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Mccoy, Dana

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Mccoy

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Mccoy, Dana
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    “His Mind Will Work Better With Both of Us”: A Qualitative Study on Fathers’ Roles and Coparenting of Young Children in Rural Pakistan
    (BMC, 2018-11-20) Jeong, Joshua; Siyal, Salma; Fink, GĂĽnther; Mccoy, Dana; Yousafzai, Aisha
    Background Parents are the primary providers of nurturing care for young children’s healthy early development. However, the literature on parenting in early childhood, especially in low- and middle-income countries, has primarily focused on mothers. In this study, we investigate how parents make meaning of fathers’ parenting roles with regards to their young children’s early health and development in rural Pakistan. Methods Data were collected between January and March 2017 through in-depth interviews with fathers (N = 33) and their partners (N = 32); as well as separate focus group discussions with fathers (N = 7) and mothers (N = 7). Data were analyzed using thematic content analysis. Results Parents described a distinct division of roles between fathers and mothers; and also several shared caregiving roles of fathers and mothers. Specifically, parents highlighted aspects of fathers’ coparenting and several common ways by which fathers supported their partners. We found that these gendered divisions in parenting roles were strongly embedded within a complex network of interacting factors across the individual, family, and sociocultural contexts of the study community. Conclusions Our findings suggest a more family-centered conceptualization of fatherhood during early childhood that encompasses both fathers’ direct engagement with their young children and their indirect contributions through coparenting, while recognizing a variety of contextual systems that shape paternal parenting. Future parenting interventions that reflect the lived experiences of both fathers and mothers as parents and partners may further enhance the nurturing care environments that are critical for promoting healthy early child development.
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    Early Childhood Development and Schooling Attainment: Longitudinal Evidence from British, Finnish and Philippine Birth Cohorts
    (Public Library of Science, 2015) Peet, Evan D.; Mccoy, Dana; Danaei, Goodarz; Ezzati, Majid; Fawzi, Wafaie; Jarvelin, Marjo-Riitta; Pillas, Demetris; Fink, Gunther
    Background: While recent literature has highlighted the importance of early childhood development for later life outcomes, comparatively little is known regarding the relative importance of early physical and cognitive development in predicting educational attainment cross-culturally. Methods: We used prospective data from three birth cohorts: the Northern Finland Birth Cohort of 1986 (NFBC1986), the 1970 British Cohort Study (BCS1970), and the Cebu Longitudinal Health and Nutrition Survey of 1983 (CLHNS) to assess the association of height-for-age z-score (HAZ) and cognitive development measured prior to age 8 with schooling attainment. Multivariate linear regression models were used to estimate baseline and adjusted associations. Results: Both physical and cognitive development were highly predictive of adult educational attainment conditional on parental characteristics. The largest positive associations between physical development and schooling were found in the CLHNS (β = 0.53, 95%-CI: [0.32, 0.74]) with substantially smaller associations in the BCS1970 (β = 0.10, 95% CI [0.04, 0.16]) and the NFBC1986 (β = 0.06, 95% CI [-0.05, 0.16]). Strong associations between cognitive development and educational attainment were found for all three cohorts (NFBC1986: β = 0.22, 95%-CI: [0.12, 0.31], BCS1970: β = 0.58, 95%-CI: [0.52, 0.64], CLHNS: β = 1.08, 95%-CI: [0.88, 1.27]). Models jointly estimating educational associations of physical and cognitive development demonstrated weaker associations for physical development and minimal changes for cognitive development. Conclusion: The results indicate that although physical and cognitive early development are both important predictors of educational attainment, cognitive development appears to play a particularly important role. The large degree of heterogeneity in the observed effect sizes suggest that the importance of early life physical growth and cognitive development is highly dependent on socioeconomic and institutional contexts.
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    Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modeling
    (Public Library of Science, 2016) Mccoy, Dana; Peet, Evan D.; Ezzati, Majid; Danaei, Goodarz; Black, Maureen M.; Sudfeld, Christopher; Fawzi, Wafaie; Fink, Gunther
    Background: The development of cognitive and socioemotional skills early in life influences later health and well-being. Existing estimates of unmet developmental potential in low- and middle-income countries (LMICs) are based on either measures of physical growth or proxy measures such as poverty. In this paper we aim to directly estimate the number of children in LMICs who would be reported by their caregivers to show low cognitive and/or socioemotional development. Methods and Findings: The present paper uses Early Childhood Development Index (ECDI) data collected between 2005 and 2015 from 99,222 3- and 4-y-old children living in 35 LMICs as part of the Multiple Indicator Cluster Survey (MICS) and Demographic and Health Surveys (DHS) programs. First, we estimate the prevalence of low cognitive and/or socioemotional ECDI scores within our MICS/DHS sample. Next, we test a series of ordinary least squares regression models predicting low ECDI scores across our MICS/DHS sample countries based on country-level data from the Human Development Index (HDI) and the Nutrition Impact Model Study. We use cross-validation to select the model with the best predictive validity. We then apply this model to all LMICs to generate country-level estimates of the prevalence of low ECDI scores globally, as well as confidence intervals around these estimates. In the pooled MICS and DHS sample, 14.6% of children had low ECDI scores in the cognitive domain, 26.2% had low socioemotional scores, and 36.8% performed poorly in either or both domains. Country-level prevalence of low cognitive and/or socioemotional scores on the ECDI was best represented by a model using the HDI as a predictor. Applying this model to all LMICs, we estimate that 80.8 million children ages 3 and 4 y (95% CI 48.1 million, 113.6 million) in LMICs experienced low cognitive and/or socioemotional development in 2010, with the largest number of affected children in sub-Saharan Africa (29.4.1 million; 43.8% of children ages 3 and 4 y), followed by South Asia (27.7 million; 37.7%) and the East Asia and Pacific region (15.1 million; 25.9%). Positive associations were found between low development scores and stunting, poverty, male sex, rural residence, and lack of cognitive stimulation. Additional research using more detailed developmental assessments across a larger number of LMICs is needed to address the limitations of the present study. Conclusions: The number of children globally failing to reach their developmental potential remains large. Additional research is needed to identify the specific causes of poor developmental outcomes in diverse settings, as well as potential context-specific interventions that might promote children’s early cognitive and socioemotional well-being.
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    Development and validation of an early childhood development scale for use in low-resourced settings
    (Springer Nature, 2017) Mccoy, Dana; Sudfeld, Christopher; Bellinger, David; Muhihi, Alfa; Ashery, Geofrey; Weary, Taylor Evans; Fawzi, Wafaie; Fink, Gunther
    Background:Low-cost, cross-culturally comparable measures of the motor, cognitive, and socioemotional skills of children under 3 years remain scarce. In the present paper, we aim to develop a new caregiver-reported early childhood development (ECD) scale designed to be implemented as part of household surveys in low-resourced settings. Methods: We evaluate the acceptability, test-retest reliability, internal consistency, and discriminant validity of the new ECD items, subscales, and full scale in a sample of 2481 18- to 36-month-old children from peri-urban and rural Tanzania. We also compare total and subscale scores with performance on the Bayley Scales of Infant Development (BSID-III) in a subsample of 1036 children. Qualitative interviews from 10 mothers and 10 field workers are used to inform quantitative data. Results: Adequate levels of acceptability and internal consistency were found for the new scale and its motor, cognitive, and socioemotional subscales. Correlations between the new scale and the BSID-III were high (r > .50) for the motor and cognitive subscales, but low (r < .20) for the socioemotional subscale. The new scale discriminated between children’s skills based on age, stunting status, caregiver-reported disability, and adult stimulation. Test-retest reliability scores were variable among a subset of items tested. Conclusions: Results of this study provide empirical support from a low-income country setting for the acceptability, reliability, and validity of a new caregiver-reported ECD scale. Additional research is needed to test these and other caregiver reported items in children in the full 0 to 3 year range across multiple cultural and linguistic settings.
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    Poverty, physical stature, and cognitive skills: Mechanisms underlying children’s school enrollment in Zambia.
    (American Psychological Association (APA), 2015) Mccoy, Dana; Zuilkowski, Stephanie Simmons; Fink, Gunther
    Past research suggests robust positive associations between household socioeconomic status and children’s early cognitive development in Western countries. Relatively little is known about these relations in low-income country settings characterized by economic adversity, high prevalence of malnutrition and infectious disease, and relatively lower school enrollment. The present study develops and empirically evaluates an adapted model of early childhood development using a sample of 2,711 Zambian 6-year-olds. Early learning in and out of the home was found to explain much of the relation between socioeconomic status and children’s cognitive skills, including language, nonverbal reasoning, and executive function. Child height-for-age (a proxy for overall nutritional status and health) was also predictive of children’s cognitive skills and both early and on-time school enrollment. Implications for global child development, intervention, and future work are discussed
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    Risk Factors for Childhood Stunting in 137 Developing Countries: A Comparative Risk Assessment Analysis at Global, Regional, and Country Levels
    (Public Library of Science, 2016) Danaei, Goodarz; Andrews, Kathryn; Sudfeld, Christopher; Fink, Gunther; Mccoy, Dana; Peet, Evan; Sania, Ayesha; Smith Fawzi, Mary C.; Fawzi, Wafaie; Ezzati, Majid
    Background: Stunting affects one-third of children under 5 y old in developing countries, and 14% of childhood deaths are attributable to it. A large number of risk factors for stunting have been identified in epidemiological studies. However, the relative contribution of these risk factors to stunting has not been examined across countries. We estimated the number of stunting cases among children aged 24–35 mo (i.e., at the end of the 1,000 days’ period of vulnerability) that are attributable to 18 risk factors in 137 developing countries. Methods and Findings: We classified risk factors into five clusters: maternal nutrition and infection, teenage motherhood and short birth intervals, fetal growth restriction (FGR) and preterm birth, child nutrition and infection, and environmental factors. We combined published estimates and individual-level data from population-based surveys to derive risk factor prevalence in each country in 2010 and identified the most recent meta-analysis or conducted de novo reviews to derive effect sizes. We estimated the prevalence of stunting and the number of stunting cases that were attributable to each risk factor and cluster of risk factors by country and region. The leading risk worldwide was FGR, defined as being term and small for gestational age, and 10.8 million cases (95% CI 9.1 million–12.6 million) of stunting (out of 44.1 million) were attributable to it, followed by unimproved sanitation, with 7.2 million (95% CI 6.3 million–8.2 million), and diarrhea with 5.8 million (95% CI 2.4 million–9.2 million). FGR and preterm birth was the leading risk factor cluster in all regions. Environmental risks had the second largest estimated impact on stunting globally and in the South Asia, sub-Saharan Africa, and East Asia and Pacific regions, whereas child nutrition and infection was the second leading cluster of risk factors in other regions. Although extensive, our analysis is limited to risk factors for which effect sizes and country-level exposure data were available. The global nature of the study required approximations (e.g., using exposures estimated among women of reproductive age as a proxy for maternal exposures, or estimating the impact of risk factors on stunting through a mediator rather than directly on stunting). Finally, as is standard in global risk factor analyses, we used the effect size of risk factors on stunting from meta-analyses of epidemiological studies and assumed that proportional effects were fairly similar across countries. Conclusions: FGR and unimproved sanitation are the leading risk factors for stunting in developing countries. Reducing the burden of stunting requires a paradigm shift from interventions focusing solely on children and infants to those that reach mothers and families and improve their living environment and nutrition.
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    Overcoming the streetlight effect: Shining light on the foundations of learning and development in early childhood.
    (American Psychological Association (APA), 2024-10-17) Mccoy, Dana; Sabol, Terri
    Developmental theory has long emphasized a range of skills that young children need for healthy development across the life course. Nevertheless, most evaluations of early childhood programs and policies have focused on measuring a somewhat limited set of competencies. In this article, we explore this “streetlight effect” in early childhood intervention research and propose an initial set of skills that we argue are the foundations of learning and development (FOLD skills) and accordingly should be prioritized alongside traditionally measured outcomes as targets of intervention during the preschool period (i.e., between ages 3-5 years). These FOLD skills include both well-studied and emerging constructs such as curiosity, creativity, self-regulation and executive function, critical thinking, perspective taking, and internal representations of self. To better understand FOLD skills’ potential as more practical, effective, and inclusive targets of early childhood programs and policies, we review research regarding each skill’s malleability, measurability, predictive validity, and universality. We end with a set of future directions for the field, including the need to: (1) formulate a more inclusive taxonomy of FOLD skills that incorporates currently omitted competencies relevant to marginalized populations; (2) measure these skills in scalable and actionable ways; and (3) enhance or modify intervention strategies to optimize the development of these FOLD skills in the preschool period.
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    Country-Level Improvements in Nurturing Care and Child Development
    (American Medical Association (AMA), 2024-01-01) Mccoy, Dana; Cuartas Ricaurte, Jorge; Seiden, Jonathan
    This cross-sectional study examines whether provision of nurturing care in 31 countries over 10 years was associated with improvements in countries’ child development outcomes.
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    Building a model of cultural universality with specificity for global early childhood development
    (Wiley, 2021-12-28) Mccoy, Dana
    Numerous longstanding developmental theories have emphasized the important role that culture and context play in shaping young children’s skill development. Nevertheless, the field lacks explicit models describing the extent to which early childhood development may be similar (universal) versus different (specific) across cultures. In this article, I review evidence from multiple fields regarding both similarities and differences in the form, timing, and relevance of early health, learning, and psychosocial skills across cultures. I then synthesize this evidence, highlighting themes intended to build an integrated model of developmental universality with specificity that can be used to inform science and policy. I conclude with recommendations for the field, including suggestions for a more inclusive approach to studying early childhood development that breaks down established barriers among fields, stakeholders, and geographies.