JD. Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton. Nova Jersey, NJ: John Wiley & Sons; 2010.
23. Vilaça SPP. Desenvolvimento infantil e capacitação materna como resultado da aplicação do Programa de Empowerment Parental para o Desenvolvimento Infantil (PEPDI) [Dissertation]. Braga: Universidade do Minho; 2013 [cited 2023 Feb 21]. Available from: https://hdl.handle.net/1822/24370
https://hdl.handle.net/1822/24370...
24. Pinto RMP. O impacto do modelo Touchpoints nas representações do educador [Thesis]. Lisboa: Instituto Politécnico de Lisboa; 2013 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.21/3270
http://hdl.handle.net/10400.21/3270...
25. Castelão ASD. A construção de uma parentalidade confiante: influência do Modelo Touchpoints na relação educador-família [Thesis]. Lisboa: Instituto Politécnico de Lisboa; 2013 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.21/3261
http://hdl.handle.net/10400.21/3261...
- 2626. Soares HM. The contribution of nursing intervention in the study of touchpoints model’s efficacy [Dissertation]. Porto: Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto; 2016. ), and one study carried out in a hybrid format, with face-to-face meetings and telephone contact for follow-up ( 2020. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
). Of the interventions not applied, one will be in a group ( 1818. DiCero KE. Small Circles: A Parenting Adolescent Prevention and Intervention Program for Young Families in the Teen Parent Shelter Program in Massachusetts [Dissertation]. Newton, MA: William James College; 2018 [cited 2023 Feb 21]. Available from: https://www.proquest.com/docview/2171058719?pq-origsite=gscholar&fromopenview=true
https://www.proquest.com/docview/2171058...
) and two will occur individually ( 1717. Martins PAC. Cuidar para a promoção do desenvolvimento infantil [Thesis]. Lisboa: Escola Superior de Enfermagem de Lisboa; 2017 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.26/18990
http://hdl.handle.net/10400.26/18990...
- 1818. DiCero KE. Small Circles: A Parenting Adolescent Prevention and Intervention Program for Young Families in the Teen Parent Shelter Program in Massachusetts [Dissertation]. Newton, MA: William James College; 2018 [cited 2023 Feb 21]. Available from: https://www.proquest.com/docview/2171058719?pq-origsite=gscholar&fromopenview=true
https://www.proquest.com/docview/2171058...
).
The main contents worked on in the interventions were the experience of the parents during pregnancy and labor ( 1616. Fareleira F, Xavier MR, Velte J, Teixeira A, Martins C. Parenting, child development and primary care-‘Crescer em Grande!’ intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol. BMJ Open. 2021;11:11(5):e042043. https://doi.org/10.1136/bmjopen-2020-042043
https://doi.org/10.1136/bmjopen-2020-042...
- 1717. Martins PAC. Cuidar para a promoção do desenvolvimento infantil [Thesis]. Lisboa: Escola Superior de Enfermagem de Lisboa; 2017 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.26/18990
http://hdl.handle.net/10400.26/18990...
, 1919. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
, 2121. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
- 2222. Brandt K, Murphy MEJ. Touchpoints in a nurse home visiting program. In: Lester BM, Sparrow JD. Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton. Nova Jersey, NJ: John Wiley & Sons; 2010. , 2424. Pinto RMP. O impacto do modelo Touchpoints nas representações do educador [Thesis]. Lisboa: Instituto Politécnico de Lisboa; 2013 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.21/3270
http://hdl.handle.net/10400.21/3270...
, 2626. Soares HM. The contribution of nursing intervention in the study of touchpoints model’s efficacy [Dissertation]. Porto: Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto; 2016. ); the change in the relationship with the family after the baby’s birth; the difficulty of fatherhood; the child’s temperament ( 1919. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
); strengthening the parent-health-professional relationship with a focus on child development, parent-child interaction, appropriate behaviors for the child’s age; increased knowledge of families and use of community resources ( 2020. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
- 2121. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
, 2323. Vilaça SPP. Desenvolvimento infantil e capacitação materna como resultado da aplicação do Programa de Empowerment Parental para o Desenvolvimento Infantil (PEPDI) [Dissertation]. Braga: Universidade do Minho; 2013 [cited 2023 Feb 21]. Available from: https://hdl.handle.net/1822/24370
https://hdl.handle.net/1822/24370...
, 2727. Shimpuku Y, Iida M, Hirose N, Tada K, Tsuji T, Kubota A, et al. Prenatal education program decreases postpartum depression and increases maternal confidence: a longitudinal quasi-experimental study in urban Japan. Women Birth. 2022;35(1):e456–e46. https://doi.org/10.1016/j.wombi.2021.11.004
https://doi.org/10.1016/j.wombi.2021.11....
); strategies for developing parental sensitivity and understanding of child development ( 1717. Martins PAC. Cuidar para a promoção do desenvolvimento infantil [Thesis]. Lisboa: Escola Superior de Enfermagem de Lisboa; 2017 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.26/18990
http://hdl.handle.net/10400.26/18990...
, 2020. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
- 2121. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
); anticipatory care adjusted to key ages based on the Touchpoints Model ( 1616. Fareleira F, Xavier MR, Velte J, Teixeira A, Martins C. Parenting, child development and primary care-‘Crescer em Grande!’ intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol. BMJ Open. 2021;11:11(5):e042043. https://doi.org/10.1136/bmjopen-2020-042043
https://doi.org/10.1136/bmjopen-2020-042...
17. Martins PAC. Cuidar para a promoção do desenvolvimento infantil [Thesis]. Lisboa: Escola Superior de Enfermagem de Lisboa; 2017 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.26/18990
http://hdl.handle.net/10400.26/18990...
18. DiCero KE. Small Circles: A Parenting Adolescent Prevention and Intervention Program for Young Families in the Teen Parent Shelter Program in Massachusetts [Dissertation]. Newton, MA: William James College; 2018 [cited 2023 Feb 21]. Available from: https://www.proquest.com/docview/2171058719?pq-origsite=gscholar&fromopenview=true
https://www.proquest.com/docview/2171058...
19. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
20. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
- 2121. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
, 2323. Vilaça SPP. Desenvolvimento infantil e capacitação materna como resultado da aplicação do Programa de Empowerment Parental para o Desenvolvimento Infantil (PEPDI) [Dissertation]. Braga: Universidade do Minho; 2013 [cited 2023 Feb 21]. Available from: https://hdl.handle.net/1822/24370
https://hdl.handle.net/1822/24370...
); child’s developmental skills ( 2121. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
, 2626. Soares HM. The contribution of nursing intervention in the study of touchpoints model’s efficacy [Dissertation]. Porto: Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto; 2016. ); situations predictable to occur in relation to development, challenges and parenting concerns ( 1818. DiCero KE. Small Circles: A Parenting Adolescent Prevention and Intervention Program for Young Families in the Teen Parent Shelter Program in Massachusetts [Dissertation]. Newton, MA: William James College; 2018 [cited 2023 Feb 21]. Available from: https://www.proquest.com/docview/2171058719?pq-origsite=gscholar&fromopenview=true
https://www.proquest.com/docview/2171058...
, 2323. Vilaça SPP. Desenvolvimento infantil e capacitação materna como resultado da aplicação do Programa de Empowerment Parental para o Desenvolvimento Infantil (PEPDI) [Dissertation]. Braga: Universidade do Minho; 2013 [cited 2023 Feb 21]. Available from: https://hdl.handle.net/1822/24370
https://hdl.handle.net/1822/24370...
).
Changes in the intervention during the research were described in only one study, with the inclusion of night classes for spouses and boyfriends at the request of mothers ( 1919. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
). Two studies offered incentives for participation, such as toys and books, calendars, certificates and gifts from grocery stores ( 2020. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
) and $50 shopping vouchers ( 2121. Guthrie KF, Gaziano C, Gaziano EP. Toward Better Beginnings: Enhancing Healthy Child Development and Parent-Child Relationships in a High-Risk Population. Home Health Care Manag Pract. 2009;21(2):99-108. https://doi.org/10.1177/1084822308322650
https://doi.org/10.1177/1084822308322650...
). Adherence to the intervention was described in only one study, which did not describe the strategies used to maintain or improve adherence ( 1919. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
). Figure 4 details the characteristics of the interventions.
Discussion
Intervention programs are considered essential for understanding the behavior and needs of children by parents, promoting parenting competence, learning about child development and greater stimulation of children ( 44. Jeong J, Franchett EE, Ramos CV, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Med. 2021;18(5):e1003602. https://doi.org/10.1371/journal.pmed.1003602
https://doi.org/10.1371/journal.pmed.100...
, 66. Li Y, Li S, Tang L, Bai Y. The effect of ECD program on the caregiver’s parenting knowledge, attitudes, and practices: based on a cluster-randomized controlled trial in economically vulnerable areas of China. BMC Public Health. 2022;22(1958). https://doi.org/10.1186/s12889-022-14268-5
https://doi.org/10.1186/s12889-022-14268...
, 2828. Gondim EC, Scorzafave LGDS, Santos DD, Henrique NCP, Pereira FM, Mello DF. Matching between maternal knowledge about infant development and care for children under one year old. Rev. Latino-Am. Enfermagem. 2022;30:e3675. https://doi.org/10.1590/1518-8345.5967.3675
https://doi.org/10.1590/1518-8345.5967.3...
29. Goldfeld S, Bryson H, Mensah F, Price A, Gold L, Orsini F, et al. Nurse home visiting to improve child and maternal outcomes: 5-year follow-up of an Australian randomised controlled trial. PLoS One. 2022;17(11):e0277773. https://doi.org/10.1371/journal.pone.0277773
https://doi.org/10.1371/journal.pone.027...
- 3030. Luoto JE, Lopez GI, 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...
). Thus, this review mapped the characteristics and effects of interventions that used the Touchpoints Model with emphasis on the essential components described in TIDieR ( 1515. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ Open. 2014;348:g1687. https://doi.org/10.1136/bmj.g1687
https://doi.org/10.1136/bmj.g1687...
). By mapping the complete description of the interventions, it becomes possible to identify characteristics that provide the achievement of favorable results, to implement them, replicate them, or develop new studies based on the findings.
There was a concentration of production in the United States, possibly because it is the country in which the model was created, and because of the existence of the Brazelton Touchpoints Center (BTC), which promotes training for professionals ( 99. Brazelton TB, Sparrow J. The Touchpoints Model of Development [Internet]. Boston: Brazelton Touchpoints Center; 2015 [cited 2022 Dec 20]. Available from: https://www.brazeltontouchpoints.org/wp-content/uploads/2011/09/Touchpoints-Model-of-Development-April-2015.pdf
https://www.brazeltontouchpoints.org/wp-...
), and in Portugal, for hosting a BTC partner foundation, the Brazelton/Gomes Pedro Foundation, which works to disseminate a clinical intervention paradigm based on the model ( 3131. Fundação Brazelton Gomes-Pedro [Homepage]. c2023 [cited 2023 Jan 25]. Available from: https://www.fundacaobgp.com/pt
https://www.fundacaobgp.com/pt...
).
The first reflection about the studies is about the variability of interventions with regard to content, strategies and volume. Figure 4 shows that there is repetition of only one intervention ( 2525. Castelão ASD. A construção de uma parentalidade confiante: influência do Modelo Touchpoints na relação educador-família [Thesis]. Lisboa: Instituto Politécnico de Lisboa; 2013 [cited 2023 Feb 21]. Available from: http://hdl.handle.net/10400.21/3261
http://hdl.handle.net/10400.21/3261...
- 2626. Soares HM. The contribution of nursing intervention in the study of touchpoints model’s efficacy [Dissertation]. Porto: Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto; 2016. ). In the others, although some elements are recurrent, the complete design of each one is always new. This occurs because they are designed according to research objectives, which focus on specific aspects of expected results. It is observed, therefore, that there was no particular intervention tested in multiple aspects, even though all were based on the Touchpoints model. The discussion on the constituent elements of the interventions, below, sheds light on aspects that can contribute to the understanding of such interventions, based on common points and variability.
The predominance of nurses as responsible for applying most interventions is in line with this professional’s profile. Studies have highlighted the essential role of nurses in empowering parents through strategies that allow exploring parenting, incorporating knowledge about CD ( 2828. Gondim EC, Scorzafave LGDS, Santos DD, Henrique NCP, Pereira FM, Mello DF. Matching between maternal knowledge about infant development and care for children under one year old. Rev. Latino-Am. Enfermagem. 2022;30:e3675. https://doi.org/10.1590/1518-8345.5967.3675
https://doi.org/10.1590/1518-8345.5967.3...
- 2929. Goldfeld S, Bryson H, Mensah F, Price A, Gold L, Orsini F, et al. Nurse home visiting to improve child and maternal outcomes: 5-year follow-up of an Australian randomised controlled trial. PLoS One. 2022;17(11):e0277773. https://doi.org/10.1371/journal.pone.0277773
https://doi.org/10.1371/journal.pone.027...
), support the construction of the parental role, and understand the reality of each assisted family, for physical health care and to promote a safe environment ( 3232. Reticena KO, Gomes MFP, Fracolli LA. Promotion of positive parenting: The perception of primary care nurses. Texto Contexto Enferm. 2022;31:e20220203. https://doi.org/10.1590/1980-265X-TCE-2022-0203en
https://doi.org/10.1590/1980-265X-TCE-20...
). Thus, although the Touchpoints model appears to be appropriate for the different professionals who work with children, it is possible that studies have prioritized nurses in carrying out interventions due to this broad profile.
As for the contexts of application, the predominance of consultations in Primary Health Care (PHC) and home visits (HV) can synergistically contribute to actions based on the model. PHC is a favorable environment with infrastructure to implement interventions to promote child development in the monitoring of children’s health in the early years ( 77. Luz RMD, Marinho DCB, Lima APE, Coriolano-Marinus MWL. Educational interventions in child development and health literacy assumptions: an integrative review. Rev Bras Enferm. 2023;76(1):e20220116. https://doi.org/10.1590/0034-7167-2022-0116pt
https://doi.org/10.1590/0034-7167-2022-0...
), and scientific evidence shows that home visits offer favorable conditions for working on early childhood issues and needs, with better development of children in cognitive, behavioral and socio-emotional dimensions ( 2929. Goldfeld S, Bryson H, Mensah F, Price A, Gold L, Orsini F, et al. Nurse home visiting to improve child and maternal outcomes: 5-year follow-up of an Australian randomised controlled trial. PLoS One. 2022;17(11):e0277773. https://doi.org/10.1371/journal.pone.0277773
https://doi.org/10.1371/journal.pone.027...
, 3333. Hilário JS, Henrique NC, Santos JS, Andrade RD, Fracolli LA, Mello DF. Child development and home visits in early childhood: concept map. Acta Paul Enferm. 2022;35:eAPE003652. https://doi.org/10.37689/acta-ape/2022AR03653
https://doi.org/10.37689/acta-ape/2022AR...
).
As for the various resources used in the interventions, such as leaflets, videos, guides/scripts, handouts, books and toys, they are similar to those usually used in research on educational interventions ( 44. Jeong J, Franchett EE, Ramos CV, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Med. 2021;18(5):e1003602. https://doi.org/10.1371/journal.pmed.1003602
https://doi.org/10.1371/journal.pmed.100...
, 77. Luz RMD, Marinho DCB, Lima APE, Coriolano-Marinus MWL. Educational interventions in child development and health literacy assumptions: an integrative review. Rev Bras Enferm. 2023;76(1):e20220116. https://doi.org/10.1590/0034-7167-2022-0116pt
https://doi.org/10.1590/0034-7167-2022-0...
, 3030. Luoto JE, Lopez GI, 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...
). However, the absence of information about the intervention material is remarkable, given that it was available in only two studies, one that shared the folder used ( 2727. Shimpuku Y, Iida M, Hirose N, Tada K, Tsuji T, Kubota A, et al. Prenatal education program decreases postpartum depression and increases maternal confidence: a longitudinal quasi-experimental study in urban Japan. Women Birth. 2022;35(1):e456–e46. https://doi.org/10.1016/j.wombi.2021.11.004
https://doi.org/10.1016/j.wombi.2021.11....
), and another that provided the Uniform Resource Locator (URL) of the videos and songs ( 1818. DiCero KE. Small Circles: A Parenting Adolescent Prevention and Intervention Program for Young Families in the Teen Parent Shelter Program in Massachusetts [Dissertation]. Newton, MA: William James College; 2018 [cited 2023 Feb 21]. Available from: https://www.proquest.com/docview/2171058719?pq-origsite=gscholar&fromopenview=true
https://www.proquest.com/docview/2171058...
). This makes it difficult to objectively appreciate such materials and even relate the results to their quality. Still, it does not allow interventions to be replicated in other contexts for new evaluations.
The main contents explored in the interventions were the parents’ experience during pregnancy and labor; parent-child interaction; child’s behaviors as their language; understanding of child development; anticipatory care for every age; parenting challenges and concerns. These contents are in line with the main topics to be addressed from the prenatal Touchpoint ( 99. Brazelton TB, Sparrow J. The Touchpoints Model of Development [Internet]. Boston: Brazelton Touchpoints Center; 2015 [cited 2022 Dec 20]. Available from: https://www.brazeltontouchpoints.org/wp-content/uploads/2011/09/Touchpoints-Model-of-Development-April-2015.pdf
https://www.brazeltontouchpoints.org/wp-...
), showing fidelity to this aspect of the model. However, as previously mentioned, it was not possible to access the contents of the interventions in a complete way, which makes it impossible to measure whether the interventions follow all the principles and assumptions, guaranteeing this fidelity.
Although the volume of the intervention differed between the studies, ranging from six weeks to 18 months, and, in most cases, there is no description of the duration of each meeting, nor the fidelity of the intervention, that is, whether it was delivered as planned or recommended by the model ( 1515. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ Open. 2014;348:g1687. https://doi.org/10.1136/bmj.g1687
https://doi.org/10.1136/bmj.g1687...
), all had positive results. This shows that the effects on parental behaviors, knowledge and attitudes can be quickly visible when using an approach that values disorganization and vulnerability as an opportunity to support and validate parenting practices, rather than treating them as weaknesses or harmed behaviors.
Review studies have shown good effectiveness of interventions focused on parenting to promote development ( 44. Jeong J, Franchett EE, Ramos CV, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Med. 2021;18(5):e1003602. https://doi.org/10.1371/journal.pmed.1003602
https://doi.org/10.1371/journal.pmed.100...
, 3434. Shah R, Camarena A, Park C, Martin A, Clark M, Atkins M, et al. Healthcare-Based Interventions to Improve Parenting Outcomes in LMICs: A Systematic Review and Meta-Analysis. Matern Child Health J. 2022;26:1217-30. https://doi.org/10.1007/s10995-022-03445-y
https://doi.org/10.1007/s10995-022-03445...
), although another review points out the infeasibility of performing meta-analyses or meta-syntheses of studies of this nature, or understanding why the interventions work, due to the variability of the interventions tested ( 1010. Draper CE, Klingberg S, Wrottesley SV, Milner K, Fisher J, Lakes KD, et al. Interventions to promote development in the next 1000 days: A mapping review. Child Care Health Dev. 2022. https://doi.org/10.1111/cch.13084
https://doi.org/10.1111/cch.13084...
). Adherence was mentioned in only one study ( 1919. Percy MS, McIntyre L. Using Touchpoints to promote parental self-competence in low-income, minority, pregnant, and parenting teen mothers. J Pediatr Nurs. 2001;(3):180-6. https://doi.org/10.1053/jpdn.2001.24181
https://doi.org/10.1053/jpdn.2001.24181...
), which did not detail the strategies used to maintain or improve it.
Fragility is observed in the description of these central constructs of the interventions, which was also identified in a systematic review and meta-analysis that evaluated the effectiveness of parental interventions ( 44. Jeong J, Franchett EE, Ramos CV, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Med. 2021;18(5):e1003602. https://doi.org/10.1371/journal.pmed.1003602
https://doi.org/10.1371/journal.pmed.100...
). This lack of transparency makes it difficult to carry out interventions on a large scale, as it does not allow for the understanding of more or less successful interventions, and the dissemination of what worked or not, for whom and how ( 1313. Ahun MN, Aboud F, Wamboldt C, Yousafzai AK. Implementation of UNICEF and WHO’s care for child development package: Lessons from a global review and key informant interviews. Front Public Health. 2023;11:1140843. https://doi.org/10.3389/fpubh.2023.1140843
https://doi.org/10.3389/fpubh.2023.11408...
).
Regarding the mode of delivery, a greater offer of interventions individually, to the detriment of group interventions, shows a possible preference of researchers for the individual approach. This contradicts current research that points to the widespread use of group strategies, as they promote learning among peers through the exchange of knowledge and sharing of experiences, frustrations and anxieties ( 66. Li Y, Li S, Tang L, Bai Y. The effect of ECD program on the caregiver’s parenting knowledge, attitudes, and practices: based on a cluster-randomized controlled trial in economically vulnerable areas of China. BMC Public Health. 2022;22(1958). https://doi.org/10.1186/s12889-022-14268-5
https://doi.org/10.1186/s12889-022-14268...
- 77. Luz RMD, Marinho DCB, Lima APE, Coriolano-Marinus MWL. Educational interventions in child development and health literacy assumptions: an integrative review. Rev Bras Enferm. 2023;76(1):e20220116. https://doi.org/10.1590/0034-7167-2022-0116pt
https://doi.org/10.1590/0034-7167-2022-0...
, 3030. Luoto JE, Lopez GI, 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...
).
The use of current technologies in interventions was not identified, such as the internet (message sending applications, videoconferences, social media), and only one of them was carried out in a hybrid format, with face-to-face meetings and telephone follow-up ( 2020. Farber ML. Parent mentoring and child anticipatory guidance with Latino and African American families. Health Soc Work. 2009;34(3):179-89. https://doi.org/10.1093/hsw/34.3.179
https://doi.org/10.1093/hsw/34.3.179...
); this may be related to the fact that most studies were conducted more than 10 years ago. Currently, technologies are part of everyday life for families and enhance communication between health professionals and parents, facilitating and favoring different ways of delivering interventions, although there is the challenge of disparities in access to these technologies ( 77. Luz RMD, Marinho DCB, Lima APE, Coriolano-Marinus MWL. Educational interventions in child development and health literacy assumptions: an integrative review. Rev Bras Enferm. 2023;76(1):e20220116. https://doi.org/10.1590/0034-7167-2022-0116pt
https://doi.org/10.1590/0034-7167-2022-0...
).
The interventions did not explore the TP Model in depth, did not describe how it was used in its design, and which principles were applied. However, in the description of contents and effects, three principles were identified in most studies: “use the child’s behavior as their language, focus on the parent/child relationship and look for opportunities to support parental dominance” ( 99. Brazelton TB, Sparrow J. The Touchpoints Model of Development [Internet]. Boston: Brazelton Touchpoints Center; 2015 [cited 2022 Dec 20]. Available from: https://www.brazeltontouchpoints.org/wp-content/uploads/2011/09/Touchpoints-Model-of-Development-April-2015.pdf
https://www.brazeltontouchpoints.org/wp-...
).
All interventions carried out qualification/training in the TP model for the professionals who applied the interventions with the target audience, but there is no information on how or if the consistency of professionals in working with families was verified.
In the present review, the strategies used in the interventions were directed towards changing the knowledge, behavior and attitude of the parents in order to understand the development and behavior of their children. Research identified the paradigm shift proposed by the TP model, focused on anticipatory guidance and collaborative practice based on the experiential learning of parents ( 99. Brazelton TB, Sparrow J. The Touchpoints Model of Development [Internet]. Boston: Brazelton Touchpoints Center; 2015 [cited 2022 Dec 20]. Available from: https://www.brazeltontouchpoints.org/wp-content/uploads/2011/09/Touchpoints-Model-of-Development-April-2015.pdf
https://www.brazeltontouchpoints.org/wp-...
).
The main outcomes of the interventions were better global CD results, greater understanding of CD and the child’s behavior as its language, improved sense of parental competence and greater maternal sensitivity, greater interaction, responsiveness and time with the child, greater use of toys and learning materials, resembling the results of other parenting interventions ( 44. Jeong J, Franchett EE, Ramos CV, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLoS Med. 2021;18(5):e1003602. https://doi.org/10.1371/journal.pmed.1003602
https://doi.org/10.1371/journal.pmed.100...
, 66. Li Y, Li S, Tang L, Bai Y. The effect of ECD program on the caregiver’s parenting knowledge, attitudes, and practices: based on a cluster-randomized controlled trial in economically vulnerable areas of China. BMC Public Health. 2022;22(1958). https://doi.org/10.1186/s12889-022-14268-5
https://doi.org/10.1186/s12889-022-14268...
, 2828. Gondim EC, Scorzafave LGDS, Santos DD, Henrique NCP, Pereira FM, Mello DF. Matching between maternal knowledge about infant development and care for children under one year old. Rev. Latino-Am. Enfermagem. 2022;30:e3675. https://doi.org/10.1590/1518-8345.5967.3675
https://doi.org/10.1590/1518-8345.5967.3...
29. Goldfeld S, Bryson H, Mensah F, Price A, Gold L, Orsini F, et al. Nurse home visiting to improve child and maternal outcomes: 5-year follow-up of an Australian randomised controlled trial. PLoS One. 2022;17(11):e0277773. https://doi.org/10.1371/journal.pone.0277773
https://doi.org/10.1371/journal.pone.027...
- 3030. Luoto JE, Lopez GI, 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...
, 3434. Shah R, Camarena A, Park C, Martin A, Clark M, Atkins M, et al. Healthcare-Based Interventions to Improve Parenting Outcomes in LMICs: A Systematic Review and Meta-Analysis. Matern Child Health J. 2022;26:1217-30. https://doi.org/10.1007/s10995-022-03445-y
https://doi.org/10.1007/s10995-022-03445...
).
It was possible to examine the nature and extent of the interventions that used the TP model, and, although the positive effect is evidenced in all studies, the weakness in the description of the volume does not allow relating them to the duration of the intervention, and the heterogeneity of the interventions limits the comparison of these results.
As the main contributions of the study, one can consider the positive outcomes present in all investigations, in addition to highlighting the importance that reports of intervention studies contemplate in a more comprehensive way the description of the intervention itself.
Although the positive outcomes may justify the recommendation to test interventions based on the TP model in the Unified Health System (SUS), it is only possible to consider that they should include the common characteristics described in the studies, such as the anticipatory care approach, guidance on child development and parenting, carried out by nurses and in PHC. However, the lack of details on the interventions does not allow us to state that such positive outcomes, even in short-term interventions, are related to the non-prescriptive approach and other characteristics of the professional-family relationship that differentiate the TP model from traditional interventions.
Even so, such results justify further studies for the use of the model in public policies in Early Childhood, to support practices that promote CD, with emphasis on the socio-emotional, as it is innovative, when considering Touchpoints instead of just developmental milestones, and when acting from the perspective of family-child and professional-family interactions ( 99. Brazelton TB, Sparrow J. The Touchpoints Model of Development [Internet]. Boston: Brazelton Touchpoints Center; 2015 [cited 2022 Dec 20]. Available from: https://www.brazeltontouchpoints.org/wp-content/uploads/2011/09/Touchpoints-Model-of-Development-April-2015.pdf
https://www.brazeltontouchpoints.org/wp-...
).
Although no time or language cut-off was carried out, the limitations of the study refer to the small number of publications located, mainly in the last five years, with a predominance of studies in the grey literature to the detriment of the nine databases, and the exclusion of two searches due to not being located. Still, the incomplete description of the key components of the interventions makes it difficult to understand the results and compare them.
Conclusion
Interventions focused on the period from pregnancy to three years of age, and most were carried out by nurses in Primary Care and in the HV, prioritizing the dissemination of Touchpoints content according to age, and aspects of parenting. The studies showed potential for favorable results for child development and parenting. The variability of interventions made it difficult to map the most effective characteristics.
The mapping of interventions that used the TP model responds to the need in the field of parental interventions and explores a model that can be used and better characterized in new interventions to compose public policies in Early Childhood, given the positive results observed so far.
Acknowledgments
We would like to thank librarian Juliana Takahashi for her collaboration in defining the research search strategy and searching the databases.
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» https://doi.org/10.1053/jpdn.2001.24181 -
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*
This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Finance Code 001, PROEX Support: 1818/2023. Brazil. Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Grant #405746/2021-0, Brazil.
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How to cite this article
Vicente JB, Pegorin TC, Santos ALO, Veríssimo MLOR. Interventions for child development based on the Touchpoints Model: scoping review. Rev. Latino-Am. Enfermagem. 2023;31:e4035. [cited year mon day]. Available from: URL . https://doi.org/10.1590/1518-8345.6732.4035 -
All authors approved the final version of the text.
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Publication Dates
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Publication in this collection
09 Oct 2023 -
Date of issue
2023
History
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Received
21 Feb 2023 -
Accepted
01 Aug 2023