Oportunidades do ambiente domiciliar e fatores associados para o desenvolvimento motor entre três e 18 meses de idade

Abstract

The home environment has been reported as one of the factors that most influence the development as it provides the child opportunities for exploration that allows the motor behavior to be stimulated naturally. The interaction with their parents, the variability of stimulation and the materials for play are critical indicators for the quality of family environment. The objectives of this study were to evaluate the opportunities present in the home environment for motor development of infants aged between three and 18 months, residents in Juiz de Fora, Minas Gerais, and the association of these biological, behavioral, demographic and socioeconomic factors. This is an epidemiological, cross-sectional population-based survey. Participants in this research were selected by random sampling process stratified multistage cluster. The primary sampling units were census tracts and the population base used was built from a previous survey. The study included 239 infants aged between three and 18 months. Data on characteristics of the infant and his family were collected and the questionnaire of the Associação Brasileira de Empresas de Pesquisa was applied. Subsequently, parents completed the questionnaire Affordance in the Home Environment for Motor Development –Infant Scale, which assesses the opportunities for motor development in domiciliary environments. To interpret the data, first proceeded the bivariate analysis, in which was applied the chi-square (c 2) or Fisher exact. To verify the associations of independent and control variables with the opportunities in home environment, logistic regression analysis was used. The factors that showed p less than 0.10 in bivariate analysis were considered eligible to write the multivariate models. Great part of the sample studied showed low opportunities of home environment. Significant association was found between the opportunities for motor stimulation present at home and the following variables: age, duration of breastfeeding, need for hospitalization in the first year of life, number of people, adults and children in the household, family head, maternal and paternal education, mother's marital status, socialization with father, socioeconomic status, monthly incomes and per capta and type of residence. After regression it was found that infants with older age and that were hospitalized in the first year of life had better opportunities of stimulation for motor development. The higher socioeconomic status, the greater education of the mother and the fact of the father be considered the head of the family were predictors of a more suitable environment with opportunities. The results also suggest that infants who live at home, compared to apartment, with three or more adults have richer environment of opportunities for stimulation. The stratified analysis by age showed that for the group aged between three and nine months, the duration of breastfeeding, the presence of siblings, the number of adults in the household, type of residence, socioeconomic status and the monthly income were the main factors associated with opportunities for motor development present in the home. For the group aged between ten and 18 months, the main factors associated with better opportunities for motor stimulation in the home were the mother's marital status, maternal and paternal education, socioeconomic status and income per capta. The results showed the main factors associated to the opportunities present in the home environment for motor development through an overview of the context in which the child lives. Thus, this study highlights the need for planning of public health and public politics that consider the aspects investigated here in order to improve the actual situation.