Author:

• Iná da Silva dos Santos - Santos, I. S. - <inasantos.epi@gmail.com>
ORCID: https://orcid.org/0000-0003-1258-9249

Co-author(s):

• Tiago Neuenfeld Munhoz - Munhoz, T. N. - <tyagomunhoz@hotmail.com>
ORCID: https://orcid.org/0000-0003-1281-9542
• Raquel Siqueira Barcelos - Barcelos, R. S. - <bio.raquelbarcelos@gmail.com>
ORCID: https://orcid.org/0000-0001-6580-0509
• Cauane Blumenberg - Blumenberg, C. - <cblumenberg@equidade.org>
ORCID: https://orcid.org/0000-0002-4580-3849
• Caroline Cardozo Bortolotto - Bortolotto, C.C. - <kkbortolotto@hotmail.com>
ORCID: https://orcid.org/0000-0003-3318-7900
• Alicia Matijasevich Manitto - MATIJASEVICH, A.M - <alicia.matijasevich@usp.br, amatija@yahoo.com>
ORCID: https://orcid.org/0000-0003-0060-1589
• Cristiane Salum - Salum, C. - <crisalum@gmail.com>
ORCID: https://orcid.org/0000-0003-0191-371X
• Hernane Guimarães dos Santos Júnior - Santos Júnior, H.G. - <hernanegs@gmail.com>
ORCID: https://orcid.org/0000-0002-9998-2141
• Letícia Marques - Marques, L. - <marquesleticia@hotmail.com>
ORCID: https://orcid.org/0000-0001-5963-2166
• Luciano Correia - Correia, L. - <correialuciano@hotmail.com>
ORCID: https://orcid.org/0000-0001-8948-8660
• Marta Rovery de Souza - Souza, M.R. - <martary@gmail.com>
ORCID: https://orcid.org/0000-0001-6910-843X
• Pedro Israel Cabral de Lira - Lira, P. I. C. - <lirapicpe@gmail.com; lirapic@ufpe.br>
ORCID: https://orcid.org/0000-0002-1534-1620
• Marina Fragata Chicaro - Chicaro, M.F. - <marina@fmcsv.org.br>
• Elisa Altafim - Altafim, E. - <ealtafim@fmcsv.org.br>
• Esmeralda Correa Macana - Macana, E.C. - <esmeralda.macana@itausocial.org.br>
ORCID: https://orcid.org/0000-0003-1899-3250
• Vitor Pereira - Pereira, V. - <vitpereira@gmail.com>
ORCID: https://orcid.org/0000-0002-6487-7704
• Cesar Gomes Victora - Victora, C.G - <cvictora@gmail.com>
ORCID: https://orcid.org/0000-0002-2465-2180

Abstract:

The Happy Child Program (Programa Criança Feliz – PCF, in Portuguese) reaches 1.4 million Brazilian children under three years of age with home visits aimed at neuropsychomotor development. Based on a conceptual model, the implementation and impact of the PCF were evaluated in a randomized study in 30 municipalities. A total of 3,242 children were allocated to the intervention (IG) or control (CG) group, 80.0% of which were prospectively followed up for three years. Development was assessed by the Ages and Stages Questionnaire (ASQ3). Intention-to-treat analyzes showed mean scores of 203.3 in the IG and 201.3 in the CG (p=0.427). Additional analyzes with instrumental variables and pairing by propensity scores also showed no effect, since the number of contacts received was not associated with ASQ3 scores (correlation=-0.013; p=0.436). No impact was observed on stimulation, responsive interactions or psychological attributes of children. Visits were interrupted for 12 months due to COVID-19, being replaced by virtual contacts. The implementation study revealed low coverage in the IG, contamination of the GC, deficiencies in management and low quality of visits in many municipalities. The study did not demonstrate the impact of PCF implemented under routine conditions and provides elements for its improvement.

Keywords:

Child development; Program evaluation; Impact

Content:

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