Center-based Child Care Programs Research Articles

The Impacts of Childcare Interventions on Children’s Outcomes in Low- and Middle-Income Countries: A Systematic Review

Center-based childcare programs are expanding rapidly in low-and middle-income countries. The impacts of these programs on women's labor market outcomes are consistently positive, but what are the impacts on children's developmental outcomes? We systematically review 71 studies of center-based childcare interventions that report impacts on children and find that most (93 percent of studies and 81 percent of estimates) have positive point estimates. Girls tend to benefit more than boys, but poorer children do not consistently benefit more or less than wealthier children. These results are consistent across experimental and quasi-experimental studies.

Secure communities as immigration enforcement: How secure is the child care market?

Immigrants comprise nearly 20% of the child care workforce in the U.S. This paper studies the impact of a major immigration enforcement policy, Secure Communities (SC), on the structure and functioning of the child care market. Relying on the staggered introduction of SC across counties between 2008 and 2014, we find that the program reduced children’s participation in center-based child care programs. The estimated reductions are substantially larger among advantaged children and in jurisdictions with a greater fraction of undocumented individuals. We also find that SC reduced the equilibrium supply and wages of immigrant and native workers in the center-based sector as well as the number of center-based facilities. There is no compensating increase in the home-based or private household sectors. Our findings suggest that immigrants and natives are likely to be complements in child care service production.

Investigating the association between professional development and educators’ beliefs in U.S. center- and home-based early childhood education

The child-centered beliefs held by educators in early childhood education (ECE) are important in high-quality interactions between children and adults and are central to the recent policy emphasis on childcare quality. Using a national ECE workforce sample of home- and center-based centers from the 2019 National Survey of Early Care and Education (N=7,505), this study examined the relationships between professional development experiences and ECE educators' child-centered beliefs measured by a revised Parental Modernity Scale. We focused on the three PD models of mentoring and coaching, workshops, and college courses, and found that attending college courses was related to greater child-centered beliefs in home-based educators. Mentoring and coaching were found to effectively promote center-based educators’ beliefs. In terms of the contexts that support PD participation in home- and center-based childcare programs, our findings suggest that providing more opportunities to participate in coaching and college courses can offer effective support and thus improve ECE quality. The policy and practical implications of the findings are discussed.

Designing a childhood obesity preventive intervention using the multiphase optimization strategy: The Healthy Bodies Project.

Preventing the development of childhood obesity requires multilevel, multicomponent, comprehensive approaches. Study designs often do not allow for systematic evaluation of the efficacy of individual intervention components before the intervention is fully tested. As such, childhood obesity prevention programs may contain a mix of effective and ineffective components. This article describes the design and rationale of a childhood obesity preventive intervention developed using the multiphase optimization strategy, an engineering-inspired framework for optimizing behavioral interventions. Using a series of randomized experiments, the objective of the study was to systematically test, select, and refine candidate components to build an optimized childhood obesity preventive intervention to be evaluated in a subsequent randomized controlled trial. A 24 full factorial design was used to test the individual and combined effects of four candidate intervention components intended to reduce the risk for childhood obesity. These components were designed with a focus on (a) improving children's healthy eating behaviors and nutrition knowledge, (b) increasing physical activity and reducing sedentary activity in the childcare setting, (c) improving children's behavioral self-regulation, and (d) providing parental web-based education to address child target outcomes. The components were tested with approximately 1400 preschool children, ages 3-5 years in center-based childcare programs in Pennsylvania, the majority of which served predominantly Head-Start eligible households. Primary child outcomes included healthy eating knowledge, physical and sedentary activity, and behavioral self-regulation. Secondary outcomes included children's body mass index and appetitive traits related to appetite regulation. Four intervention components were developed, including three classroom curricula designed to increase preschool children's nutrition knowledge, physical activity, and behavioral, emotional, and eating regulation. A web-based parent education component included 18 lessons designed to improve parenting practices and home environments that would bolster the effects of the classroom curricula. A plan for analyzing the specific contribution of each component to a larger intervention was developed and is described. The efficacy of the four components can be evaluated to determine the extent to which they, individually and in combination, produce detectable changes in childhood obesity risk factors. The resulting optimized intervention should later be evaluated in a randomized controlled trial, which may provide new information on promising targets for obesity prevention in young children. This research project highlights the ways in which an innovative approach to the design and initial evaluation of preventive interventions may increase the likelihood of long-term success. The lessons from this research project have implications for childhood obesity research as well as other preventive interventions that include multiple components, each targeting unique contributors to a multifaceted problem.

Association of Child Masking With COVID-19–Related Closures in US Childcare Programs

It is not known how effective child masking is in childcare settings in preventing the transmission of SARS-CoV-2. This question is critical to inform health policy and safe childcare practices. To assess the association between masking children 2 years and older and subsequent childcare closure because of COVID-19. A prospective, 1-year, longitudinal electronic survey study of 6654 childcare professionals at home- and center-based childcare programs in all 50 states was conducted at baseline (May 22 to June 8, 2020) and follow-up (May 26 to June 23, 2021). Using a generalized linear model (log-binomial model) with robust SEs, this study evaluated the association between childcare program closure because of a confirmed or suspected COVID-19 case in either children or staff during the study period and child masking in both early adoption (endorsed at baseline) and continued masking (endorsed at baseline and follow-up), while controlling for physical distancing, other risk mitigation strategies, and program and community characteristics. Child masking in childcare programs as reported by childcare professionals at baseline and both baseline and follow-up. Childcare program closure because of a suspected or confirmed COVID-19 case in either children or staff as reported in the May 26 to June 23, 2021, end survey. This survey study of 6654 childcare professionals (mean [SD] age, 46.9 [11.3] years; 750 [11.3%] were African American, 57 [0.9%] American Indian/Alaska Native, 158 [2.4%] Asian, 860 [12.9%] Hispanic, 135 [2.0%] multiracial [anyone who selected >1 race on the survey], 18 [0.3%] Native Hawaiian/Pacific Islander, and 5020 [75.4%] White) found that early adoption (baseline) of child masking was associated with a 13% lower risk of childcare program closure because of a COVID-19 case (adjusted relative risk, 0.87; 95% CI, 0.77-0.99), and continued masking for 1 year was associated with a 14% lower risk (adjusted relative risk, 0.86; 95% CI, 0.74-1.00). This survey study of childcare professionals suggests that masking young children is associated with fewer childcare program closures, enabling in-person education. This finding has important public health policy implications for families that rely on childcare to sustain employment.

Through the lens of early educators: Understanding the use of expulsion and suspension in childcare programs

As a means to comprehend barriers and challenges to the agenda of early care and education, this study was designed to understand the practice of expulsion and suspension in early childhood settings, particularly center-based childcare programs. Qualitative data were obtained through interviews with 9 teachers and 4 administrators from 3 childcare programs. State- and program-level policies were analyzed. Results reveal that preschoolers are expelled and suspended for a variety of behaviors. Expulsion and suspension are used to achieve 3 purposes: protecting the interests of others, addressing families, and addressing challenging behaviors. Although participants agreed that expulsion and suspension have failed to address family or challenging behaviors exhibited by children, there is a consensus that such practices are necessary to protect the interests of other children, adults, and the program.

Need for and concerns about non-parental childcare programs for infants and toddlers in Hong Kong: Voices of parents

This study examined Hong Kong parents’ need for, and concerns about, the quality of non-parental childcare programs for infants and toddlers. A total of 266 Hong Kong parents whose children were enrolled in center-based childcare programs for infants and toddlers participated in a quantitative survey, and 22 parents participated in qualitative interviews. The results showed that there was a large demand for childcare programs for infants and toddlers in Hong Kong, due mainly to the number of dual working parents. Parents considered location to be the most important determinant of their program selection and also expected an upward adjustment to the teacher-child ratio in their children’s programs. Finally, parents considered mealtime (e.g., bottle feeding), self-care training (e.g., toileting), and cognitive development activities to be the three most important aspects of their children’s educational and care activities. The findings are discussed in light of the importance of developing non-parental childcare programs for infants and toddlers that address parents’ needs and concerns. This study can inform both research and policy concerning center-based childcare programs in Hong Kong.

Supporting Families Exposed to Adverse Childhood Experiences Within Child Care Settings: A Feasibility Pilot

Childhood adversity is strongly associated with poor health and well-being in childhood and adulthood. Young children are at greatest risk during their developmental years. Child care providers can participate in preventing the impact of adversity on children by becoming communities of support for families in need. This project aimed to explore the feasibility and acceptability of identifying childhood adversity and strengthening family protective factors by incorporating professional development and both universal and targeted interventions that included screening, motivational interviewing, parent cafes, and parenting workshops within ten family and center-based child care programs. A total of 159 caregivers completed the screen about their experiences of adversity, with 60% disclosing adversity during their childhood and 53% disclosing current risk for adversity for their child. An intergenerational association was found between caregivers’ past exposure to adversity and their child’s current risk (p = 0.023). However, this association was no longer significant (p = 0.14) when accounting for their current protective factors (p = 0.002). Most families (77%) who disclosed moderate to high adversity or risk on the screen participated in a brief interview with their child care provider. Eleven parent events were also conducted with an attendance of 91. Child care providers reported that these interventions were both feasible and beneficial. Caregivers showed significant improvements in protective factors (p = 0.013) over the course of the project.

Neighborhood context and center-based child care use: Does immigrant status matter?

This study examined associations between individual families’ use of center-based child care and neighborhood structure (concentrated poverty and concentrated affluence, as measured with Census data), processes, and resources (child-centered collective efficacy, presence of friends/kin, and availability of services for children, as measured in a survey of neighborhood residents). The potential moderating role of family immigrant status also was investigated. Data were obtained from the 3-year-old cohort of the Project on Human Development in Chicago Neighborhoods (N = 999; 42% immigrant). Multilevel models accounting for background factors at the individual level revealed that greater neighborhood concentrated affluence was associated with families’ higher likelihood of using center-based child care, whereas greater neighborhood child-centered collective efficacy was associated with their lower likelihood of using this type of care. In addition, among immigrant families only, as the size of neighborhood friends/kin networks increased, the likelihood of participating in center-based child care programs was higher. Findings are discussed in terms of the potential for improving immigrant families’ access to center-based child care by reducing neighborhood structural barriers and fostering neighborhood networks.

Implementing the Academy of Nutrition and Dietetics Benchmarks for Nutrition Education for Children: Child-Care Providers’ Perspectives

BackgroundNational childhood obesity prevention policies recommend that child-care providers educate young children about nutrition to improve their nutrition knowledge and eating habits. Yet, the provision of nutrition education (NE) to children in child-care settings is limited. ObjectiveUsing the 2011 Academy of Nutrition and Dietetics benchmarks for NE in child care as a guiding framework, researchers assessed child-care providers' perspectives regarding delivery of NE through books, posters, mealtime conversations, hands-on learning, and sensory exploration of foods to young children (aged 2 to 5 years). DesignUsing a qualitative design (realist method), individual, semistructured interviews were conducted until saturation was reached. Participants/settingThe study was conducted during 2012-2013 and used purposive sampling to select providers. Final sample included 18 providers employed full-time in Head Start or state-licensed center-based child-care programs in Central Illinois. Main outcome measureChild-care providers’ perspectives regarding implementation of NE. Statistical analyses performedThematic analysis to derive themes using NVivo software. ResultsThree overarching themes emerged, including providers’ motivators, barriers, and facilitators for delivering NE to children. Motivators for delivering NE included that NE encourages children to try new foods, NE improves children’s knowledge of healthy and unhealthy foods, and NE is consistent with children’s tendency for exploration. Barriers for delivering NE included that limited funding and resources for hands-on experiences and restrictive policies. Facilitators for delivering NE included providers obtain access to feasible, low-cost resources and community partners, providers work around restrictive policies to accommodate NE, and mealtime conversations are a feasible avenue to deliver NE. Providers integrated mealtime conversations with NE concepts such as food-based sensory exploration and health benefits of foods. ConclusionsPresent study findings offer insights regarding providers’ perspectives on implementing NE in child care. Drawing from these perspectives, registered dietitian nutritionists can train providers about the importance of NE for encouraging healthy eating in children, integrating NE with mealtime conversations, and practicing low-cost, hands-on NE activities that meet the food safety standards for state licensing. Such strategies may improve providers’ ability to deliver NE in child-care settings.

Providers perspectives on self-regulation impact their use of responsive feeding practices in child care

Supporting children's self-regulation in eating through caregivers' practice of responsive feeding is paramount to obesity prevention, and while much attention has been given to supporting children's self-regulation in eating through parents' responsive feeding practices in the home setting, little attention has been given to this issue in childcare settings. This qualitative study examines childcare providers' perspectives on using responsive feeding practices with young children (2–5years). Individual semi-structured interviews were conducted with providers until saturation was reached. Data was analyzed using thematic analysis. The final sample included 18 providers who were employed full-time in Head Start or state-licensed center-based childcare programs, cared for children (2-5y), and were directly responsible for serving meals and snacks. Providers were primarily (67%) employed in childcare programs that served children from low-income families and received reimbursement for meals and snacks from the US Department of Agriculture's Child and Adult Care Food Program. Three factors emerged that shaped childcare providers' experiences using responsive feeding practices: the providers' perspectives about whether or not young children can self-regulate food intake, their understanding of Child and Adult Care Food Program (CACFP) portion size regulations, and the availability of food at the center where they worked. Future research should examine how childcare providers' understanding of children's ability to self-regulate their food intake, the appropriate use of the CACFP regulations in relationship to serving sizes, and having food available to offer seconds promotes providers' use of responsive feeding practices in center-based childcare programs and children's dietary behaviors.

The Demand for Teacher Characteristics in the Market for Child Care: Evidence from a Field Experiment

Many preschool-age children in the U.S. attend center-based child care programs that are of low quality. This paper examines the extent to which teacher qualifications – widely considered important inputs to classroom quality – are valued by providers during the hiring process. To do so, we administered a resume audit study in which job-seeker characteristics were randomly assigned to a large number of resumes that were submitted in response to real child care job postings in 14 cities. Our results indicate that center-based providers may not hire the most qualified applicants. For example, we find that although providers have a strong preference for individuals with previous work experience in early childhood education (ECE), those with more ECE experience are less likely to receive an interview than those with less experience. We also find that individuals with bachelor's degrees in ECE are no more likely to receive an interview than their counterparts at the associate's level, even in the market for lead preschool-age teachers. Furthermore, those revealing high levels of academic performance, as measured by grade point average, are generally not preferred by child care providers. Finally, it appears that some non-quality attributes do not influence hiring decisions (e.g., signaling car ownership), while others have large effects on teacher hiring (e.g., applicant race/ethnicity). Together, our findings shed light on the complex trade-offs made by center-based providers attempting to offer high-quality programs while earning sufficient revenue to stay in business.

“Great Job Cleaning Your Plate Today!” Determinants of Child-Care Providers’ Use of Controlling Feeding Practices: An Exploratory Examination

BackgroundNational early childhood obesity prevention policies recommend that child-care providers avoid controlling feeding practices (CFP) (eg, pressure-to-eat, food as reward, and praising children for cleaning their plates) with children to prevent unhealthy child eating behaviors and childhood obesity. However, evidence suggests that providers frequently use CFP during mealtimes. ObjectiveUsing the Academy of Nutrition and Dietetics (2011) benchmarks for nutrition in child care as a framework, researchers assessed child-care providers’ perspectives regarding their use of mealtime CFP with young children (aged 2 to 5 years). DesignUsing a qualitative design, individual, face-to-face, semi-structured interviews were conducted with providers until saturation was reached. Participants/settingProviders were selected using maximum variation purposive sampling from varying child-care contexts (Head Start, Child and Adult Care Food Program [CACFP]–funded centers, non-CACFP programs). All providers were employed full-time in Head Start or state-licensed center-based child-care programs, cared for children (aged 2 to 5 years), and were directly responsible for serving meals and snacks. Main outcome measureChild-care providers’ perspectives regarding CFP. Statistical analyses performedThematic analysis using NVivo (version 9, 2010, QSR International Pty Ltd) to derive themes. ResultsProviders’ perspectives showed barriers, motivators, and facilitators regarding their use of mealtime CFP. Providers reported barriers to avoiding CFP such as CFP were effective for encouraging desired behaviors, misconceptions that providers were encouraging but not controlling children’s eating, and fear of parents’ negative reaction if their child did not eat. Providers who did not practice CFP were motivated to avoid CFP because they were unnecessary for encouraging children to eat, and they resulted in negative child outcomes and obesity. Facilitators as an alternative to CFP included practicing healthful feeding practices such as role modeling, peer modeling, and sensory exploration of foods. ConclusionsTraining providers about negative child outcomes associated with CFP, children’s ability to self-regulate energy intake, and differentiating between controlling and healthful feeding strategies may help providers to avoid CFP.

Teachers’ Social–Emotional Capacity: Factors Associated With Teachers’ Responsiveness and Professional Commitment

ABSTRACTResearch Findings: Early care and education has pronounced implications for young children’s social-emotional learning. Although program structural and classroom process quality indicators have been widely explored, teachers’ personal social–emotional capacity has only recently been recognized as an indicator of quality. This study reviewed and identified indicators of teachers’ social-emotional capacity and established a two factor structure of psychological load and coping abilities. We also explored correlational associations between teachers’ social-emotional capacity and their professional commitment and responsiveness to children’s negative emotions. The sample consisted of 1,129 teachers in center-based child-care programs and public preschools in the US. We found that teachers’ psychological load (depression, stress and emotional exhaustion) was associated with teachers’ negative reactions to children and teachers’ professional commitment after controlling for a wide range of teacher/classroom characteristics. Conversely, teachers’ coping abilities (reappraisal emotion regulation and problem-focused coping strategies) were related to their positive reactions to children’s negative emotions. Practice or Policy: The findings suggest further studies to identify training and professional development program components that might address early childhood teachers’ psychological difficulties and coping strategies. Child-care programs may also need efforts that support teachers’ social–emotional capacity as a way to improve teachers’ responsiveness and professional commitment.

Teacher–Child Interactions in Infant/Toddler Child Care and Socioemotional Development

Research Findings: The teacher–child relationships that develop in infant/toddler child care provide a critical caregiving context for young children’s socioemotional development. However, gaps remain in researchers’ understanding of the individual-level processes that facilitate socioemotional development, specifically in center-based child care programs. Guided by ecological theory, this article offers a review of the current literature on this topic, including influential factors and developmental outcomes associated with teacher–child interaction quality, the teacher–child relationship as a compensatory mechanism for children facing risk, and differential susceptibility to caregiving experiences. Practice or Policy: Within the context of infant/toddler child care, many opportunities exist for researchers to refine the measurement of individual teacher–child interactions, test young children’s self-regulation as an outcome variable, and develop understanding of compensatory and differential susceptibility mechanisms. Clarifying these processes will inform early childhood education teacher training in terms of how teachers can best facilitate healthy socioemotional outcomes, especially for the most vulnerable children.

Comparisons among quality measures in child care settings: Understanding the use of multiple measures in North Carolina's QRIS and their links to social-emotional development in preschool children

Quality Rating and Improvement Systems (QRIS) include the assessment of classroom quality as one component of how early childhood programs are monitored and licensed in many states across the United States. However, varying measures and foci of quality exist and have led to challenges in accurately depicting program quality across programs and improvement efforts. The current validation study explores several measures of classroom quality and their associations with components and overall star ratings of the North Carolina QRIS and preschool children's social-emotional outcomes within center-based child care programs. Data for this study were collected in 2009, 10 years after the start of North Carolina's QRIS. Results indicate that individual levels of star ratings did not generally represent distinctive levels of classroom quality, but did differentiate classrooms at the lower and higher levels of quality. Structural features of the environments such as teacher education and teacher–child ratio were associated with classroom quality across these measures in the expected directions; however, teacher experience was not. Further, children's social-emotional outcomes were predicted to a varying degree by star levels and different aspects of classroom quality as represented by these various measures. Results are discussed in terms of the differing levels of quality and teaching processes in classrooms. Future directions for research are presented to contribute to an increased understanding of QRIS and children’ experiences in early care and education programs.

Church Sponsored Child Care: Association of Regulatory Level with Quality

Abstract Multiple types of child care are exempt from government licensure or regulation in the United States, yet previous research has shown that stricter adherence to regulatory standards predicts higher quality programs. This study compares global child care quality and teacher-child interaction quality in church-sponsored child care centers that are legally-exempt from licensure and operate at three regulatory levels. Observations were completed in 59 church-sponsored, center-based child care programs. Centers that voluntarily followed stricter levels of regulation had higher quality. The findings have implications for policymakers and legislators who create and implement child care standards and subsidy policies.

Results From the Quality Early Childhood Training Program

High-quality child care is related to children's positive developmental outcomes. One way to increase quality of care is to provide training to child care providers. This study used assessment-based training to determine if overall quality of care in center-based preschools could be enhanced. Participants were recruited from six center-based child care programs serving preschool-age children and included program administrators, teachers, teacher aides, and enrolled children. Program administrators (N = 6) were assessed with the Program Administration Scale (Talan & Bloom, 2004), classrooms (N = 14) with the Early Childhood Environment Rating Scale Revised (ECERS-R; Harms, Clifford, & Cryer, 2005) and the Early Language and Literacy Classroom Observation—Research Edition (ELLCO; Smith & Dickinson, 2002), teachers (N = 24) with the Classroom Assessment Scoring System (CLASS; Pianta, La Paro, & Hamre, 2007), and children (N = 135) with an author-created measurement designed to assess typical skills across five child domains. Assessments were administered at two time points and individualized targeted training was provided in between. Results demonstrated that after 7 months of intervention, the largest effect sizes were seen at the program administration and classroom levels and that smaller effect sizes were found at the teacher and child levels.

When are Field Experiments with Individual Assignment Too Risky? Lessons from a Center-Based Child Care Study in Guatemala

Randomized controlled trials, prized for generating unbiased estimates of treatment effects, have become popular in development economics. However, RCTs do not always offer sufficient statistical power, which is reduced in experiments with imperfect compliance to treatment assignment. This is of critical importance if effect sizes are modest, and if non-compliance may occur. Both are likely in experiments in center-based childcare programs with individual-level randomization for several reasons. Dropout in the treatment group may occur because families' demand for preschool is unknown when the sample is constructed, and it evolves over time as households experience shocks and as they learn about the center. Non-compliance in the control group arises when children access the program or alternative preschool programs. This paper uses a recent evaluation of the Hogares Comunitarios program in Guatemala to illustrate challenges inherent in experimental evaluations and offers strategies to identify situations in which studies are more likely to succeed.

Physical Activity and Beverages in Home- and Center-based Child Care Programs

ObjectiveTo describe and compare obesity prevention practices related to physical activity and beverages in home- and center-based child care programs. MethodsA telephone survey of licensed home- and center-based child care programs in Florida, Massachusetts, Michigan, and Washington between October and December 2008. ResultsMost programs reported almost universal access to outdoor play areas and staff who frequently engage in and lead physical activities. About half of the programs reported ≤ 60 minutes of outdoor play time per day for preschoolers. Fewer home-based programs offered a variety of fixed and portable play equipment. Over a third of the programs did not have adequate indoor space for all physical activities. Over two thirds of programs offered juice 3 or 4 times per week or more. Conclusions and ImplicationsMany child care programs could increase active opportunities (by increasing outdoor time and providing better spaces for indoor physical activity) and decrease juice provision.