How does context shape differences and changes in caregivers' engagement in psychosocial stimulation over time?...

As few as 34% of 3- and 4-year-olds in low- and middle-income countries (LMICs) receive adequate psychosocial stimulation from their caregivers (e.g., reading books, telling stories, playing). While previous research suggests that structural conditions within LMICs meaningfully influence caregivers' capacities to engage in psychosocial stimulation of children, it remains unclear how such conditions may underlie both within-household and between-person changes in psychosocial stimulation over time. To address these gaps, the present study utilized longitudinal, repeated-measures data from two LMICs in the Multiple Indicator Cluster Surveys Plus, namely, Georgia and Mongolia. Household demographics and structural conditions were examined as predictors of caregivers' engagement in psychosocial stimulation over time using longitudinal multilevel modeling (N = 745). Results indicated that over time, caregivers' engagement in psychosocial stimulation had a small, but significant decline. In addition, various household demographic factors (i.e., male child, larger household size) and structural conditions (i.e., living in a rural community, having fewer material resources, experiencing a recent decline in income, residing in Mongolia [compared to Georgia]) were associated with lower levels of caregiver psychosocial stimulation. These findings highlight how interventions to improve psychosocial stimulation in LMICs may be most effective if they are predicated on the multilevel contextual needs of families.