Attending Child Care Centers Research Articles

The impact of a vaccine scare on parental views, trust and information needs: a qualitative study in Sydney, Australia

BackgroundVaccine safety scares can undermine public confidence in vaccines and decrease immunisation rates. Understanding and addressing parental concerns arising during such scares can assist in lessening their impact. In Australia in April 2010 there was a temporary suspension of influenza vaccine for children under 5 years of age after reports of an increase in the rate of adverse events following vaccination. This qualitative study aimed to explore the impact of the vaccine suspension on parental knowledge, attitudes, trust, information needs, and intent related to influenza vaccination and broader immunisation programs.MethodsSemi-structured interviews were conducted with 25 parents of children attending childcare centres in Sydney, Australia, between June 2010 and May 2011. Centres were selected to include parents from a range of socioeconomic backgrounds. Interview transcripts were coded and analysed using an approach informed by grounded theory.ResultsFindings indicated that, for those who recalled the vaccine suspension, there was a lasting sense of uncertainty and confusion and a perceived lack of information. Parents had distinct information needs following the vaccine suspension, especially in regards to vaccine safety, testing and recommendations. For many, influenza vaccination intent was conditional on receipt of information from a trusted, authoritative source allaying safety concerns. Importantly, the impact of the scare was contained to influenza vaccines only, and not other vaccine programs.ConclusionsParental concerns and information gaps following a vaccine safety scare need to be actively addressed. We provide policy and practice suggestions for proactively managing such incidents, particularly in relation to communication of timely, targeted information to parents and immunisation providers.

Infectious morbidity and resource use in children under 2 years old at childcare centres.

To analyse the associations between childcare centres and infectious morbidity and resource consumption. Cohort study from birth to 2 years. number and types of infections, drug consumption and medical visits. Exposure variable: attending or not attending a childcare centre. School age: 6-12, >12-18, >18-24 months. The initial cohort comprised 445 children, and the final cohort comprised 419 children. The mean number of recurrent infections and wheezing was higher in children attending childcare centres in all age groups with significant differences. Recurrent acute otitis media was observed in the 12- to 18-month group with an odds ratio of 6.04 (95% confidence interval, 1.3-27.6; P = 0.001) in the children attending childcare centres. In children older than 6 months, there was greater consumption of antibiotics, inhaled bronchodilators, oral and inhaled corticosteroids and montelukast. Attending a childcare is associated with an increased frequency of recurrent infections and wheezing, as well as the consumption of antibiotics, bronchodilators, corticosteroids and montelukast.

A comparison of physical activity levels in childcare contexts among Finnish and Dutch three-year-olds

The aim of the current study was to determine Finnish and Dutch three-year-old preschool children’s physical activity (PA) levels and how levels vary across gender, location, time of day and social contexts in both countries. A modified version of the Observational System for Recording Physical Activity in Children-Preschool (OSRAC-P) was used to measure children’s PA levels and contextual variables (e.g. group composition, prompts) of children attending childcare centres in Finland and the Netherlands. In total, 90 Finnish children (46 boys and 44 girls) and 97 Dutch children (46 boys and 51 girls) were observed. Three-level linear regression analyses with cross level interactions were used to assess differences between the countries in the association between the context variables and PA. During the observations, the present sample of children was mostly sedentary in nature. Outdoor location and prompts (both positive and negative) were associated with higher levels of activity in both countries. Non-solitary playing was associated with higher activity levels in the Netherlands, but not in Finland, whereas child-initiated play was positively associated with Finnish but not Dutch children’s PA levels. Finnish children were more active in the morning compared to the afternoon, while in the Dutch children PA was unaffected by time. The present findings indicate that better understanding of the contextual factors and interactions in children’s PA behaviours across the two countries could help in planning childcare interventions to increase the PA levels of preschool children.

Integrated Pest Management Intervention in Child Care Centers Improves Knowledge, Pest Control, and Practices

IntroductionTo reduce young children's exposure to pests and pesticides, an integrated pest management (IPM) intervention was provided for child care center staff. MethodsThe 7-month IPM education and consultation intervention was conducted by trained nurse child care health consultants in 44 child care centers in California. IPM knowledge surveys were completed by child care staff, objective IPM assessments were completed by research assistants pre- and postintervention, and activity logs were completed by the nurses. ResultsThere were significant increases in IPM knowledge for the child care staff who attended workshops. There were reductions in the prevalence of pests and increases in IPM practices at the postintervention compared with the preintervention time point. The nurses consulted an average of 5.4 hours per center. DiscussionA nurse-led IPM intervention in child care centers can reduce exposure to harmful substances for young children attending child care centers.

유아기 자녀를 둔 아버지의 원가족 경험과 어머니의 양육스트레스: 아버지의 양육참여의 매개효과 검증

This study is to examine the relationships between experiences in the family of origin with fathers, parenting participation of fathers, and parenting stress of mothers. The subjects in this study consisted of 203 couples with children of ages 3, 4, and5 attending child care centers in the Gyeong-gi province. The results of this research are summarized as follows. First, experiences in the family of origin with fathers, have meaningful correlations with parenting participation of fathers and parenting stress of mothers. Also, parenting participation of fathers has meaningful correlations with parenting stress of mothers. Second, experiences in the family of origin with fathers have direct/indirect influence on parenting stress of mothers and parenting participation of fathers played a mediating role between the two variables. It is significant that these results give the basic research data for developing aparental education program that can lower parenting stress of mothers by parenting participation of fathers.

Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings (n = 38) in Montreal, Quebec, as well as their educators, participated in the study. Parents were interviewed using the Child Care Satisfaction Rating Scale, a measure of parent perception of child care quality. The home-based and centre-based child care settings were evaluated by research assistants using the Quebec Educational Quality Observation Scale. Correlational analyses revealed significant associations between global satisfaction and quality scores, as well as subscale scores for parental and observational assessments of child care quality. In addition, Chi-square analyses revealed that parental satisfaction with the parent–educator relationship and with their child’s emotional well-being in child care was stronger for children in home-based settings than in centre-based care. This research provided empirical support for parents’ ability to discriminate quality child care. It is argued that quality assessment should take the perspectives of multiple stakeholders into account.

Physical activity and sedentary behaviour of toddlers and preschoolers in child care centres in Alberta, Canada.

To describe duration of physical activity and duration and bouts of sedentary behaviour during child care in a sample of toddlers and preschoolers (19-60 months) from Alberta, Canada, and to examine whether duration and bouts differed among sex, age and parental immigration status groups. One hundred and fourteen children aged 19-60 months from eight child care centres throughout Alberta participated. Data were collected at baseline of a study examining revised Alberta Child Care Accreditation Standards. Duration of physical activity (light (LPA), moderate-to-vigorous (MVPA)) and duration and bouts (1-4, 5-9, 10-14, and ≥15 minutes) of sedentary behaviour during child care were accelerometer-derived using 15-second epochs during October/November, 2013. Median [Interquartile ranges] and ANOVAs, accounting for the clustered nature of the data, were calculated. Minutes/hour spent in sedentary behaviour, LPA and MVPA were 36.9 [32.9, 40.7], 18.4 [16.0, 20.9] and 4.2 [2.5, 5.6] respectively. Frequency/hour of sedentary bouts lasting 1-4, 5-9, 10-14 and ≥15 mins were 6.7 [6.1, 7.6], 0.9 [0.6, 1.1], 0.4 [0.2, 0.5] and 0.3 [0.2, 0.4] respectively. Preschoolers participated in less sedentary behaviour and more LPA and MVPA, and had fewer sedentary bouts lasting 10-14 and ≥15 mins compared to toddlers (p < 0.05). This is the first Canadian study to report on the duration of physical activity and duration and bouts of sedentary behaviour among both toddlers and preschoolers attending child care centres. These findings suggest child care interventions are needed to increase MVPA and decrease total sedentary behaviour while continuing to promote short sedentary bouts.

Randomized, Double-Blind, Placebo-Controlled Study of Synbiotic Yogurt Effect on the Health of Children

To assess the effects of daily consumption of a synbiotic yogurt drink on the health, growth, and quality of life of healthy children 12-48 months of age in out-of-home child care. Healthy children attending child care centers were enrolled in a prospective, double-blind, placebo-controlled clinical trial. The intervention was a yogurt drink containing Streptococcus thermophilus, Lactobacillus bulgaricus, and Bifidobacterium animalis subspecies lactis (BB-12) (5 × 10(9) cfu/100 mL serving), and 1 g of inulin (synbiotic group) vs a similar nonsynbiotic-containing acidified milk drink (placebo group) once daily for 16 weeks. The end points were days of diarrhea, fever, vomiting, symptoms of upper respiratory tract infection, use of antibiotics, physician visits, child care absenteeism, parental work absenteeism, and quality of life (PedsQL 4.0; Mapi Research Trust, Lyon, France). Compared with placebo (n = 73), children receiving synbiotic (n = 76) had significantly fewer days of reported fever (1.85 vs 1.95, P < .05), significant improvement in social functioning (P < .035; pre-to-end intervention), and school functioning (P < .045; pre-to-mid intervention). More days with ≥ 3 loose/watery stools were reported in the synbiotic group (P < .05). Daily supplementation of children's diet with yogurt containing probiotic bacteria BB-12 and inulin significantly reduced days of fever and improved social and school functioning. The increased frequency of bowel movements may be explained by an accelerating effect of BB-12 and inulin on intestinal transit. Further research on the possible benefits of synbiotics on children's health is advised. ClinicalTrials.gov: NCT00653705.

The effects of school holidays on transmission of varicella zoster virus, England and Wales, 1967-2008.

BackgroundChanges in children’s contact patterns between termtime and school holidays affect the transmission of several respiratory-spread infections. Transmission of varicella zoster virus (VZV), the causative agent of chickenpox, has also been linked to the school calendar in several settings, but temporal changes in the proportion of young children attending childcare centres may have influenced this relationship.MethodsWe used two modelling methods (a simple difference equations model and a Time series Susceptible Infectious Recovered (TSIR) model) to estimate fortnightly values of a contact parameter (the per capita rate of effective contact between two specific individuals), using GP consultation data for chickenpox in England and Wales from 1967–2008.ResultsThe estimated contact parameters were 22–31% lower during the summer holiday than during termtime. The relationship between the contact parameter and the school calendar did not change markedly over the years analysed.ConclusionsIn England and Wales, reductions in contact between children during the school summer holiday lead to a reduction in the transmission of VZV. These estimates are relevant for predicting how closing schools and nurseries may affect an outbreak of an emerging respiratory-spread pathogen.

Directly Observed Physical Activity among 3-Year-Olds in Finnish Childcare

The main purpose of the study was to determine 3-year-olds’ physical activity levels and how these vary across season, gender, time of day, location, and the physical and social environment in childcare settings in Finland. A modified version of the Observational System for Recording Physical Activity in Children-Preschool (OSRAC-P) was used to measure physical activity levels and contextual variables (e.g., group composition, prompts) of children attending childcare centres. In total, 81 children (42 boys and 39 girls) were observed in autumn and in winter. Three-level linear regression analyses were used to assess differences between the seasons in the association between the context variables and physical activity. During the observations, the present sample of children was mostly sedentary in nature, engaging in moderate to vigorous physical activity in only 2 % of all observations. The results further showed a significant difference between season and the children’s physical activity levels: in winter, the children spent significantly more time in sedentary-level activities and less time in moderate to vigorous physical activity than in autumn. The present sample of children was physically more active outdoors than indoors. Boys showed significantly higher physical activity levels than girls. The majority of the observations did not include any oral prompting. We conclude that childcare centres offer good opportunities to increase children’s physical activity. Interventions should focus on enhancing children’s outdoor time, free play, and positive prompting and encouragement by teachers.

Infectious diseases in early education and child care programs.

1. Timothy R. Shope, MD, MPH* 1. *Department of Pediatrics, Division of General Academic Pediatrics, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA. * Abbreviations: AAP: : American Academy of Pediatrics CFOC3: : Caring for Our Children , 3rd ed ECE: : early care and education RSV: : respiratory syncytial virus Out-of-home care and education are the norms for most young children and lead to increased exposure to infectious diseases. Pediatricians need to be aware of strategies to reduce the risk of infection and guidelines for determining exclusion and return to care for mildly ill children who participate in group care arrangements. After completing this article, readers should be able to: 1. Recognize the risks of infectious diseases in children who participate in early care and education programs. 2. Understand methods for reducing infectious diseases in early care and education settings. 3. Identify which infectious diseases require exclusion from early care and education programs. Two-thirds of children younger than 6 years participate in nonparental out-of-home early education and child care. Demographic trends during the past several decades reflect an increased desire and need to work for men and women who are parents. During the first 2 years of participation, children enrolled in early care and education (ECE) programs experience a higher incidence of respiratory and diarrheal infections, otitis media, and antibiotic-resistant bacteria compared with their peers primarily cared for at home. The types of infection generally reflect common respiratory and gastrointestinal viruses in circulation in the community. However, there are some infectious diseases that can cause outbreaks or clusters of infections in ECE settings. When ill children are excluded from an ECE facility, parents may miss work, lose income, and seek health care services in an effort to return their children to child care. Pediatricians need to be aware of the infectious disease risks of child care attendance and various strategies for reducing them. In addition, pediatricians need to be knowledgeable about rational exclusion and return …

Prevalence of iron deficiency among Inuit preschool children attending childcare centres in Nunavik (632.8)

In infants and children, iron deficiency (ID) can have several adverse effects on health including lethargy, alterations of immune defense mechanisms and impaired growth and cognitive development. The purpose of this study was to determine the prevalence of ID in a group of preschool Inuit children attending childcare centres in Nunavik using conventional measurements of iron status and a relatively new parameter, soluble transferrin receptor (sTfR). sTfR is especially useful in the presence of inflammation or infection. Two hundred forty‐five Inuit children aged between 11 and 54 months (mean (SD) = 25.0 (9.6) months) were recruited between 2006 and 2010 in 10 of the 14 Nunavik communities. About half of the children were male and 52.3% (n=128) were less than 24 months old at the time of the study. Sixty‐five children were excluded because they lacked one or more of the parameters under analysis, leaving 180 subjects for the assessment of iron status. ID defined either as serum ferritin &lt;15 mg/L, sTfR &gt;1.55 or sTfR‐ferritin index (sTfR/log ferritin) &gt;1.5 was found in 73.2% of subjects. Anemia (hemoglobin (Hb) &lt;110 g/L (12‐35 months old) or &lt;112 g/L (36‐59 months old)) was present in 15% of children, while 7.2% suffered from iron deficiency anemia (IDA) (ID and C‐reactive protein (CRP) &lt;6 mg/L), and 5% from IDA and coexisting anemia of inflammation (ID and CRP 蠅6 mg/L). Iron deficiency constitutes a significant public health problem in these Canadian Aboriginal children. Measures to improve iron intake and bioavailability are required and consumption of traditional foods rich in iron must be encouraged.Grant Funding Source: Supported by Aboriginal Affairs and Northern Development Canada &amp; Kativik Regional Government

Effect of dietary calcium intake on lead exposure in Inuit children attending childcare centres in Nunavik

High blood lead levels (BLLs) can be found in Inuit from Nunavik. At the same time, various nutrients such as calcium could lower lead absorption and toxicity. We examined the effect of dietary calcium intakes on BLLs in 245 preschool Inuit children attending childcare centres in Nunavik. Calcium intake was assessed with one 24-h dietary recall and BLLs were determined by inductively coupled plasma mass spectrometry in whole blood samples. Multiple imputation was performed to deal with missing data. Median blood lead concentration was 0.08 μmol/L. A high proportion of children did not meet the Estimated Average Requirement for vitamin D intake (73 %) and, to a lower extent, for calcium (20 %). Calcium intake was negatively associated with BLLs ( p = 0.0001) while child’s age and energy intake were positively associated with BLLs ( p = 0.015 and p = 0.024, respectively). Consuming traditional foods rich in calcium as well as milk and alternatives may protect against lead exposure.

Adjustment of Korean First-Graders to Elementary School: The Role of Family Income, Type of Early Childhood Education Program, and Private Education Before and After School Entry

This study reviews the current status of Korean first graders, their experience with early care and education (ECE) programs, and their participation in private and after-school education. The research also examines how school adjustment during the first grade is related to family income, types of ECE programs, and participation in private and after-school education. Using the first year data of the Korean Child and Youth Panel Survey (KCYPS) 2010, this study analyzes 752 first graders who attended only one of two types of ECE programs (child care centers or kindergartens), after which two 25% income extremes were examined. The analysis demonstrates that children from low-income households attended child care centers more often, while children from high-income households attended kindergartens more often. For both low-income and high-income groups, child care centers had a lower starting age and longer attendance periods than did kindergartens. High-income household children started attending ECE programs earlier, experienced more private and after-school education, and received a larger number of private and after-school educational lessons. For the second research purpose, children from low-income families showed better peer relations in school adjustment, while children attending child care centers showed better teacher relations than children attending kindergartens. Children with after-school education also exhibited better peer relations. These findings show the importance of government support for early learning, especially for low-income families and offer a foundation for developing private education polices for early childhood before and after school entry.

P049: High rate of MRSA respiratory tract colonisation in HIV-positive children in Cambodia during 2004-2012

Children attending child care centres are at increased risk of infections, including those caused by MRSA (methicillin-resistant S. aureus).

Effect of a governmentally-led physical activity program on motor skills in young children attending child care centers: a cluster randomized controlled trial

ObjectiveTo assess the effect of a governmentally-led center based child care physical activity program (Youp’là Bouge) on child motor skills.Patients and methodsWe conducted a single blinded cluster randomized controlled trial in 58 Swiss child care centers. Centers were randomly selected and 1:1 assigned to a control or intervention group. The intervention lasted from September 2009 to June 2010 and included training of the educators, adaptation of the child care built environment, parental involvement and daily physical activity. Motor skill was the primary outcome and body mass index (BMI), physical activity and quality of life secondary outcomes. The intervention implementation was also assessed.ResultsAt baseline, 648 children present on the motor test day were included (age 3.3 ± 0.6, BMI 16.3 ± 1.3 kg/m2, 13.2% overweight, 49% girls) and 313 received the intervention. Relative to children in the control group (n = 201), children in the intervention group (n = 187) showed no significant increase in motor skills (delta of mean change (95% confidence interval: -0.2 (−0.8 to 0.3), p = 0.43) or in any of the secondary outcomes. Not all child care centers implemented all the intervention components. Within the intervention group, several predictors were positively associated with trial outcomes: 1) free-access to a movement space and parental information session for motor skills 2) highly motivated and trained educators for BMI 3) free-access to a movement space and purchase of mobile equipment for physical activity (all p < 0.05).ConclusionThis “real-life” physical activity program in child care centers confirms the complexity of implementing an intervention outside a study setting and identified potentially relevant predictors that could improve future programs.Trial registrationClinical trials.gov NCT00967460

Unintentional Injury in Early Childhood: Its Relationship with Childcare Setting and Provider

We hypothesized that young children cared for by non-parents outside of the home are at higher odds of injury compared to children cared for by parents at home. Data were obtained from the 2007 National Survey of Children's Health. Parent-reported injury prevalence within the last 12months for 1-5year-olds was compared for children with different childcare providers and settings. Child age, gender, race/ethnicity, special healthcare needs, residence in a Metropolitan Statistical Area, region of United States (U.S.), and measures of poverty, family structure, and parent education were considered as covariates in logistic regression models. The prevalence of injury in the U.S. for children aged 1-5 is 11.9%. Children who attend childcare centers ≥10h per week have a higher injury prevalence than those cared for by parents at home (13.9 vs. 10.4% respectively, p<0.05), but this differs by age. Among 1-year olds, the odds of injury is lower for those with care at a center compared to at home, but among 2-5year olds, the OR is 1.37 (95% CI 1.04, 1.80) for childcare center versus home care, after adjusting for covariates. The relationship between care at a center and unintentional injury appears stronger when no parent in the household has a high school degree. National data indicate that children aged 2-5 who attend childcare centers may be at increased odds of injury. Future population-based studies should capture the severity and context of the injury and characteristics of the childcare center to better define this relationship.

Early maternal employment and childhood obesity among economically disadvantaged families in the USA

Research indicates a link between maternal employment and children's risk of obesity, but little prior work has addressed maternal employment during children's infancy. This study examined the timing and intensity of early maternal employment and associations with children's later overweight and obesity in a sample of low-income families in low-income urban communities in the USA (n = 322). Logistic regression and propensity score models suggested that mothers’ entry into employment when a child was 9–23 months old predicted a higher risk of child overweight/obesity at age 7 in comparison to both earlier entries and remaining out of the labour market for at least two years. This association was more pronounced with full-time work and existed mainly for children who remained in mother care or attended child care centres. Further work is necessary to determine mechanisms for this relationship, such as breastfeeding and nutrition.

Traditional food consumption is associated with higher nutrient intakes in Inuit children attending childcare centres in Nunavik

Objectives. To describe traditional food (TF) consumption and to evaluate its impact on nutrient intakes of preschool Inuit children from Nunavik.Design. A cross-sectional study.Methods. Dietary intakes of children were assessed with a single 24-hour recall (n=217). TF consumption at home and at the childcare centres was compared. Differences in children's nutrient intakes when consuming or not consuming at least 1 TF item were examined using ANCOVA.Results. A total of 245 children attending childcare centres in 10 communities of Nunavik were recruited between 2006 and 2010. The children's mean age was 25.0±9.6 months (11–54 months). Thirty-six percent of children had consumed at least 1 TF item on the day of the recall. TF contributed to 2.6% of total energy intake. Caribou and Arctic char were the most reported TF species. Land animals and fish/shellfish were the main contributors to energy intake from TF (38 and 33%, respectively). In spite of a low TF intake, children who consumed TF had significantly (p<0.05) higher intakes of protein, omega-3 fatty acids, iron, phosphorus, zinc, copper, selenium, niacin, pantothenic acid, riboflavin, and vitamin B12, and lower intakes of energy and carbohydrate compared with non-consumers. There was no significant difference in any of the socio-economic variables between children who consumed TF and those who did not.Conclusion. Although TF was not eaten much, it contributed significantly to the nutrient intakes of children. Consumption of TF should be encouraged as it provides many nutritional, economic, and sociocultural benefits.

A Nationwide Survey on the Child Day Care and Common Infectious Diseases

' Purpose:As the number of children who attend child care centers has increased, concerns has increased about the effect of child day care on childhood illness. This study was conducted to examine the relationship between experience in child care and common infectious diseases in children under 5 years of age. Methods:Data were collected by surveying 1,000 respondents with children under age 5 through online interviews using a structured questionnaire. The contents of the survey were composed of demographic characteristics, child care facilities usage, experience in infectious diseases, and immunization status Results: Among the 1,000 children <5 years of age, 78.5% attended a child care facility. Rates of common communicable illnesses were higher in children in child care than for children reared exclusively at home. The predominant communicable diseases which the respondents' children experienced, in order of decreasing frequency, were gastroenteritis (47.1%), otitis media (41.8%) and pneumonia (19.1%). The immunization rate of vaccines that are not included the national immunization program (NIP) (Haemophilus influenzae type b vaccine - 76.6%, hepatitis A vaccine - 63.3%, pneumococcal vaccine - 59.4%, rotavirus vaccine - 43.1%) was lower than that of the NIP vaccines (90.4%) Conclusion:Children in child care experience more bouts of common infectious disease, so nationwide policies to prevent or to control the spread of infectious agents in a child-care should be available and appropriate immunization should be emphasized as the most effective method for the control of infectious disease for children. (Korean J Pediatr Infect Dis 2012;19:19-27)