Abstract
BACKGROUD: Childhood development is influenced by the quality of the environment in which children live. Social inequalities, non-responsive parental practices, and poor caregiver mental health can delay children's development. Our objective was to evaluate the socioeconomic and maternal mental health factors associated with the parenting and development of children participating in Programa Criança Feliz (Happy Child Program; PCF), a Brazilian early childhood promotion program. METHODS: This was a cross-sectional study with children aged up to 24 months who were participating in the PCF in the Federal District, Brazil. In 2022, sociodemographic data, maternal depression and anxiety, responsive and unresponsive parenting and the risk of child developmental delay were collected with validated instruments. The data were analyzed via a hybrid structural equation model. RESULTS: A total of 301 children whose data were reported by caregivers participated in the study. Mothers represented 92.4% of the caregivers. Among them, 61.8% reported having an income of up to US$200.00 per month, and half of the mothers and 66% of the fathers had incomplete secondary education or less. Half of the mothers were classified as having depression or anxiety (49.5%; 95% CI: 43.9-55.1). Nonresponsive parenting practices such as parental inconsistency (32.6%, 95% CI 27.5-38.0) and coercive practices (43%, 95% CI 37.4-48.5) were frequent. Among the children, 45.9% (95% CI: 40.2-51.7) were at risk for developmental delay, which was positively associated with the presence of maternal anxiety (β = 0.286; p = 0.001) and with lower education (β = 0.207; p = 0.006). Higher unresponsive parenting scores were associated with the presence of anxiety (β = 0.230, p = 0.036) and lower income (β = 0.392, p < 0.001). The use of coercive practices was positively associated with the presence of anxiety (β = 0.182, p = 0.019) and with mothers as heads of the family (β = 0.157, p = 0.012). CONCLUSIONS: Socioeconomic disparities and the presence of maternal anxiety were associated with unresponsive parenting and with the risk of developmental delay among children participating in the PCF in the Federal District.