Pre-pandemic support for shared reading buffers adverse parenting impacts: an RCT in Brazil

Abstract

Background: To examine whether (1) a parent-child reading program (Universidade do Bebê [UBB]), conducted in Brazil pre-pandemic can support parenting and parent-child reading 6 months into the pandemic, (2) cognitive stimulation at pandemic onset mediates effects of UBB on these outcomes, and (3) UBB pre-pandemic buffers associations between COVID-19-related distress and parenting/parent-child reading 6 months into the pandemic.

Methods: 400 women, either pregnant or with children 0-24 months, were randomized to UBB (n = 200) or control groups. UBB consisted of monthly parent workshops focusing on parent-child reading and a book-lending library. Assessments pre-pandemic (June-2019) and at pandemic onset (April-2020) included cognitive stimulation. Assessments 6 months into the pandemic (October-2020) included COVID-19 exposure/impact/distress, as well as parenting and parent-child reading.

Results: 133 families (n = 69 UBB) contributed data 6 months into the pandemic. Participation in UBB pre-pandemic was associated with parent-child reading but not parenting 6 months into the pandemic. Indirect effects of UBB through cognitive stimulation at pandemic onset were observed for both outcomes. Increased COVID-19-related distress was significantly associated with reduced parenting/parent-child reading 6 months into the pandemic in the control group only.

Conclusion: Promotion of cognitive stimulation pre-pandemic may have reduced risk for effects of the pandemic on parenting/parent-child reading.

Clinical trial registration: The trial has been registered with the Brazilian Clinical Trials Registry RBR-29RZDH on 05/28/2018.

Impact: This is the first study showing sustained impacts of a reading aloud intervention beginning in pregnancy and early infancy implemented pre-pandemic. Findings suggest that participation in a reading-aloud intervention buffered associations between COVID-19 distress and parenting/parent-child reading 6 months into the pandemic. Novel empirical evidence suggests that promotion of cognitive stimulation prior to the pandemic may buffer its impacts on parenting and parent-child book reading following onset in low- and middle-income countries. Findings provide important new support for implementation of parent-child reading aloud programs and likely have implications for early childhood development beyond the COVID-19 pandemic for disasters generally.

Fig. 1. Study flow diagram.

Participant flow from eligibility assessment through enrollment, intervention, and data collection to completion of follow-up.

Fig. 2. Effects of UBB.

Effects of UBB on a parenting and b parent–child reading 6 months into the pandemic, including total, direct, and indirect effects mediated by impacts on cognitive stimulation in the home at pandemic onset. β = standardized coefficients. Models were adjusted for baseline covariates and cognitive stimulation, as well as COVID-19-related Distress.

Fig. 3. UBB Moderated effects of COVID-19-related distress level on parenting and parent–child book reading 6 months into the pandemic.

a, b The negative associations between COVID-19-related stress and parenting 6 months into the pandemic were buffered for the UBB group, but statistically significant for the control group. Models were adjusted for baseline covariates.