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Psychometric evidence for assessing early childhood development in Brazil: the Child Development Diagnostic Form in the Criança Feliz Program.

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Τίτλος: Psychometric evidence for assessing early childhood development in Brazil: the Child Development Diagnostic Form in the Criança Feliz Program.
Συγγραφείς: Cerqueira ES; Post-Graduation Program in Food, Nutrition and Health, School of Nutrition, Federal University of Bahia, Salvador, Brazil.; Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (Fiocruz), Salvador, Bahia, Brazil., Reichenheim ME; Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil., Alves AAR; United Nations Development Programme, Brasília, Distrito Federal, Brazil., Dutra RR; Ministry of Development and Social Assistance, Family and Fight against Hunger, Brasília, Distrito Federal, Brazil., Moraes CL; Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil., Costa PRF; Post-Graduation Program in Food, Nutrition and Health, School of Nutrition, Federal University of Bahia, Salvador, Brazil.; Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (Fiocruz), Salvador, Bahia, Brazil., Ribeiro-Silva RC; Post-Graduation Program in Food, Nutrition and Health, School of Nutrition, Federal University of Bahia, Salvador, Brazil.; Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (Fiocruz), Salvador, Bahia, Brazil., Barreto ML; Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute (IGM), Oswaldo Cruz Foundation (Fiocruz), Salvador, Bahia, Brazil mauricio.barreto@fiocruz.br.
Πηγή: BMJ paediatrics open [BMJ Paediatr Open] 2026 Aug 04; Vol. 10 (1). Date of Electronic Publication: 2026 Aug 04.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101715309 Publication Model: Electronic Cited Medium: Internet ISSN: 2399-9772 (Electronic) Linking ISSN: 23999772 NLM ISO Abbreviation: BMJ Paediatr Open Subsets: MEDLINE
Imprint Name(s): Original Publication: London : BMJ Publishing Group, [2017]-
Ιατρικοί όροι (MeSH): Child Development* , Psychometrics*, Humans ; Brazil ; Infant ; Female ; Child, Preschool ; Male ; Reproducibility of Results ; Infant, Newborn ; Factor Analysis, Statistical
Περίληψη: Introduction: Child development is a multidimensional process influenced by socioeconomic conditions. The Programa Criança Feliz (PCF), Brazil's largest home-visiting initiative, uses the Formulário de Observação Inicial do Desenvolvimento Infantil (FOIDI) to monitor developmental milestones. Despite being widely implemented, the FOIDI had not previously undergone formal validation. This study evaluated configural and metric validity of FOIDI in a representative sample of Brazilian children aged 0-36 months.
Methods: A total of 183 974 assessments from 82 797 children in PCF (2020-2023) were analysed. Cohorts for seven age groups were divided into three independent partitions. Initially, Horn's parallel analysis determined the number of underlying factors. Confirmatory factor analyses followed, using weighted least-squares mean and variance adjusted estimator and polychoric correlation matrices. Model fit was evaluated using root mean square error of approximation, comparative fit index and Tucker-Lewis index. Items with factor loadings<0.40 were considered unreliable. Modification indices (MIs; univariate Lagrange multiplier) and expected parameter changes were used to identify potential cross-loadings and residual correlations. Convergent validity was estimated using average variance extracted (AVE≥0.50); discriminant validity was assessed by comparing the square root of AVE with factor correlations.
Results: Modules exhibited unidimensional (M3-M7) or bidimensional structures (M1-M2), with factor loadings ranging from 0.519 to 0.903. AVE was≥0.50 for all factors evaluated, supporting convergent validity. Discriminant validity was confirmed within the bidimensional modules. The removal of redundant items increased model parsimony without compromising informativeness.
Conclusion: The FOIDI demonstrated robust configural and metric validity, capturing core aspects of child development across different age groups in contexts of socioeconomic vulnerability. The refined instrument proved suitable for home-visiting programmes, offering a practical, reliable and scalable tool for developmental surveillance and the support of public policies.
(© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.)
Competing Interests: Competing interests: None declared.
References: Lancet Glob Health. 2022 Mar;10(3):e438-e444. (PMID: 35038406)
Child Care Health Dev. 2015 Nov;41(6):1131-9. (PMID: 26250756)
Rev Saude Publica. 2021 Aug 09;55:40. (PMID: 34378771)
BMJ Open. 2020 Nov 23;10(11):e038182. (PMID: 33234622)
Arch Dis Child. 2019 Apr;104(Suppl 1):S22-S33. (PMID: 30885963)
Psychometrika. 1965 Jun;30:179-85. (PMID: 14306381)
Cad Saude Publica. 2022 Feb 11;38(2):e00316920. (PMID: 35170705)
Pediatr Rev. 2011 Dec;32(12):533-6. (PMID: 22135423)
Acta Paediatr Suppl. 2006 Apr;450:86-95. (PMID: 16817682)
J Pediatr (Rio J). 2020 Nov - Dec;96(6):778-789. (PMID: 31794693)
Cad Saude Publica. 2008;24 Suppl 3:S444-50. (PMID: 18797720)
Pediatrics. 2022 Mar 1;149(3):. (PMID: 35132439)
Lancet. 2017 Jan 7;389(10064):77-90. (PMID: 27717614)
Cien Saude Colet. 2007 Jan-Mar;12(1):181-90. (PMID: 17680069)
Pediatrics. 1992 Jan;89(1):91-7. (PMID: 1370185)
Med Care. 2007 May;45(5 Suppl 1):S22-31. (PMID: 17443115)
Niger Postgrad Med J. 2024 Apr 1;31(2):118-129. (PMID: 38826015)
Contributed Indexing: Keywords: Child Health; Children; Developing Countries; Epidemiology; Low and Middle Income Countries
Entry Date(s): Date Created: 20260804 Date Completed: 20260804 Latest Revision: 20260813
Update Code: 20260814
PubMed Central ID: PMC13448607
DOI: 10.1136/bmjpo-2025-004362
PMID: 42552080
Βάση Δεδομένων: MEDLINE
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  Data: Psychometric evidence for assessing early childhood development in Brazil: the Child Development Diagnostic Form in the Crian&#231;a Feliz Program.
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  Data: Introduction: Child development is a multidimensional process influenced by socioeconomic conditions. The Programa Crian&#231;a Feliz (PCF), Brazil&#39;s largest home-visiting initiative, uses the Formul&#225;rio de Observa&#231;&#227;o Inicial do Desenvolvimento Infantil (FOIDI) to monitor developmental milestones. Despite being widely implemented, the FOIDI had not previously undergone formal validation. This study evaluated configural and metric validity of FOIDI in a representative sample of Brazilian children aged 0-36 months.&lt;br /&gt;Methods: A total of 183 974 assessments from 82 797 children in PCF (2020-2023) were analysed. Cohorts for seven age groups were divided into three independent partitions. Initially, Horn&#39;s parallel analysis determined the number of underlying factors. Confirmatory factor analyses followed, using weighted least-squares mean and variance adjusted estimator and polychoric correlation matrices. Model fit was evaluated using root mean square error of approximation, comparative fit index and Tucker-Lewis index. Items with factor loadings&amp;lt;0.40 were considered unreliable. Modification indices (MIs; univariate Lagrange multiplier) and expected parameter changes were used to identify potential cross-loadings and residual correlations. Convergent validity was estimated using average variance extracted (AVE≥0.50); discriminant validity was assessed by comparing the square root of AVE with factor correlations.&lt;br /&gt;Results: Modules exhibited unidimensional (M3-M7) or bidimensional structures (M1-M2), with factor loadings ranging from 0.519 to 0.903. AVE was≥0.50 for all factors evaluated, supporting convergent validity. Discriminant validity was confirmed within the bidimensional modules. The removal of redundant items increased model parsimony without compromising informativeness.&lt;br /&gt;Conclusion: The FOIDI demonstrated robust configural and metric validity, capturing core aspects of child development across different age groups in contexts of socioeconomic vulnerability. The refined instrument proved suitable for home-visiting programmes, offering a practical, reliable and scalable tool for developmental surveillance and the support of public policies.&lt;br /&gt; (&#169; Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.)
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  Data: Competing interests: None declared.
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  Data: Lancet Glob Health. 2022 Mar;10(3):e438-e444. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2235038406%22&quot;&gt;35038406)&lt;/searchLink&gt;&lt;br /&gt;Child Care Health Dev. 2015 Nov;41(6):1131-9. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2226250756%22&quot;&gt;26250756)&lt;/searchLink&gt;&lt;br /&gt;Rev Saude Publica. 2021 Aug 09;55:40. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2234378771%22&quot;&gt;34378771)&lt;/searchLink&gt;&lt;br /&gt;BMJ Open. 2020 Nov 23;10(11):e038182. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2233234622%22&quot;&gt;33234622)&lt;/searchLink&gt;&lt;br /&gt;Arch Dis Child. 2019 Apr;104(Suppl 1):S22-S33. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2230885963%22&quot;&gt;30885963)&lt;/searchLink&gt;&lt;br /&gt;Psychometrika. 1965 Jun;30:179-85. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2214306381%22&quot;&gt;14306381)&lt;/searchLink&gt;&lt;br /&gt;Cad Saude Publica. 2022 Feb 11;38(2):e00316920. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2235170705%22&quot;&gt;35170705)&lt;/searchLink&gt;&lt;br /&gt;Pediatr Rev. 2011 Dec;32(12):533-6. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2222135423%22&quot;&gt;22135423)&lt;/searchLink&gt;&lt;br /&gt;Acta Paediatr Suppl. 2006 Apr;450:86-95. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2216817682%22&quot;&gt;16817682)&lt;/searchLink&gt;&lt;br /&gt;J Pediatr (Rio J). 2020 Nov - Dec;96(6):778-789. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2231794693%22&quot;&gt;31794693)&lt;/searchLink&gt;&lt;br /&gt;Cad Saude Publica. 2008;24 Suppl 3:S444-50. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2218797720%22&quot;&gt;18797720)&lt;/searchLink&gt;&lt;br /&gt;Pediatrics. 2022 Mar 1;149(3):. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2235132439%22&quot;&gt;35132439)&lt;/searchLink&gt;&lt;br /&gt;Lancet. 2017 Jan 7;389(10064):77-90. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2227717614%22&quot;&gt;27717614)&lt;/searchLink&gt;&lt;br /&gt;Cien Saude Colet. 2007 Jan-Mar;12(1):181-90. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2217680069%22&quot;&gt;17680069)&lt;/searchLink&gt;&lt;br /&gt;Pediatrics. 1992 Jan;89(1):91-7. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%221370185%22&quot;&gt;1370185)&lt;/searchLink&gt;&lt;br /&gt;Med Care. 2007 May;45(5 Suppl 1):S22-31. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2217443115%22&quot;&gt;17443115)&lt;/searchLink&gt;&lt;br /&gt;Niger Postgrad Med J. 2024 Apr 1;31(2):118-129. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2238826015%22&quot;&gt;38826015)&lt;/searchLink&gt;
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