792 - Parental Self-Efficacy, Parental Investment and Early Child Development in an urban setting in Peru

Publication Number: 792.5850

Leslie C. Cabrera Toribio, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Eduardo Perez-Roca Quinteros, Universidad Peruana Cayetano Heredia, Lima, Lima, Peru; Roxana Sofia. Diaz Subauste, HOSPITAL NACIONAL EDGARDO REBAGLIATI MARTINS, Lima, Lima, Peru; Giancarlo Alvarado-Gamarra, 1. Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú. 2. Instituto de Investigación Nutricional, Lima, Peru., Lima, Lima, Peru; Kelly I. Kamimura-Nishimura, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: Brain architecture and functioning undergo rapid development in the first three years of age, with multiple factors involved in a complex interplay. In low-middle income countries (LMICs), 39% of children under 5 years of age are at risk of not achieving their developmental potential. Parental self-efficacy (PSE) and parental investment (PI) are factors that independently could influence in early child development (ECD) and represent potential targets for improving developmental outcomes in LMICs.

Objective: To assess the association between PSE, PI and ECD in an urban setting of a LMIC.

Design/Methods: A prospective cross-sectional study conducted among caregivers of children aged 9-24 months who were cared for at three urban health centers in Lima, Peru, 2024. Four surveys assessing sociodemographic characteristics, developmental milestones (Survey of Well-being of Young Children), parental self-efficacy (Early Intervention Parenting Self-Efficacy Scale) and parental investment (Family Care Indicators) were applied. We used Spearman's Rho to evaluate correlations, the Area Under the Curve (AUC) from the ROC curves to identify adequate ECD, and both crude and adjusted prevalence ratios (PR), with 95% confidence intervals (CI), to assess associations. We applied generalized linear models (Poisson family) for this analysis. For the adjusted model, variables with a p-value < 0.2 in the crude analysis were included. We obtained informed consent and received IRB approval.

Results: A total of 104 caregivers of children (median age of 14.5 months, IQR: 11-19 months) were included in the study. The majority were term infants with normal birth weight, and their caregivers had an adequate educational level. Among them, 53.84% demonstrated adequate ECD. The correlation between PSE and PI scores with ECD scores was weak (Figure 1). Additionally, the AUC for both separate and combined tests was regular (Figure 2). Higher PSE scores were associated with adequate ECD (adjusted PR 1.63; 95% CI 1.01-2.62; p=0.045) compared to lower scores, after adjusting for PI scores, mother's age, and primary caregiver (Table 1).

Conclusion(s): The PSE test was associated with adequate ECD. It is necessary to confirm this finding in larger prospective cohorts, particularly in urban-marginal settings within LMICs. Interventions aimed at fostering PSE can be valuable in promoting adequate ECD.

Figure 1. Correlation: a) Parental self-efficacy test and b) Parental investment with psychomotor development.


Figure 2. Diagnostic performance of the parental self-efficacy and parental investment test (Left, separately; Right, combined).


Table 1. Parental self-efficacy and investment and their association with adequate psychomotor development in infants attending three health centers, Lima, Peru, 2024.
a. Factors with a p-value <0.2 in the crude analysis were included in the adjusted model. The factors evaluated were: Parental self-efficacy test score, parental investment test score, sex, gestational age, birth weight, parents' age, educational level, marital status, primary caregiver, and household income
b. According to quartiles.
c. ‘Others’ includes grandmother, caregivers, and other support persons.
PR: Prevalence Ratio. CI: Confidence Interval.