Efeitos de um programa de práticas parentais positivas em contexto de vulnerabilidade social
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Data
2021-08-23
Autores
Martini, Juliana Aparecida
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Universidade Estadual Paulista (Unesp)
Resumo
As políticas públicas brasileiras têm voltado o olhar para a primeira infância, garantindo recursos básicos na saúde, educação, condições básicas de vida e moradia. No âmbito das políticas socioassistenciais, um dos focos seria o cuidado e o fortalecimento da capacidade protetiva das famílias através de programas e serviços. Dessa forma, o presente trabalho pretendeu avaliar o uso de um programa de intervenção direcionado às práticas parentais em famílias vulneráveis, atendidas dentro de um serviço social de acompanhamento familiar. Trata-se de um estudo quase-experimental, não randomizado, com comparações entre grupos e intragrupo, avaliações uni-cegas, e delineamento longitudinal. Foi composta uma amostra de conveniência com 30 familiares de crianças de 2 a 6 anos, beneficiárias do Programa VIVALEITE, divididos em dois grupos: Grupo Intervenção (GI) e Grupo Controle (GC). Foram utilizados os instrumentos: a) para seleção dos participantes: Ficha Cadastral de Beneficiários; b) para caracterização da amostra: Acompanhamento no CRAS, Ficha de identificação ACT, Adverse Childhood Experiences Study Questionnaire – ACE, Escala de Eventos Vitais; c) para avaliação das práticas parentais: Avaliação ACT, Escala de Parentalidade e Ajustamento Familiar – PAFAS; d) para avaliação do comportamento da criança: Questionário de Capacidades e Dificuldades - SDQ; e) para a intervenção Programa ACT – “Para Educar Crianças em Ambiente Seguros”; f) para avaliação do processo de intervenção: Exercício 6, letra b, da reunião prévia do Programa ACT, Questionário de Avaliação do Programa ACT, Subescala Sobre o Desenvolvimento Infantil da Avaliação ACT, Diários de Campo. Para o GI foram realizadas três avaliações, com aplicação dos respectivos instrumentos: 1ª avaliação (pré-intervenção): Avaliação ACT, PAFAS e SDQ; 2ª avaliação (pós-intervenção): Avaliação ACT, PAFAS, SDQ, ACE e Escala de Eventos Vitais; 3ª avaliação (follow-up): Avaliação ACT, PAFAS e SDQ. Para o GC foram realizadas duas avaliações com os mesmos instrumentos utilizados com o GI, com intervalo de dois meses e meio entre elas. Foram realizadas análises de comparação entre grupos (GI versus GC) e intragrupo (GI), considerando-se as três avaliações (pré-intervenção versus pós-intervenção versus follow-up) e análise quanti-qualitativa do processo de intervenção do GI. De acordo com os resultados, GI e GC eram semelhantes quanto às características sociodemográficas e indicadores de vulnerabilidade, porém houve diferença estatisticamente significativa quanto à idade das crianças (GC<GI). Foram observadas diferenças estatisticamente significativas entre os grupos quanto às pontuações na subescala de Hiperatividade (SDQ) no momento pré-intervenção (GC>GI) e na subescala de Ajustamento Familiar (PAFAS) após a intervenção (GI > GC). Na comparação intragrupo (GI) foi observada diferença estatisticamente significativa em relação à subescala de Ajustamento Familiar do PAFAS (pós-intervenção>follow-up). Portanto, diferentemente do esperado, os resultados não indicaram aumento da frequência de práticas parentais positivas e diminuição de problemas comportamentais da criança, em curto e médio prazo, exceto quanto ao ajustamento familiar. Apesar da dificuldade inicial de adesão das famílias, observou-se índices elevados de fidelização ao programa e assiduidade e uma avaliação positiva do mesmo. Sugere-se, então, a adaptação do Programa ACT à realidade das famílias em vulnerabilidade social, considerando o contexto em que estão inseridas, suas necessidades e desejos, podendo se constituir como ação dentro do Serviço de Acompanhamento e Atendimento Integral a Família (PAIF).
Brazilian public policies have turned their attention to early childhood, guaranteeing basic resources in health, education, basic living conditions, and housing. One of the social assistance policy guidelines is fortify the care and protective behavior of families through programs and services. Accordingly, this paper is aimed to evaluate an intervention program of parental practices in vulnerable families, assisted by a social program. This is a quasi-experimental, non-randomized study, with inter-and-intra- group comparisons, single-blind assessments, and longitudinal design. A convenience sample was composed of 30 family members of children from 2 to 6 of age, assisted by VIVALEITE Program, divided into two groups: Intervention Group (IG) and Control Group (CG). Instruments were used: a) to select the participants: Beneficiary Registration; b) for characterization of the sample: Follow-up at CRAS, ACT identification form, Adverse Childhood Experiences Study Questionnaire - ACE, Vital Events Scale; c) for assessment of parenting practices: ACT Assessment, Parenting and Family Adjustment Scale - PAFAS; d) for assessment of child behavior: Abilities and Difficulties Questionnaire - SDQ; e) for intervention ACT Program - "To Raise Children in Safe Environment"; f) for evaluation of the intervention process: Exercise 6, letter b, of the ACT Program pre-meeting, ACT Program Evaluation Questionnaire, Sub-scale About Child Development of the ACT Assessment, Field Diaries. Three assessments were carried out on IG group, with the application of the respective instruments: 1st assessment (pre-intervention): ACT Assessment, PAFAS and SDQ; 2nd assessment (post-intervention): ACT Assessment, PAFAS, SDQ, ACE and Vital Events Scale; 3rd assessment (follow-up): ACT Assessment, PAFAS and SDQ. On CG, two assessments were carried out with the same instruments used with IG, with an interval of two and a half months between them. Intergroup (IG versus CG) and intragroup (IG) comparison analyses were carried out, considering the three evaluations (pre-intervention versus post-intervention versus follow-up) and quanti-qualitative analysis of the IG intervention process. According to the results, IG and CG were similar regarding sociodemographic characteristics and vulnerability indicators, but there was a statistically significant difference regarding the age of the children (CG< IG). Statistically significant differences were observed between the groups regarding scores on the hyperactivity subscale (SDQ) at the pre-intervention time point (CG > IG) and on the family adjustment subscale (PAFAS) after the intervention (IG > CG). In the intragroup comparison (IG), a statistically significant difference was observed in Family Adjustment subscale of the PAFAS (post-intervention>follow-up). Therefore, differently from what was expected, the results did not indicate an increase in the frequency of positive parenting practices and a decrease in the child's behavioral problems in the short and medium term, except for family adjustment. Despite the initial difficulty for the families to join, we observed high rates of fidelity to the program and assiduity, and a positive evaluation of the program. It is suggested, then, the adaptation of the ACT Program to the reality of socially vulnerable families, considering the context in which it is inserted, their needs and desires, being able to constitute an action within the Comprehensive Family Care and Monitoring Service (PAIF).
Brazilian public policies have turned their attention to early childhood, guaranteeing basic resources in health, education, basic living conditions, and housing. One of the social assistance policy guidelines is fortify the care and protective behavior of families through programs and services. Accordingly, this paper is aimed to evaluate an intervention program of parental practices in vulnerable families, assisted by a social program. This is a quasi-experimental, non-randomized study, with inter-and-intra- group comparisons, single-blind assessments, and longitudinal design. A convenience sample was composed of 30 family members of children from 2 to 6 of age, assisted by VIVALEITE Program, divided into two groups: Intervention Group (IG) and Control Group (CG). Instruments were used: a) to select the participants: Beneficiary Registration; b) for characterization of the sample: Follow-up at CRAS, ACT identification form, Adverse Childhood Experiences Study Questionnaire - ACE, Vital Events Scale; c) for assessment of parenting practices: ACT Assessment, Parenting and Family Adjustment Scale - PAFAS; d) for assessment of child behavior: Abilities and Difficulties Questionnaire - SDQ; e) for intervention ACT Program - "To Raise Children in Safe Environment"; f) for evaluation of the intervention process: Exercise 6, letter b, of the ACT Program pre-meeting, ACT Program Evaluation Questionnaire, Sub-scale About Child Development of the ACT Assessment, Field Diaries. Three assessments were carried out on IG group, with the application of the respective instruments: 1st assessment (pre-intervention): ACT Assessment, PAFAS and SDQ; 2nd assessment (post-intervention): ACT Assessment, PAFAS, SDQ, ACE and Vital Events Scale; 3rd assessment (follow-up): ACT Assessment, PAFAS and SDQ. On CG, two assessments were carried out with the same instruments used with IG, with an interval of two and a half months between them. Intergroup (IG versus CG) and intragroup (IG) comparison analyses were carried out, considering the three evaluations (pre-intervention versus post-intervention versus follow-up) and quanti-qualitative analysis of the IG intervention process. According to the results, IG and CG were similar regarding sociodemographic characteristics and vulnerability indicators, but there was a statistically significant difference regarding the age of the children (CG< IG). Statistically significant differences were observed between the groups regarding scores on the hyperactivity subscale (SDQ) at the pre-intervention time point (CG > IG) and on the family adjustment subscale (PAFAS) after the intervention (IG > CG). In the intragroup comparison (IG), a statistically significant difference was observed in Family Adjustment subscale of the PAFAS (post-intervention>follow-up). Therefore, differently from what was expected, the results did not indicate an increase in the frequency of positive parenting practices and a decrease in the child's behavioral problems in the short and medium term, except for family adjustment. Despite the initial difficulty for the families to join, we observed high rates of fidelity to the program and assiduity, and a positive evaluation of the program. It is suggested, then, the adaptation of the ACT Program to the reality of socially vulnerable families, considering the context in which it is inserted, their needs and desires, being able to constitute an action within the Comprehensive Family Care and Monitoring Service (PAIF).
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Palavras-chave
Vulnerabilidade Social, Família, Relações Pais-Filhos, Comportamento infantil, Social vulnerability, Families, Parent-child relations, Child behavior