Child Care Health Consultation Research Articles

Child Care Health Consultation Improves Infant and Toddler Care

IntroductionMany families enroll their infants and toddlers in early education and child care programs. The Pennsylvania Chapter of the American Academy of Pediatrics recruited 32 child care centers that care for infants and toddlers to be linked with a child care health consultant (CCHC). MethodProject staff assigned the centers alternately to an immediate intervention or a 1-year delayed intervention (contrast) group. At entry into the project, and then 1 and 2 years later, an evaluator assessed center compliance with 13 standards for infants and toddler care selected from Caring for Our Children: National Health and Safety Performance Standards (3rd ed.). Project staff linked the Immediate Intervention centers with a CCHC in Year 1. In Year 2, in a crossover comparison, project staff linked Contrast centers with a CCHC. ResultsWorking with a CCHC effectively improved compliance with some selected health and safety standards.

Quality Early Education and Child Care From Birth to Kindergarten.

High-quality early education and child care for young children improves physical and cognitive outcomes for the children and can result in enhanced school readiness. Preschool education can be viewed as an investment (especially for at-risk children), and studies show a positive return on that investment. Barriers to high-quality early childhood education include inadequate funding and staff education as well as variable regulation and enforcement. Steps that have been taken to improve the quality of early education and child care include creating multidisciplinary, evidence-based child care practice standards; establishing state quality rating and improvement systems; improving federal and state regulations; providing child care health consultation; as well as initiating other innovative partnerships. Pediatricians have a role in promoting quality early education and child care for all children not only in the medical home but also at the community, state, and national levels.

Pandemic Influenza Preparedness Among Child Care Center Directors in 2008 and 2016.

Children in child care centers represent an important population to consider in attempts to mitigate the spread of an influenza pandemic. This national survey, conducted in 2008 and 2016, assessed directors' reports of their child care centers' pandemic influenza preparation before and after the 2009 H1N1 novel influenza pandemic. This was a telephone-based survey of child care center directors randomly selected from a national database of licensed US child care centers who were queried about their preparedness for pandemic influenza. We grouped conceptually related items in 6 domains into indexes: general infection control, communication, seasonal influenza control, use of health consultants, quality of child care, and perceived barriers. These indexes, along with other center and director characteristics, were used to predict pandemic influenza preparedness. Among 1500 and 518 child care center directors surveyed in 2008 and 2016, respectively, preparation for pandemic influenza was low and did not improve. Only 7% of directors had taken concrete actions to prepare their centers. Having served as a center director during the 2009 influenza pandemic did not influence preparedness. After adjusting for covariates, child care health consultation and years of director's experience were positively associated with pandemic influenza preparation, whereas experiencing perceived barriers such as lack of knowing what to do in the event of pandemic influenza, was negatively associated with pandemic influenza preparedness. Pandemic influenza preparedness of child care center's directors needs to improve. Child care health consultants are likely to be important collaborators in addressing this problem.

Childcare health and health consultation curriculum: Trends and future directions in nursing education

The purpose of this study was to identify graduate and undergraduate nursing courses in health and health consultation in childcare and early education, and faculty awareness and interest in federal resources. A questionnaire was sent electronically to 140 faculty in 45 schools of nursing. Fifty-nine faculty from 45 schools (42%) participated, and 80% reported at least one course related to childcare health and safety. Most faculty were not aware of federal initiatives to support childcare health and safety, and the role of nurse childcare health consultants; however, many were interested in receiving instructional materials. Utilizing federal resources to augment nursing education in childcare health and safety curriculum may strengthen the workforce of nurses providing health consultation to early childhood programs.

Assessing Indiana’s Health and Safety in Early Care and Education Programs: Identifying Areas for Improvement

The objective of this study is to describe the key National Health and Safety Standards (NHS) met in early care and education (ECE) programs in Indiana and to establish reliability for the Indiana Health and Safety Checklist. The Indiana Health and Safety Checklist, modified from the California Childcare Health Program's Health and Safety Checklist, includes 87 items and 11 subscales. It was completed in 2h by trained child care health consultants in 82 ECE programs to assess the number of key NHS met. The 82 ECE programs met the majority of NHS items. Thirteen items were not met in more than 50% of the programs. The items with the lowest compliance were emergency food supplies, children's hand washing, special health care plans, cleaning and sanitizing counters, and impact surfaces under playground equipment. The Indiana Health and Safety Checklist had moderate internal reliability for 6 of the 9 subscales analyzed. ECE programs strive to provide high quality care and the programs met the majority of NHS on the checklist. The Checklist is a reliable instrument that helped identify health and safety gaps and thus, identified the targeted interventions for child care health consultation.

Child Care Health Consultation Improves Health and Safety Policies and Practices

To evaluate the effects of county-level child care health consultation intervention programs on child care centers' health and safety policies and practices. A 3-year experimental study was conducted in 5 California counties and 111 licensed child care centers (73 intervention, 38 comparison) participated at the baseline and postintervention times. Trained research assistants conducted objective observations with a Policies Checklist and Health and Safety Checklist, which were composed of key national health and safety standards. At baseline, both groups were not significantly different on the Policies Checklist and the Health and Safety Checklist. At the post-intervention time, intervention centers had significantly more and higher-quality written health and safety policies on 9 of the 10 policies rated (medication administration, care of mildly ill children, exclusion of ill children, cleaning and sanitizing, handwashing, daily health checks, inclusion of children with special needs, emergency preparedness, staff health) than comparison centers. At the postintervention time, intervention centers improved their health and safety practices in the areas of emergency preparedness and handwashing, controlling for consultation model, time in study, and director turnover. Both groups improved their indoor and outdoor facilities and overall Health and Safety Checklist means. Child care health consultation programs can improve the written health and safety policies and may improve practices in child care centers.

Collaborative Childcare Health Consultation: A Conceptual Model

This study explored the nature of consultation between childcare providers and nurse childcare health consultants and identified factors that promote a collaborative relationship. A qualitative study using semistructured, individual interviews of five collaborative and five conflicted pairs of nurse childcare health consultants and childcare center directors. Data were analyzed following principles of grounded theory and applying the constant comparative method of analysis. Establishing a collaborative relationship was influenced by previous experiences and four themes in the relationship: open and active communication, commitment, respect, and congruent philosophies. Preparation in developing collaborative relationships should be incorporated into the education of nurse consultants and childcare directors and providers.

Child Care Health Consultation Programs in California: Models, Services, and Facilitators

To summarize findings from a descriptive evaluation study of 20 county-level child care health consultation programs, services provided, and factors that facilitated the development of the programs. A 3-year intervention study of 20 county-level child care health consultation programs, selected through a competitive review process, was conducted in California. Study participants were the child care health consultation program staff, lead agency administrators and health consultants, and early care and education (ECE) staff, including health advocates and directors. MEASUREMENT AND INTERVENTION: Data collection included focus groups, interviews, consultant activity logs, and surveys. Health consultation intervention services included health and safety assessments, on-site consultation, and workshops for ECE providers and parents. 4 child care health consultation models were established based on the type of administrative agency. Health consultants and advocates primarily provided on-site consultation and education and training on child health promotion issues. Consultation programs were facilitated by the linkages formed among agencies, community characteristics, personal relationships, lead agency support, and consultant training and knowledge. Child care health consultation programs can address the health and safety needs for ECE programs, but they need administrative support, trained staff, and sustainable relationships with local ECE programs.

Child Care Health Consultation Programs: Barriers and Recommendations

While many studies describe the need for health services in early care and education (ECE) settings and the role of child care health consultants (CCHCs), little information exists about the challenges to developing health consultation programs. The goal of this paper is to provide insight for the development of current and future child care health consultation programs by describing the barriers identified by CCHCs related to program implementation in 20 California counties. Forty-four child care health consultants participated in nine focus groups during their health consultation training at the California Training Institute. Participants were asked to discuss the barriers they encountered while establishing new county-wide child care health consultation programs. Themes were assigned to each response, and frequency and percentage of each theme were documented and trends were identified. The four general themes describing barriers to program implementation were: Program Management, Child Care Culture, Geography and Community Services. Twenty additional sub-themes, including Multi-agency involvement, Chaos, Travel time, and Fragmentation, were assigned to each response. The most frequent general theme was Program Management. The most frequent sub-theme was Professional Support. The barriers identified by the child care health consultants can be valuable for administrators and clinicians establishing or developing child care health consultation programs. Program managers should be prepared for the unique challenges of child care health consultation and provide flexibility and support for child care health consultants.

Use of Public Health Nurse Competencies to Develop a Childcare Health Consultant Workforce

The purpose of this article is to describe the efforts in the state of Georgia to train public health nurse-childcare health consultants (PHN-CCHCs) using the framework of the "Core competencies for public health practice." The goal of the training was twofold: (1) to prepare a statewide cadre of PHNs as the primary workforce for Georgia's emerging childcare health consultation (CCHC) system and (2) to prepare their district nurse directors to lead and support CCHCs. Administrators attended a 2-day workshop followed by access to executive coaching for their management teams. PHNs participated in a three-phase training program, with phases 1 and 3 offered as 3-day workshops with field experiences, and phase 2 offered online and as a practicum. Forty-four administrators and over 85 PHN-CCHCs completed the training. Graduates of the program reported satisfaction with training and reported the use of PHN core competencies in CCHC. Graduates also found enhanced skills in using core competencies to be applicable to a variety of population-based practices. Beyond CCHC being instituted in selected health districts, interest in CCHC has occurred statewide. The PHN-CCHC program enhanced the knowledge and use of core competencies and heightened interest in CCHC statewide.

Assessing the Need for Child‐Care Health Consultants

This study surveyed health and safety needs of child-care programs; examined the perceptions of directors, the person identified as being responsible for a program, concerning health consultation; and determined how directors would secure funds to pay for consultative services. The survey was conducted in a state without mandates for child-care health consultation and minimal access to consultants. The researchers designed and pilot-tested a Child Care Health and Safety Survey. Working with a task group of statewide child health experts, the researchers revised the survey and mailed it to a random sample of child-care programs. Twenty-two Head Start Programs, 122 licensed child-care centers, and 116 family child-care homes participated, representing a return rate of 73, 36, and 30%, respectively. The majority of programs expressed interest in child-care health consultation offered for free or fee-based. Directors identified reasonable means of obtaining funds to support consultation. All programs had needs related to supporting health practices in their settings, provision of health services for staff, and health screening for children. Public health nurses, specially trained to advise child care, are well positioned to offer consultation. Systems of health consultation may be accepted as fee-for-service arrangements, supporting sustainability.

Partnership to Build Sustainable Public Health Nurse Child Care Health Support

Child care health consultation, an emerging health care delivery system aimed at improving the health and well-being of children enrolled in child care settings, is consistent with the public health core function of assurance. Public health nurses are the primary workforce for such consultation. Few states have critical masses of consultants, and many are struggling to financially support such programs. Through an academic-community partnership, Georgia's public health nurses are building a consultative system of child care health support. This partnership focuses on adding value in child care while strategically and financially supporting the sustainability of this population-focused practice.

For the record…

Journal for Specialists in Pediatric NursingVolume 7, Issue 1 p. 41-41 ErratumFree Access For the record… This article corrects the following: Child Care Health Consultation: An Ecological Model Angela A. Crowley, Volume 6Issue 4Journal for Specialists in Pediatric Nursing pages: 170-181 First Published online: June 12, 2007 First published: 23 February 2007 https://doi.org/10.1111/j.1744-6155.2002.tb00001.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume7, Issue1January 2002Pages 41-41 RelatedInformation

Child care health consultation: an ecological model.

To present an ecological model of child care health consultation that defines the role of the health consultant as a resource and advocate within child care programs, as well as a supportive link among families, child care providers, and the healthcare system. Nurses have provided health consultation to child care programs for more than 30 years and represent the majority of health consultants nationally. Pediatric nurses and advanced practice nurses are well prepared to shape and lead the development of this emerging role. With expertise in caring for children, understanding families, and care across systems, pediatric nurses and advanced practice nurses should engage in current state and national efforts to develop child care health consultants.

Child care health consultation: the Connecticut experience.

The quality of child care is of increasing national concern. Federal initiatives are recommending child care health consultation to promote healthy, safe, and developmentally appropriate care. However, few studies have investigated the implementation of this recommendation. The purpose of this study was to explore the experience of Connecticut child care center directors and their health consultants who were engaged in mandated, weekly, on-site health consultation. One hundred Connecticut child care center directors and their health consultants participated in a mailed, self-administered survey. The centers were stratified by region and selected by random probability sampling. Descriptive analyses of the data examined the perspectives of both groups. Eighty-four percent of the child care center directors reported that health consultation visits were important or very important for the management of their programs. Eighty-one percent of the health consultants believed that their directors considered the visits important or very important. The reported tasks of the health consultants were consistent with regulatory requirements. Cost was cited as a factor that negatively influenced access to services by at least 37% of the director sample. Demographics of the sample, description of the role, and recommendations by directors and health consultants are included. Health consultation visits were highly valued among this sample as an effective means of promoting children's health and development in child care centers. Future initiatives should promote child care health consultation through training, infrastructure development, and funding of health consultation services.