Asthma-Related Environmental Practices and Asthma Awareness in California Child Care Centers

Abstract

Asthma prevalence is increasing. Child care centers can play an important role in controlling asthma morbidity in young children. Therefore, we assessed asthma-related environmental practices in licensed centers and asthma awareness among child care staff. Two cross-sectional surveys were mailed to 1,250 randomly selected California licensed facility child care centers in 2002. Site directors were asked about the presence of items that can trigger asthma and asthma experience in their centers and were requested to distribute surveys to three child care staff members. Staff surveys assessed asthma knowledge, attitudes, and beliefs using previously validated questions. Univariate and multivariate analyses examined frequencies and relations between responses and asthma-related factors. A total of 284 (24%) site directors and 666 (18%) staff members completed surveys. The median number of children enrolled at the centers was 48 (range, 1–1,356), with a median of 2 children with asthma (range, 0–55). During the preceding year, 55% of site directors treated an asthma episode with medication. Dust was the most commonly reported asthma trigger (84%). Although smoking in California child care centers is illegal, tobacco smoke was reported by 7% of centers. Among staff, the mean percentage of correct responses to knowledge questions was 66% (standard deviation ± 15%). Independent predictors of higher asthma knowledge among staff members were asthma training, older age, longer time working in child care, and personal asthma experience. The findings indicate that asthma-related environmental risk factors are commonly reported in child care centers and asthma knowledge among staff varies. Interventions in both areas could improve management and outcomes of children with asthma. (Pediatr Asthma Allergy Immunol 2005; 18[1]:12–24.)