Family Child Care Research Articles

Resource Well-Being among Family Child Care Business Owners

Family child care, a paid child care service operated out of a care provider’s home, is a common child care choice for working parents. While studies show positive associations between providers’ income and care quality, little is known about their resource management and perceived resource well-being. Using surveys and interviews, this study explored the association between household income and overall perceived resource well-being among seven family child care providers in the Los Angeles, California area. The surveys offered providers’ demographic information and characteristics about their child care businesses. The analysis of the interview data identified four resource well-being themes regarding perceptions about: past and present economic situations, demands on time, contributions providers’ family members make to support the business functions, and quality and availability of community resources. The findings suggest household income predicts little about how providers perceive their overall resource well-being. Understanding income as only a part of resource management may better elucidate links between income and child care quality. Discussions include implications for financial counselors and planners.

Parental preferences and patterns of child care use among low-income families: A Bayesian analysis

Parents' selections of child care arrangements involve complex decisions made in the context of child and family needs, resources and constraints. This study analyzed data from a survey of low-income parents to examine the factors associated with the type of care arrangement used most often. We employed Bayesian estimation methods to account for the interrelated nature of parental employment and child care decisions. We incorporated parental preferences for characteristics of child care to predict the type of care setting based on a factor analysis of parent responses about the importance of different care characteristics. We found that latent factors that were associated with a higher probability of working, or of working more hours, also increased the probability of using centers or family child care, and decreased the likelihood of using family, friend or neighbor (informal) care. In concordance with the existing literature, low-income families in Minnesota were more likely to use informal care for infants (relative to preschool-age children), and households with more educated parents were more likely to use centers. Hispanic families were less likely to use any form of non-parental care. Given the potential of high-quality child care to increase the well-being and developmental trajectories of low-income children, understanding parents' decisions about child care and employment is fundamental to improving child and family outcomes.

Nutrition-Related Practices of Family Child Care Providers and Differences by Ethnicity.

Child care settings play an important role in shaping children's eating behaviors; yet few studies have included family child care homes (FCCHs). We examined provider-reported nutrition-related practices in FCCHs and observed adherence to nutrition guidelines from the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC), exploring differences by provider ethnicity. We assessed baseline data from a cluster-randomized trial, including surveys with FCCH providers and observational data collected at the FCCH. We examined provider-reported nutrition-related practices and if providers met NAP SACC guidelines using observational data. Differences by ethnicity were assessed using chi-square and multivariate log-linear analysis adjusting for education. Providers completed a telephone survey (n = 166, 100% female and 72% Hispanic) and participated in 2 full-day observations (n = 119). Many providers reported engaging in positive nutrition-related practices. Significant differences by ethnicity included the following: Hispanic providers less likely to report feeding practices that were responsive to children's self-regulation, but also less likely to report eating and drinking unhealthy foods/beverages in front of children and having screens on during meals and more likely to report seeking nutrition trainings. Using observational data, only 10 of 26 NAP SACC practices were met by >60% of providers. Few ethnic differences in meeting guidelines were found (7 of 26 practices). While providers engage in some positive nutrition practices, improvement is needed to ensure that all providers actually meet evidence-based guidelines. Ethnic differences in certain practices underscore the need for culturally relevant trainings. NCT02452645.

The Quality of Nutrition and Physical Activity Environments of Family Child-Care Homes in a State in the Southern United States

BackgroundFamily child-care homes (FCCHs) are an important provider of nonparental child care for low-income families. Little is known about the quality of nutrition and physical activity environments of FCCHs in the southern United States, where child obesity and child poverty levels are high. ObjectivesTo assess the quality of the nutrition and physical activity environments of a sample of FCCHs in Mississippi and examine the differences by urban vs rural location. DesignCross-sectional study. Participants/settingData were from a random sample of 134 FCCHs that enroll children aged 3 to 5 years. The sample was stratified by urban vs rural location and participation in the Child and Adult Care Food Program. Providers completed a modified version of the Environment and Policy Assessment and Observation-Self Report tool by mail and reported on provisions, practices, policies, and the general FCCH nutrition and physical activity environment. Main outcome measuresA nutrition environment score (range=0 to18), physical activity environment score (range=0 to 24), and a combined nutrition and physical activity environment score (range=0 to 42) were calculated from Environment and Policy Assessment and Observation-Self Report tool data. Statistical analyses performedDescriptive statistics and t tests were computed, with statistical significance set at P≤0.05. ResultsAverage scores for the nutrition, physical activity, and combined nutrition and physical activity environment were 9.4, 11.1, and 20.5, respectively. The average nutrition environment score (9.6 vs 9.2; P=0.39) and physical activity environment score (11.3 vs 11.0; P=0.62) did not differ between urban and rural homes. The combined nutrition and physical activity scores (20.8 vs 20.2; P=0.50) also did not differ between urban and rural homes. ConclusionsFindings highlight the need to improve the nutrition and physical activity environments of FCCHs, regardless of geographic location. Further research is needed to understand barriers to providing higher-quality nutrition and physical activity environments.

Boosting family child care success in Quality Rating and Improvement Systems

As states develop and revise Quality Rating and Improvement Systems (QRIS), more research attention is needed on the implementation of quality improvement strategies that effectively support family child care programs. The aims of the current study were to compare family child care providers who participated in a model of supplemental quality improvement supports (Stars Plus) with family child care providers who participated in QRIS but did not receive the supplemental services. Specifically, we examined the movement trajectories of family child care programs across all five rated levels over a two-year period as well as examined whether Stars Plus participation predicted the attainment of the highest quality levels in Delaware’s QRIS. Results gathered from the application of survival analysis to statewide QRIS administrative data suggested that Stars Plus family child care providers were 1.8 times more likely to move up a star level than family child care providers who participated in the QRIS but did not receive Stars Plus. Further, logistic regression analysis demonstrated that Stars Plus family child care providers were 5.2 times more likely to achieve Star Level 4 or 5 than family child care providers who participated in the QRIS without this intensive support. Findings suggested family child care providers may be more successful in state QRIS when quality improved supports are tailored to meet their needs.

Exploring rural and urban Go NAP SACC trained child care providers perceptions and needs regarding the promotion of physical activity and healthy eating

Introduction: Early childhood is an optimal time to support the development of physical activity and healthy eating behaviors. As over half of children are cared for in family child care homes and ...

The Ecology of Physical Activity in Family Childcare Environments: A GIS-Supported Qualitative Study

The Ecology of Physical Activity in Family Childcare Environments: A GIS-Supported Qualitative Study

Factors promoting and inhibiting the use of resources for family childcare

Factors promoting and inhibiting the use of resources for family childcare

Nutritional Quality of Meals and Snacks Served and Consumed in Family Child Care

BackgroundImproving the nutritional quality of food, including beverages, served in early care and education settings should enhance children’s diet quality. However, few studies have explored the relationship between what is served and consumed in family child-care homes (FCCHs). ObjectiveTo describe the nutritional quality of food served to children in FCCHs and to assess the extent to which children eat what is served. DesignThis study was a cross-sectional analysis using baseline data (n=166) from a cluster-randomized controlled trial (2013-2016). Participants/settingEligible FCCHs in central North Carolina had to have at least two children between 18 months and 4 years, have been in business for at least 2 years, and serve at least one meal and one snack. Main outcome measuresFood was captured using the Diet Observation at Child Care protocol. Statistical analysesFrequencies, means, and multivariate analysis were used to examine the relationship between food served and consumed by food groups and by Healthy Eating Index (HEI-2010). ResultsChildren consumed between 61% and 80% of what was served, with vegetables having the lowest percent consumed (61.0%). Total HEI-2010 score for food served was 63.6 (10.4) and for food consumed was 61.7 (11.5) out of a 100-point maximum. With regards to food served, FCCH providers came close to meeting HEI-2010 standards for dairy, whole fruit, total fruit, and empty calories. However, providers appeared to fall short when it came to greens and beans, seafood and plant proteins, total vegetables, whole grains, and fatty acids. They also exceeded recommended limits for sodium and refined grains. ConclusionsAlthough FCCHs are serving some healthy food, mainly fruit, dairy, and few empty calories, there is room for improvement with regards to vegetables, grains, seafood and plant protein, fatty acids, and sodium. Future trainings should help providers find ways to increase the serving and consumption of these foods.

Modifying the Environment and Policy Assessment and Observation (EPAO) to better capture feeding practices of family childcare home providers.

To describe the modification and validation of an existing instrument, the Environment and Policy Assessment and Observation (EPAO), to better capture provider feeding practices. Modifications to the EPAO were made, validity assessed through expert review, pilot tested and then used to collect follow-up data during a two-day home visit from an ongoing cluster-randomized trial. Exploratory factor analysis investigated the underlying factor structure of the feeding practices. To test predictive validity of the factors, multilevel mixed models examined associations between factors and child's diet quality as captured by the Healthy Eating Index-2010 (HEI-2010) score (measured via the Dietary Observation in Childcare Protocol). Family childcare homes (FCCH) in Rhode Island and North Carolina, USA.ParticipantsThe modified EPAO was pilot tested with fifty-three FCCH and then used to collect data in 133 FCCH. The final three-factor solution ('coercive control and indulgent feeding practices', 'autonomy support practices', 'negative role modelling') captured 43 % of total variance. In multilevel mixed models adjusted for covariates, 'autonomy support practices' was positively associated with children's diet quality. A 1-unit increase in the use of 'autonomy support practices' was associated with a 9·4-unit increase in child HEI-2010 score (P=0·001). Similar to the parenting literature, constructs which describe coercive controlling practices and those which describe autonomy-supportive practices emerged. Given that diets of pre-schoolers in the USA remain suboptimal, teaching childcare providers about supportive feeding practices may help improve children's diet quality.

Beverage Policy Implementation by Child and Adult Care Food Program Participation and Program Type: A Statewide Examination in Georgia.

The child care setting is a promising venue to establish healthy habits and promote obesity prevention. One major contributor to weight gain among young children is high intake of sugar-sweetened beverages (SSBs). Increasing access to water and other healthy beverages is a viable strategy to reduce childhood obesity. The goal of our study was to investigate implementation of the beverage policies in child care programs in Georgia (GA) by Child and Adult Care Food Program (CACFP) participation and program type. The study employed a cross-sectional design. A statewide survey was conducted using the GA Child Care Wellness Survey. A random sample of 3054 child care programs was obtained. Programs were stratified by six state regions to acquire a representative sample. A total of 974 surveys were returned. Sixty-seven percent of the respondents were enrolled in CACFP. Programs participating in CACFP (96%) were less likely to serve SSBs (x2(2) = 15.309, p < 0.001), than non-CACFP programs (90%). CACFP programs were more likely to serve low-fat or fat-free milk to 2-5-year olds than non-CACFP programs (87% vs. 35%, p < 0.001). Family child care homes were significantly more likely to comply with serving only whole milk to 1 year olds (66%; p < 0.001) than other program types. All program types had low compliance with implementing water policies. Study outcomes provide vital information on the implementation of beverage policies that can inform beverage policy training, with the ultimate goal of reducing obesity risk and promoting healthier diets among preschool children in GA.

Canadian report card on health equity across the life-course: Analysis of time trends and cross-national comparisons with the United Kingdom

Addressing social determinants of health (SDoH) has been acknowledged as an essential objective for the promotion of both population health and health equity. Extant literature has identified seven potential areas of investment to address SDoH: investments in sexual and reproductive health and family planning, early learning and child care, education, universal health care, as well as investments to reduce child poverty, ensure sustainable economic development, and control health hazards. The aim of this paper is to produce a ‘report card’ on Canada’s success in reducing socioeconomic and health inequities pertaining to these seven policy domains, and to assess how Canadian trends compare to those in the United Kingdom (UK), a country with a similar health and welfare system. Summarising evidence from published studies and national statistics, we found that Canada’s best successes were in reducing socioeconomic inequalities in early learning and child care and reproductive health—specifically in improving equity in maternal employment and infant mortality. Comparative data suggest that Canada’s outcomes in the latter areas were like those in the UK. In contrast, Canada’s least promising equity outcomes were in relation to health hazard control (specifically, tobacco) and child poverty. Though Canada and the UK observed similar inequities in smoking, Canada’s slow upward trend in child poverty prevalence is distinct from the UK’s small but steady reduction of child poverty. This divergence from the UK’s trends indicates that alternative investment types and levels may be needed in Canada to achieve similar outcomes to those in the UK.

Physical Activity and Sedentary Behaviors of Children in Family Child Care Homes: Are There Opportunities for Improvement?

Many children attend family child care homes (FCCHs), an important setting to influence children's physical activity (PA) and sedentary behavior (SB). This study assessed children's PA and SB while in FCCHs, characteristics of the FCCH PA environment, and relationships between the environment and child PA and SB. Children ages 1.5-4.0 years (n = 495) were recruited from 165 FCCHs in North Carolina. Children's moderate to vigorous PA and SB were measured via accelerometry for 3 days. FCCH PA environments were assessed over 2 days using the Environment and Policy Assessment and Observation for FCCHs. Ten subscores and an overall PA environment score (possible range: 0-30) were calculated; higher scores indicate better quality. Children accumulated 30 (13)minutes of moderate to vigorous PA and 143 (42)minutes of SB in FCCHs daily. FCCHs scored low on the Environment and Policy Assessment and Observation for FCCHs, with an average overall score of 13 (2). FCCHs scored highest on screen time and screen time practices subscores, and lowest on PA education/professional development and PA policy subscores. Although no statistically significant associations were observed, some large Cohen d effect sizes were noted (eg,outdoor playtime subscore and moderate to vigorous PA). This study highlights opportunities to improve FCCHs and increase children's behaviors (eg,providing adequate time and outdoor play spaces).

State Regulations Promoting Infant Physical Activity in Early Care and Education

State policies have the potential to improve early care and education (ECE) settings, but little is known about the extent to which states are updating their licensing and administrative regulations, especially in response to national calls to action. In 2013, we assessed state regulations promoting infant physical activity in ECE and compared them with national recommendations. To assess change over time, we conducted this review again in 2018. We reviewed regulations for all US states for child care centers (centers) and family child care homes (homes) and compared them with three national recommendations: (1) provide daily tummy time; (2) use cribs, car seats, and high chairs for their primary purpose; and (3) limit the use of restrictive equipment (e.g., strollers). We performed exact McNemar's tests to compare the number of states meeting recommendations from 2013 to 2018 to evaluate whether states had made changes over this period. From 2013 to 2018, we observed significant improvement in one recommendation for homes-to use cribs, car seats, and high chairs for their primary purpose (odds ratio 11.0; 95% CI 1.6-47.3; p = 0.006). We did not observe any other significant difference between 2013 and 2018 regulations. Despite increased awareness of the importance of early-life physical activity, we observed only modest improvement in the number of states meeting infant physical activity recommendations over the past 5 years. In practice, ECE programs may be promoting infant physical activity, but may not be required to do so through state regulations.

How Well Can Family Childcare Providers Report on Preschoolers' Motor Skill Competence?

Assessing children's movement skill competence objectively is resource and time intensive. Family childcare providers (FCCPs) are with young children for most of a normal weekday and may have an understanding of their motor skill competence. This study examined how well FCCPs can report on preschoolers' motor skills. Seventy-eight 3-5 year olds (53.1% girls) from 26 FCCPs participated. The Test of Gross Motor Development-2 assessed actual motor skill competence and a survey assessed preschoolers' motor competence as reported by FCCPs. Bivariate correlations examined associations between actual and FCCPs' proxy-report of preschoolers' motor skill competence. Regression models tested the predictive power of FCCPs' proxy-report on actual preschoolers' motor skill competence, accounting for age and sex. There were moderate significant correlations for locomotion (r = .30), object control (r = .38), and overall motor skill competence (r = .36). The regression models showed proxy report was statistically associated with preschoolers' object control skills (β = .78, p = .011) and overall motor skills (β = .72, p = .022), but not locomotor skills (β = .52, p = .084). FCCPs' proxy-report of preschoolers' motor skill competence explained 20.9, and 20.1% of preschoolers' variance in object control, and overall motor skill competence, respectively after adjusting for biological sex and age (increasing). FCCPs may be used as an alternative source of information in reporting young children's actual motor skill competence, at least for the object control domain. There is an opportunity for education of FCCPs regarding children's locomotor skill development.

Family child care providers' responsiveness toward children: The role of professional support and perceived stress

Approximately 7 million 0- to 5-year-old children attend family child care, which is a non-parental, paid care provided in a child care provider's home in the U.S. Despite the importance of family child care providers' role in supporting young children's development, studies on family child care providers' responsiveness for children in their care are lacking. This study investigates whether family child care providers' perceived professional support (i.e., professional resources and connectedness with children's families) and perceived personal stress are independently and jointly associated with their responsiveness toward children's emotional and social challenges. Survey data were collected from 888 family child care providers in 40 states in the U.S. We found that when family child care providers have more professional resources, they utilize less negative guidance. Further, when family child care providers have more positive connectedness with children's families, they utilize more positive guidance. Family child care providers' perceived personal stress was significantly associated with their responsiveness toward children's negative emotions. Examining interactions between perceived professional support and personal stress, we found that perceived professional support was positively associated with family child care providers' responsiveness only when their stress level was low. The study emphasizes a need for providing targeted interventions for family child care providers to support their professional development as well as psychological wellbeing.

Predictors of Parent Engagement Based on Child Care Providers’ Perspectives

ObjectiveDetermine the predictors of child care providers’ parent engagement regarding child nutrition in child care centers (CCCs) and family child care homes (FCCHs). DesignCross-sectional. SettingChild care centers and FCCHs. ParticipantsChild care center directors (n = 337) and FCCH providers (n = 1,153) completed a self-administered survey. Main Outcome MeasuresFifteen variables were examined as predictors for parent engagement: providers’ perceived barriers to communication, participation in Go Nutrition and Physical Self- Assessment in Child Care, National Association for the Education of Young Children accreditation, participation in Quality Ratings and Improvement Systems, feeding practices, and professional development. AnalysisStructural equation modeling examined the relation between variables for CCCs and for FCCHs. ResultsFor CCCs, NAEYC accreditation, providers’ perceived barriers regarding parents’ cultural beliefs about food, parents not liking the taste of healthy foods, and parents prioritizing other food-related topics over healthy eating significantly predicted parent engagement. For FCCHs, participation in Go Nutrition and Physical Self- Assessment in Child Care, perceiving parents to be busy, not wanting to offend parents, and practicing family-style dining were significantly related to parent engagement. For both CCCs and FCCHs, professional development regarding child nutrition was related to parent engagement. Conclusions and ImplicationsFocusing professional development on child care contexts and addressing providers’ perceived barriers may improve parent engagement.

Family Childcare Types and Conduct Problem Behaviors in Young Children: The Mediation Role of Caregiver-Child Interaction.

Background: Previous studies have demonstrated the impacts of genetic, family, and community factors on child conduct problems (CPs). However, little is understood regarding the association between family childcare types and child conduct problem behaviors, as well as whether and to what extent caregiver-child interaction mediates the above association.Methods: 9,289 children first entering kindergartens in the Longhua New District of Shenzhen, China were enrolled in this cross-sectional study. Primary caregivers were invited to fulfill a self-administered structured questionnaire containing data regarding socio-demographics, family childcare types, caregiver-child interaction, and child conduct problem behaviors (measured by the Conners' Conduct Problem Subscale). A series of multiple logistic and linear regression models were employed to assess the associations among family childcare, caregiver-child interaction, and child conduct problem behaviors.Results: Family childcare types other than by parents together (i.e., mother alone, mother with others, grandparents, or changing caregivers) were all significantly associated with higher risks of conduct problem behaviors in young children (adjusted ORs ranged from 2.18 to 2.55, and adjusted βs ranged from 0.043 to 0.073; all p < 0.05), after adjusting for confounders including child age, gender, parental education level, parental age at pregnancy, marital status, and family income. The following family childcare types (mother alone, or grandparents, or changing caregivers) vs. the childcare by parents together showed significant relative indirect effects on conduct problem behaviors through caregiver-child interaction, indicating the significant mediation effect of caregiver-child interaction on the above associations. Mediation of caregiver-child interaction on the effect of being cared by mother with others relative to care by parents together on child conduct problem behaviors was yet non-significant.Conclusions: Family childcare types other than by parents together are associated with increased risks for conduct problem behaviors in young children. Caregiver-child interaction may function as a potential mediator for the above association.

Town Square: An innovative pathway to family child care professionalization

Children's earliest years are times of significant development and learning, yet the professionals who provide care for young children often do not receive the economic or professional support they need and deserve. Given the unique situations of child care professionals, especially those running their own family child care businesses, we must find innovative ways to support them as they care for and guide our youngest citizens.

NP16 - Development of an Intervention to Enhance Children's Nutrient Quality in Family Child Care Homes

Objective: Describe Happy Healthy Homes, an interdisciplinary, community-based study in Oklahoma, to improve FCCH environments and children's health through the development and testing of two interventions: a nutrition intervention to increase quality of foods served and promote compliance with Child and Adult Care Food Program (CACFP) best-practices and a healthy environment intervention to reduce children's exposure to toxins. Description: Early childhood is a critical developmental period that largely determines health throughout the life course. Over 60% of U.S. children spend time in weekly early care and education (ECE) environments away from home. The physical and social environments of ECEs influence children's health in multiple ways and, as such, ECEs are important settings for health promotion interventions. Family Child Care Homes (FCCH), ECE that provide care for children in the provider's own home, serve over one million children in the U.S. Matched attention intervention trials offer an opportunity to test nutrition interventions in FCCHs along with other intervention to promote children's health. Evaluation: Cluster randomized controlled trial with matched attention design. Fifty-two FCCH providers in and around Oklahoma City were randomly assigned into either of the two interventions, where each serves as an attention control for the other. Interventions were based on existing evidence base for health promotion interventions in ECE, Public Health Ecological Model, Social Cognitive Theory, Social Support, Self-Determination Theory, and Adult Learning Practices. Both interventions were completed over three months and consists of two 90-minute home visits with interactive activities, reflection, and goal setting, and a three-hour small group class. The aims include determining the effectiveness, over a 12-month follow-up period, of a pilot community-based intervention to enhance meeting (CACFP) best practices. Multiple observed and self-reported measures were collected at baseline and at 3 and 12 months post-baseline. Conclusions and Implications: Implementation of this intervention will enhance the quality of nutrition provided to young children in FCCH and can be used to scale to rural environments and other states. Funding: 2017-68001-26355. The following is the supplementary data to this article: Download .pdf (.5 MB) Help with pdf files Poster