This study examines the impact of Auxilio Brasil (AB), a cash transfer program to mothers of school-age children, on resource-deprived populations in Brazil and its protective effects on child neurodevelopment and mental health. The investigators will conduct a randomized clinical trial (RCT) among those already receiving AB in which 300 families will be randomized in a 1:1 ratio to receive either a high ($40/month) or low ($2/month) supplemental transfer for 2 years. Three hundred children (index child participants; 7-10 years old) will be enrolled across both study arms. Additionally, up to 150 siblings ("sibling participants;" 7-10 years old) will be enrolled. Eligible families who decide to participate will sign a study-specific informed consent (mother) and assent (child) form. The UNIFESP team will conduct the respective assessments at baseline, approximately 8- and 16- months, 24-months and approximately 6-months post-RCT. Aim 1: Determine the impact of high vs low cash transfers on children's exposure to adversities (ACEs) and neurodevelopment. Aim 2: Determine the impact of cash transfers on children's inflammatory markers and HPA activity/cortisol. Exploratory Aim: The investigators will explore (i) whether sex/gender of the children moderates the pathways in the above mediation model; and (ii) whether cash transfer-related effects persist 6 months post-RCT.
Age range
23 Years – 45 Years
Sex
ALL
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Adverse Childhood Experiences (ACEs) - FHE
Timeframe: Baseline
Changes in Adverse Childhood Experiences (ACEs) - FHE
Timeframe: 8 months
Changes in Adverse Childhood Experiences (ACEs) - FHE
Timeframe: 16 months
Changes in Adverse Childhood Experiences (ACEs) - FHE
Timeframe: 24 months
Changes in Adverse Childhood Experiences (ACEs) - FHE
Timeframe: 6 months post-RCT
Adverse Childhood Experiences (ACEs) - CTC
Timeframe: Baseline
Changes in Adverse Childhood Experiences (ACEs) - CTC
Timeframe: 8 months
Changes in Adverse Childhood Experiences (ACEs) - CTC
Timeframe: 16 months
Changes in Adverse Childhood Experiences (ACEs) - CTC
Timeframe: 24 months
Changes in Adverse Childhood Experiences (ACEs) - CTC
Timeframe: 6 months-post RCT
Child internalizing and externalizing symptoms
Timeframe: Baseline
Changes in Child internalizing and externalizing symptoms
Timeframe: 8 months
Changes in Child internalizing and externalizing symptoms
Timeframe: 16 months
Changes in Child internalizing and externalizing symptoms
Timeframe: 24 months
Changes in Child internalizing and externalizing symptoms
Timeframe: 6 months-post RCT
Access to health care
Timeframe: Baseline
Changes in Access to health care
Timeframe: 8 months
Changes in Access to health care
Timeframe: 16 months
Changes in Access to health care
Timeframe: 24 months
Child brain MRI scan
Timeframe: Baseline
Changes in Child brain MRI scan
Timeframe: 24 months
Child Executive Function
Timeframe: Baseline
Changes in Child Executive Function
Timeframe: 24 months
Changes in Child Executive Function
Timeframe: 6 months-post RCT
Biospecimen - Child hair sample
Timeframe: Baseline
Biospecimen - Changes in Child hair sample
Timeframe: 24 months
Biospecimen - Blood Draw - IL-6
Timeframe: Baseline
Biospecimen - Blood Draw - Change in IL-6
Timeframe: 24 months
Biospecimen - Blood Draw - CRP
Timeframe: Baseline
Biospecimen - Blood Draw - Change in CRP
Timeframe: 24 months
Family Adaptability and Cohesion Evaluation Scale-III (FACES-III)
Timeframe: Baseline
Change in Family Adaptability and Cohesion Evaluation Scale-III (FACES-III)
Timeframe: 24 months