3. Ethical Considerations

This study was approved by the institutional review board (No.2018-07-002). A pamphlet was prepared to explain the objectives and procedures of the study to children and primary caregivers. It also explained that participants could withdraw from the study at any time without repercussions and that information about participants would remain confidential and would not be used for purposes other than research. A researcher then called the primary caregivers via phone to again explain the purpose and procedure of the study and obtained verbal consent. Written consent forms were then sent to the primary caregivers who had given verbal consent, and they were signed by the primary caregivers and given to the children to bring to the CCC. Verbal consent was obtained from the children before both data collection and the start of the program.

To avoid any stigma from being classified as a low-income family, we avoided using descriptions that could add to that stigma such as "low-income families" or "single-parent families" in all educational materials, and the educators also fully recognized this problem before conducting research.