Attending Child Care Research Articles

Health, Social, and Economic Outcomes Experienced by Families as a Result of Receiving Assistance from a Community-Based Diaper Bank.

Objectives This paper aims to describe low-income recipients of a community-based diaper bank and the multiple daily challenges they face. Our paper seeks to document the health, social, and financial outcomes recipients experienced after receiving assistance. Methods We surveyed families (n = 150) about their experiences receiving diapers from a diaper bank in the southeastern United States. Additionally, we conducted short, focused interviews with families (n = 15) about outcomes after receiving diapers. Results Families experience regularly a range of challenges meeting basic needs. These difficulties include high unmet needs for transportation, food, and nonfood essentials such as personal hygiene items. Families experiencing the greatest difficulty in paying utility or medical bills were significantly more likely to have a high level of diaper need compared to families facing these challenges less often (AORs ranging from 3.40 to 9.39). As a result of receiving diapers, families reported positive health, social, and economic outcomes. Families reported positive changes in parental mood; improved child health and happiness; increased opportunities for childcare, work, and school attendance; and the ability to divert household finances toward other basic needs, including utilities and medical care. Conclusions for Practice The monetary value of the supplemental provision of diapers is a small investment in affected families' economic, social, and health outcomes. The positive effects continue far longer than the diapers provided. We demonstrate the social value of such an operation, and recommend the expansion of federal, state, and local safety net programs to help low-income families secure a steady supply of diapers.

Child-care quality moderates the association between maternal depression and children's behavioural outcome.

Maternal depression is a risk factor for adverse outcomes in the child, including emotional and behavioural difficulties. There is evidence that child care attendance during the preschool years may moderate associations between familial risk factors and child outcome. However, the possibility that high-quality child care provides protection for children exposed to maternal depression or that low-quality child care provides additional riskhas not been investigated. We study whether child-care quality moderates the association between probable history of maternal depression (PMD) and child behavioural and emotional outcomes over the preschool period. Within a longitudinal study, we examined PMD (no depression; clinical PMD before the child's birth; subclinical PMD from 0 to 5years; clinical PMD from 0 to 5years), child-care quality and child emotional and behavioural difficulties at the ages of 2, 3 and 4years. Child-care quality was evaluated in settings, and trajectories were calculated to reflect (a) global quality and (b) two quality subfactors: 'Teaching and interactions' and 'Provision for learning'. Data were analysed for 264 families. Significant interactions emerged between clinical PMD and global quality of child care for children's externalising behaviour (b=-.185, p=.008), more specifically hyperactivity/inattention (b=-.237, p=.002). In the context of clinical PMD, children attending high-quality child care presented fewer difficulties than those attending a low-quality care. Child-care quality was not associated with outcomes for children whose mothers did not report a PMD or a PMD before their birth. In the context of PMD, high-quality child care was associated with fewer behavioural problems and may thus constitute a protective factor.

Probiotics Did Not Prevent Child Care Absences Due to Infection in Danish Study

The increased use of probiotics to prevent and treat various illnesses has raised the possibility that infants and toddlers attending child care might

Frequency of Hypertension Associated with Pregnancy among The Pregnant Women Attending Maternal and Child Care Centers in Belbeis City.

Frequency of Hypertension Associated with Pregnancy among The Pregnant Women Attending Maternal and Child Care Centers in Belbeis City.

Australian Children Growing Up with Opportunity

AbstractThis article focuses on the early years of children in Australia. It discusses the inequality of opportunity as reflected in the statistics and the potential impacts of this inequality. A brief literature review is provided regarding the impact of formal childcare and preschool attendance on child development, with a specific focus on the impact for children from disadvantaged families. The article concludes with a discussion of possible policy directions to counteract the inequality of opportunity.

Parental disease prevention health beliefs and triggers for keeping children home from childcare-a qualitative study in Sydney, Australia.

Infectious diseases cause considerable morbidity and mortality in children less than 5years of age. Children attending childcare centres are at increased risk of contracting infections. It is of public health interest to understand what triggers and underpins parental decisions to send an unwell child to childcare, with the obvious attendant risks to other children and childcare staff as well as the affected child. This study aimed to examine parents' disease prevention health beliefs and practices with a particular focus on how these factors influence childcare attendance decisions. Semistructured, in-depth interviews were conducted between June 2009 and May 2011 with parents who had at least one child under 5years of age enrolled in a childcare centre. Six centres in the metropolitan area of Sydney, Australia, were selected to include parents from a range of demographic and socio-economic backgrounds. Forty-two interviews were conducted, recorded, and transcribed. Themes emerging from the data included "vitamin dirt," contagion, and contagion prevention and control. These interacted with parents' decision-making about childcare attendance, and parents made choices in a complex context of obligations to their child, social contract obligations to others, peer expectations, and the need to work. Vaccination received only scant mention as a preventive health measure. Decision-making by parents concerning childcare attendance was made without reference to any external guidelines. This study provides insights into parental disease prevention beliefs, behaviours, and decision-making. It reveals a need for policies to support parents with unwell children. In addition, resources and educative efforts to raise awareness of vaccination as a preventive health measure, and awareness of infectious disease contagion more broadly, would assist in providing parents with a greater evidence base for making decisions about childcare attendance when their child is unwell.

Determining Educators' Needs to Support Healthy Eating Environments in Early Childhood Settings

THE PROVISION OF A nutritious diet early in life can have an immense effect on future health and wellbeing. The number of children attending child care is increasing, thus this setting is strategically placed to establish positive eating habits. This qualitative study sought to understand the needs of Australian early childhood education and care staff in relation to the provision of a healthy eating environment. Key stakeholders formed a consultancy group to provide feedback and advice. The study was underpinned by the Spiral Action Research model. Analysis of 48 in-depth interviews identified the following themes: healthy eating activities, resources, nutrition training, attitudes towards healthy eating and the proposed intervention, and barriers to healthy eating. Participants were open to using an online repository of nutrition resources and information wrapped in support. This formative data informed the development of a ‘best practice’ website including discussion boards intended to foster an online ‘community of practice’.

Patterns and Correlates of Sedentary Behaviour in Children Attending Child Care

Patterns and Correlates of Sedentary Behaviour in Children Attending Child Care

Effectiveness of vaccination recommendations versus mandates: Evidence from the hepatitis A vaccine

I provide novel evidence on the effectiveness of two vaccination policies – simple non-binding recommendations to vaccinate versus mandates requiring vaccination prior to childcare or kindergarten attendance – in the context of the only disease whose institutional features permit a credible examination of both: hepatitis A. Using provider-verified immunization data I find that recommendations significantly increased hepatitis A vaccination rates among young children by at least 20 percentage points, while mandates increase rates by another 8 percentage points. These policies also significantly reduced population hepatitis A incidence. My results suggest a range of policy options for addressing suboptimally low population vaccination rates.

Householdss Responses to Price Changes of Formal Childcare

The current understanding about how households respond to price changes in formal childcare is not extensive. This study examines this response through a 1998 reform in Norway that introduced a money transfer to families who did not send their child to childcare. This cash-for-care reform raised the price of formal childcare relative to its alternatives by about 115% for 1–2 year olds but not 3–5 year olds. Using household surveys conducted before and after the reform the analysis reveals that childcare attendance fell by 13.7 percentage points because of the reform. The results also indicate that the most important alternative to formal childcare is parental care. Furthermore, households of low socioeconomic status are more price sensitive, with the main substitute mode of care for this group being parental/relative care, whereas for high socioeconomic status families the substitutes include day parks and nannies as well as parental care.

Does Early Child Care Attendance Influence Children's Cognitive and Non-Cognitive Skill Development?

While recent studies mostly find that attending child care earlier improves the skills of children from low socio-economic and non-native backgrounds in the short-run, it remains unclear whether such positive effects persist. We identify the short- and medium-run effects of early child care attendance in Germany using a fuzzy discontinuity in child care starting age between December and January. This discontinuity arises as children typically start formal child care in the summer of the calendar year in which they turn three. Combining rich survey and administrative data, we follow one cohort from age five to 15 and examine standardised cognitive test scores, non-cognitive skill measures, and school track choice. We find no evidence that starting child care earlier affects children's outcomes in the short- or medium-run. Our precise estimates rule out large effects for children whose parents have a strong preference for sending them to early child care.

Taxing Childcare: Effects on Childcare Choices, Family Labor Supply and Children

Previous studies report a range of estimates for the response of female labor supply and childcare attendance to childcare prices. We shed new light on these questions using a policy reform that raises the price of public daycare. After the reform, children are 8 percentage points less likely to attend public daycare which implies a compensated price elasticity of -0.6. There is little labor supply response in the full sample, though declines for vulnerable subgroups. Spillover effects on older siblings and fertility decisions show that the policy affects the whole household, not just targeted family members.

Child Care Exposure Influences Childhood Adiposity at 2 Years: Analysis from the ROLO Study.

The first 2 years of life are instrumental for childhood physical development. Factors contributing to childhood obesity are difficult to determine; child care exposure is one to consider, by influencing food preference and physical activity development. To investigate the association of child care exposure with adiposity at 2 years. Data were collected as part of the secondary analysis of the prospective ROLO study (randomized control trial of low glycemic index diet) in Dublin, Ireland. Mothers were recruited antenatally and followed up at 2 years postpartum. Maternal and childhood anthropometric data and lifestyle questionnaires, reporting on child care attendance (defined as nonparental care), exposure (weeks), and infant-feeding practices, were collected. Anthropometric measures and lifestyle data were collected for 273 mothers and children aged 2 years, 52.7% of whom attended child care. Child care was predominately provided by a nonrelative (83.7%), either in a crèche (57%) or by a childminder (26.7%). More than half (56.2%) of the children attended child care part-time (≤30 hours/week). Central adiposity measures (abdominal circumference, waist:height ratio) and total adiposity (sum of all skin folds) were significantly elevated in children with increasing time in child care. Children provided with "meals and snacks" had elevated adiposity measures versus those given "snacks or no food." No difference in the infant-feeding practices was identified between the child care groups. Children attending child care have higher total and central adiposity, proportional to exposure. More research is required to investigate this link to appropriately design health promotion and obesity prevention programs targeting children at 2 years.

Experiences with full-time child care attendance on young children in Norway: parents' and early childhood teachers' views

The aim of this study was to explore the experiences of parents and early childhood teachers in Norway regarding the benefits of child care to young children. Both positive and negative benefits were explored. In the autumn of 2009, 41 parents and 35 early childhood teachers of children aged 1.5 years or less, living in the city of Trondheim and nearby communities, were assessed by means of a semi-structured qualitative interview. There was agreement among parents and early childhood teachers that children benefited from child care. Parents, however, tended to overestimate the benefit of socialization and learning for this young age-group. However, early childhood teachers focused more on socialization, in terms of waiting for turns, observing certain rules. One third of parents did not report any negative experiences of child care. The others reported negative experiences on occasion or under certain circumstances such as long hours, poor-quality care or too many children per adult early childhood teacher. All but four of the early childhood teachers suggested that high standards had to be satisfied to make child care good enough for the youngest children.

Rhinovirus Infections and Associated Respiratory Morbidity in Infants: A Prospective Cohort Study.

Risk factors promoting rhinovirus (RV) infections are inadequately described in healthy populations, especially infants. To determine the frequency of symptomatic and asymptomatic RV infections and identify possible risk factors from host and environment among otherwise healthy infants. In a prospective birth cohort, respiratory health was assessed in 41 term-born infants by weekly telephonic interviews during the first year of life, and weekly nasal swabs were collected to determine RV prevalence. In a multilevel logistic regression model, associations between prevalence and respiratory symptoms during RV infections and host/environmental factors were determined. Twenty-seven percent of nasal swabs in 41 infants tested positive for RVs. Risk factors for RV prevalence were autumn months [odds ratio (OR) = 1.71, P = 0.01, 95% confidence interval (CI): 1.13-2.61], outdoor temperatures between 5 and 10°C (OR = 2.33, P = 0.001, 95% CI: 1.41-3.86), older siblings (OR = 2.60, P = 0.001, 95% CI: 1.50-4.51) and childcare attendance (OR = 1.53, P = 0.07, 95% CI: 0.96-2.44). Fifty-one percent of RV-positive samples were asymptomatic. Respiratory symptoms during RV infections were less likely during the first 3 months of life (OR = 0.34, P = 0.003, 95% CI: 0.17-0.69) and in infants with atopic mothers (OR = 0.44, P = 0.008, 95% CI: 0.24-0.80). Increased tidal volume (OR = 1.67, P = 0.03, 95% CI: 1.04-2.68) and outdoor temperatures between 2 and 5°C (OR = 2.79, P = 0.02, 95% CI: 1.17-6.61) were associated with more symptoms. RVs are highly prevalent during the first year of life, and most infections are asymptomatic. Frequency of RV infections is associated with environmental factors, while respiratory symptoms during RV infections are linked to host determinants like infant age, maternal atopy or premorbid lung function.

Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance.

Routine childhood immunizations against infectious diseases are an integral part of our public health infrastructure. They provide direct protection to the immunized individual and indirect protection to children and adults unable to be immunized via the effect of community immunity. All 50 states, the District of Columbia, and Puerto Rico have regulations requiring proof of immunization for child care and school attendance as a public health strategy to protect children in these settings and to secondarily serve as a mechanism to promote timely immunization of children by their caregivers. Although all states and the District of Columbia have mechanisms to exempt school attendees from specific immunization requirements for medical reasons, the majority also have a heterogeneous collection of regulations and laws that allow nonmedical exemptions from childhood immunizations otherwise required for child care and school attendance. The American Academy of Pediatrics (AAP) supports regulations and laws requiring certification of immunization to attend child care and school as a sound means of providing a safe environment for attendees and employees of these settings. The AAP also supports medically indicated exemptions to specific immunizations as determined for each individual child. The AAP views nonmedical exemptions to school-required immunizations as inappropriate for individual, public health, and ethical reasons and advocates for their elimination.

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.

The relationship between childcare and adiposity, body mass and obesity-related risk factors: protocol for a systematic review of longitudinal studies.

BackgroundThe rising prevalence of obesity, particularly in childhood, is a global public health emergency. There is some evidence that exposure to non-parental childcare before age 6 years is associated with subsequent development of obesity and obesity-related behaviours such as physical activity, sedentary behaviour, sleep, diet and stress, although these findings are inconsistent. It is possible that the relationship between early childcare and later obesity and obesity-related behaviours depends on characteristics of childcare exposure such as type (i.e. informal versus formal care), duration (i.e. number of years spent in childcare), intensity (e.g. number of hours per week) and timing (i.e. age of onset of childcare) of care received. The relationship may also be moderated by socio-demographic characteristics of children and their families. We will conduct a systematic review exploring longitudinal associations between childcare (type, duration, intensity and timing) and measures of adiposity and body mass, physical activity, sedentary behaviour, sleep, diet and stress. We will also assess whether these relationships vary by socio-demographic factors.MethodsWe will include studies that explore longitudinal associations between childcare attendance in children aged <6 years not in primary school at first assessment and body weight, adiposity, physical activity, diet, sleep and stress. We will limit studies to those involving middle- and high-income countries. Two independent reviewers will screen search results in two stages: (1) title and abstract and (2) and full text. One reviewer will extract relevant data and a second will verify this information. We will assess risk of bias of included studies using an adaption of the United States Department of Agriculture National Evidence Library Bias Assessment Tool. We will tabulate and summarise results narratively. We may conduct meta-analysis if at least five studies report comparable data.DiscussionTo our knowledge, this will be the first systematic review to summarise the existing evidence on longitudinal associations between childcare and adiposity, body mass and obesity-related risk factors. The results will be of relevance to other researchers, childcare practitioners and policy makers.Systematic review registrationPROSPERO CRD42015027233Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0312-7) contains supplementary material, which is available to authorized users.

Parent-related mechanisms underlying the social gradient of childhood overweight and obesity: a systematic review.

Low socio-economic status (SES) is a significant risk factor for childhood overweight and obesity (COWOB) in high-income countries. Parents to young children buffer and accentuate social and cultural influences, and are central to the development of this disease. An understanding of the parent-related mechanisms that underlie the SES-COWOB relationship is needed to improve the efficacy of prevention and intervention efforts. A systematic review of relevant literature was conducted to investigate the mechanisms by which levels of SES (low, middle and high) are associated to COWOB, by exploring mediation and interaction effects. Six electronic databases were searched yielding 5155 initial records, once duplicates were removed. Studies were included if they investigated COWOB, SES, parent-related factors and the multivariate relationship between these factors. Thirty studies were included. Factors found to be mediating the SES-COWOB relationship or interacting with SES to influence COWOB were categorized according to an ecological systems framework, at child, parent, household and social system level factors. High parent body mass index, ethnicity, child-care attendance, high TV time (mother and child), breastfeeding (early weaning), food intake behaviours and birthweight potentially mediate the relationship between SES and COWOB. Different risk factors for COWOB in different SES groups were found. For low SES families, parental obesity and maternal depressive symptoms were strong risk factors for COWOB, whereas long maternal working hours and a permissive parenting style were risk factors for higher SES families. None of the studies investigated parental psychological attributes such as attitudes, beliefs, self-esteem and so on as potential mechanisms/risk factors. Families from different SES groups have different risk and protective factors for COWOB. Prevention and intervention efforts may have improved efficacy if they are tailored to address specific risk factors within SES.

Ready to Learn: The Role of Childcare Attendance on Children's School Outcomes in Italy

This work investigates the casual eect of childcare attendance on children’s school achievements. We analyse data about children’s school outcomes in mathematics and language focusing on pupils attending second and fth grade in Italian primary school in conjunction with data providing public childcare coverage at provincial level. Using IV identication strategy, we show that childcare attendance leads to better school outcomes and early investment in education boosts both mathematics and language skills. For both school grades our results highlight a positive and signicant eect of childcare attendance on children’s school achievements which does not dissipate over time.