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Text and audio messages to promote positive parenting during Covid – Ana Balsa (translation)

Article written by Ana Balsa, professor and researcher at the Economic and Business Science Faculty at the Universidad de Montevideo (UM), in collaboration with Anita Bloomfield.

Family environments are key to children's development in their first years of life. Evidence shows that children raised in violent homes, with low parental engagement and little stimulation develop far less their cognitive and socio-emotional abilities. The Covid-19 pandemic brought with it an economic and health crisis, which, along with lockdown measures, increased family stressors and triggered situations of domestic violence, accidents at home, as well as mental and emotional health problems. Between February and April, calls to the telephone counseling line for victims of gender violence practically tripled in Uruguay, a country already marked by high rates of femicide (the 7th in Latin America). In a survey directed at Uruguayan women using Facebook and Instagram and carried out during confinement, one in five women declared that they were victims of violence or knew someone who was.

For obvious reasons, there is less quantitative evidence of violence against boys and girls, although everything suggests that the lockdown subjected them to more psychological and physical violence. In a study carried out by Unicef with the Universidad de la República, 26% of surveyed families declared to have increased the frequency of shouting and 18% of them also increased punishments. There is also anecdotal evidence of girls who reported abuse through the Plan Ceibal program (a program that gives a computer to children of  lower secondary education). The youngest children are the most invisible to this type of situation and they are the ones that may potentially face the worst  consequences due to the development stages they go through.

Given the urgency of effective interventions in the face of the current situation, and seeking to act through prevention and containment, together with a group of researchers from the Universidad de Montevideo and the Universidad Católica del Uruguay, we adapted a program of text messages and audio aimed at households with young children, which we have been implementing in early childhood centers in Uruguay (CAIF centers) since 2018. This program, called Crianza Positiva, aims to improve parenting practices and develop parenting skills starting from the recognition of behavioral biases in parental investment decisions. Using an experimental design for our intervention (Balsa et al. 2020; Bloomfield et al. 2020), our evaluations show that sending messages promoting positive parenting increases the quantity and quality of parental involvement and improves the communication between mothers and their children. In particular, we find that those who receive the messages engage more frequently in physical, didactic and social activities with their children, and increase their reflective capacity, as well as their ability to ask for support from the community. The effects are around 0.24 standard deviations. We also found that mothers increase the duration of their vocalizations when they play with their children.

In the Covid version of the messages of the Crianza Positiva program we keep aiming at intensifying the quality and frequence of parental investment, but we also seek to modify the following short-term objectives: (i) reduce episodes of domestic violence, (ii) reduce accidents at home, and (iii) improve the mental and emotional health of all household members.

Messages are sent to vulnerable households three times a week for 24 weeks. They arrive indistinctly to both the mother and the father of the child, promoting co-parenting. These messages are sent in text, audio or audiovisual format, through an Android app and they are adapted to the sex and name of the baby as well to the sex of the adult who receives them. The messages include content on topics such as sensitive observation and expression of affection and positive care, the importance of a routine and home safety, language (talking and reading to the baby) and free play, self caring tools (emotion management and releasing tensions) as well as the promotion of parenthood reflection.

 As in the previous program, the structure of the messages are based on behavioral economics tools constructed from identifying barriers to positive parenting. For each of the topics covered, the messages are designed in such a way as to activate four mechanisms. First, they seek to mitigate bias by reporting / recalling the effects of good parenting practices on the child. Additionally, they seek to break down complex parental tasks into easier tasks with simple suggestions and concrete activities. In this way, the messages attempt to address problems of inattention and cognitive fatigue. Third, messages try to transform negative identities into positive ones, through the stimulation of self-care and the use of parental resources. Finally, an attempt is made to help strengthen routines and forge new habits through repetition, to combat status quo bias.

Adapting messages to the Covid pandemic. As we pointed out, messages were adapted to deal with different consequences derived from the lockdown and the uncertainty associated with the pandemic. Some messages seek to work with the family's ability to cope with the lockdown; other messages seek to provide tools to deal with negative emotions caused by the pandemic through relaxation and breathing exercises. Watching for changes in the child's behavior (due to problems of abuse or violence that may arise) is discussed several times, and it is continuously reminded to parents to resort to the CAIF center of reference in case of needing help or wanting to clear up doubts. Positive discipline and affection are reinforced, and the consequences of violence on the baby are emphasized. The importance of having a safe home is also highlighted to minimize accidents. Here are a couple of messages that illustrate the adaptations mentioned above:

"These days you have been 'tuning up' your home to make it 'accident proof'. Think back to those times when you sought to make {BABY NAME}’s environment safer and more protected. These measures become especially important in these times when we spend more time at home and it becomes more difficult to manage the space that we must share while we work, study, play ... It is important to talk with those who live with you, and try to make agreements to use the shared space in a better way according to the needs of each one. And think together about making perhaps some changes to make coexistence easier in these times. "

"This week we have seen the importance of routines in babies' lives. We are experiencing a period when many of our routines have changed drastically, such as work, study, or attending CAIF, and this can cause insecurity, and sometimes even a feeling of chaos. The situation also impacts {BABY}, which can be reflected in more anger, tantrums, fears or new behaviors. Although today it is a challenge to organize routines in the midst of so much change, it is still important. Transmit {BABY} security and confidence, making it clear that you are there for him/her. It is key to take turns among the adults in childcare, and organize ourselves as well as possible (with schedules if necessary) with time and space. "

Messages have around 300 characters to ensure attention to the content from the parents. Some of them also include a link with more exhaustive materials on emotions in Covid times or parenting manuals tailored to the child's development stage, tips for achieving a safer home or links to web pages with children's songs and children's books.

The program was launched on July 1st, 2020. Sending messages is expected to end by late December 2020. Also in this instance we have randomized the assignment of the messages in order to be able to evaluate the effects once the intervention is finished. We implemented the intervention in 22 CAIF centers (early childhood and family care centers) in 15 departments of Uruguay, which are treating 338 families with children between 0 and 2 years of age. Additionally, 17 centers constitute the control group. We look forward to contributing with positive evidence in the months to come.

References

Balsa, A., López Boo, F., Bloomfield, J., Cristia, A., Valdés, R., Cid, A., González, M., Ferro, M.P. (2020). The effect of Crianza Positiva e-messaging program on adult-child language interactions.

Bloomfield, J., Balsa, A., Cid, A. (2020). Using Behavioral Insights in Early Childhood Interventions: the Effects of Crianza Positiva E-Messaging Program on Parental Investment.