Child Care Settings Research Articles

The emotional power of educational branding: exploring parental decision-making in South Australia’s preschool choices

ABSTRACT While some research has focused on the implications of choice discourses in childcare settings, insufficient attention has been paid to how parental figures of preschoolers are activated and summoned through contradictory discourses that position them as both rational and emotional. Through a qualitative analysis of twenty parent questionnaires, this paper captures the dynamics of inclusion/exclusion flowing from these processes, and the transformation of the preschool sector in South Australia. Using an affective-discursive analytical approach, the research highlights how language, discourse and imagery are powerful tools that engage peoples’ feelings and emotions within a broader classed, raced, and gendered social environment. Its contribution to knowledge, therefore, rests in its effort to broaden our understandings of the meanings and practices of parents choosing a pre-school for their child, by adding affect theory to what otherwise might be ‘only’ a discursive analysis of the wider macro-economic and political trends linked to neoliberalism.

Measles secondary vaccine failure in a childcare setting: an outbreak report.

The Sunshine Coast Public Health Unit (SCPHU) identified a measles case in a childcare educator (CE) with secondary vaccine failure (SVF). The CE had been exposed to a confirmed measles case in a hospital emergency department and later developed symptoms including fever, cough, malaise, and a rash. Diagnostic tests confirmed measles virus infection. Sunshine Coast Public Health Unit (SCPHU) implemented control measures including contact tracing, vaccination, post-exposure prophylaxis, and quarantine for susceptible contacts. Out of 372 identified contacts, 72 were identified as susceptible, all of whom were infants and children. Despite the CE having close contact to all susceptible infants and children, no onward transmission occurred. This suggests that SVF cases pose a lower risk of spreading measles compared to immunologically naïve individuals. This report highlights the importance of prioritising immunologically naïve cases in outbreak responses.

A comparison of assessment tools for childcare centers in high vs. low resource settings.

Studies suggest issues may arise when using childcare setting assessment tools designed for high-resource settings in low-resource settings to assess and improve the quality of care, including placing disproportionate weight on features of the childcare environment that may not be available or culturally appropriate within the low-resource context. This study compares a novel assessment tool developed in and for low-income and low-resource settings with a standardized "gold standard" tool developed for use in high-resource settings. The study included a randomized sample of 34 childcare centers in a low-resource context that provided care for approximately 918. Results suggest that the WCI-QCUALS assessment tool performed better at differentiating among childcare settings that were consolidated into the lowest rating on the ECERS-R. Further, the WCI-QCUALS was found to be a feasible, appropriate stand-alone tool for assessing the quality of childcare centers in low-resource settings. Additional refinement and validity testing in other countries and contexts will improve the understanding of how the quality of childcare across different contexts can be measured, and improved assessment of childcare quality in low-resource settings will enhance the ability to identify low-quality care that can be remedied to ensure appropriate care for vulnerable children.

Barriers to access to local produce in an early childhood setting in rural Appalachia

This case study examines young children’s access to fresh local produce in childcare settings in rural Appalachia. In-depth, semi-structured interviews with childcare center directors participating in farm to early care and education programming were conducted in the spring of 2023. Centering the per­spective of childcare directors, this research explores why farm to school programming is diffi­cult to implement. It specifically addresses the bar­riers preventing early childcare centers from pro­viding access to fresh and local produce to enrolled children. Eight primary obstacles to implementing farm to early care and education programming were identified: lack of staff; too wide a variety of tasks for directors; the “extra” work that fresh pro­duce requires; lack of knowledge about how to grow food; lack of required kitchen equipment; need for additional funding; unclear or out-of-date regulations about food safety; and a lack of paren­tal time. Limitations of the research include the specific geographic location of the study and the long-lasting implications of the COVID-19 pan­demic. Recommendations drawn from this case study include improving communication between childcare centers and regulatory agencies; creative use of alternative gardening practices; participating in a regional food hub; and improved funding.

키워드 네트워크 분석을 활용한 어린이집 권리존중보육에 관한 연구 동향

This study aims to examine research trends by using the frequency and research methods of research on respect for rights in daycare centers and keyword network analysis. To this end, 111 domestic research papers registered in KCI from 2011 to 2024 were selected through a keyword search related to respect for rights childcare and analyzed by period. As a result, first, 88 studies were published in the second period (2018-March 2024), and quantitative research was the most common research method. Second, the keyword network analysis results showed that the keywords ‘respect for rights of infants and toddlers’, ‘respect for rights of infants and toddlers’, and ‘early childhood teachers’ appeared frequently in all periods. The centrality analysis results showed that ‘respect for rights of infants and toddlers’, ‘respect for rights of infants and toddlers’, and ‘early childhood teachers’ appeared in the top keywords in all periods, and ‘early childhood rights’ was ranked high in the first period, and ‘teacher professionalism’ and ‘organizational health’ were ranked high in the second period. Through the results of this study, we identified research trends in childcare rights-respecting childcare in daycare centers and derived the need for expanding the diversity of related research. It is significant in that it suggests future directions for strengthening teacher professionalism for childcare rights-respecting childcare in childcare settings.

3.N. Round table: Health inequalities over life-course between people with & without childhood social care experience

Abstract The burden of ill health is not carried equally, children and young people with experiences of childhood social care (CSC), e.g. kinship, foster, residential or ‘out-of-home’ care, are affected by multiple cumulative disadvantages and experience high inequalities in health compared to the rest of the population. CSC, and the adversities often associated with it, are linked to health problems that persist into adulthood and adversely affect education, employment, and the future European society. Public and policy interest in improving outcomes for CSC recipients has increased markedly, as has research on the association between CSC and life outcomes. But current research is siloed, with limited comparative perspective and has not led to a strong evidence base to inform policy and practice. Wider international networks to connect research, practice and policy are needed to change this. The objective of the workshop is to bring together evidence on health inequalities between people with and without CSC experience across Europe. The panel will set the scene for the discussion by raising questions that stem from their work for the audience to respond. We will ask the audience to engage with these questions based on their experience (e.g. academic, clinical or other professional). The real-time reactions will be collected via Mentimeter during presentations, moderated and fed back to the audience and panel for discussion. This will allow us to collect diverse responses across countries and from different professional perspectives, providing learning and insights for both the panel and audience. The added value of a EUPHA workshop is the high-profile European level attention on this population. A spotlight on CSC experiences bringing together evidence from topic experts and health practitioners committed to improving childhood health inequalities across Europe and will foster a strong foundation for future collaborations and comparative research. The format is interactive and will include an introductory video of lived experiences of CSC to put a human face on this topic. We will then hear 4x5 minute expert presentations from social epidemiologists, health and social care professionals (20m) followed by a moderated discussion with the audience (35m). The presentations cover research across Europe, consider how inequalities accumulate across the life course to place children in care settings and identify where gaps in services fail children. MA sets the scene by asking what the international evidence is telling us about the health of people with CSC experiences. VS explores the accumulation of disadvantage across the life-course and intergenerational experiences of CSC. HF uses the Swedish example to ask why welfare services are not meeting the health needs of children. Finally, SS will consider solutions: what additions support is required for health practitioners dealing with children in care settings and what can/cannot be achieved from within the doctor’s office? Key messages • Participants will gain new insights on the health of children with social care experience from each other by sharing evidence and discussing key questions from diverse perspectives across Europe. • The workshop provides a foundation for participants to build future international networks and comparative research that will lead to a strong evidence base to inform policy and practice.

How can health practitioners support children and young people in social care?

Abstract Health practitioners are responsible for safeguarding, delivering preventive and responsive care for children and young people in social care settings. However, drivers and determinants that place children in care settings lie outside of the doctor’s office. In fact, primary care health practitioners often deal with children and young people who face or are at risk of severe neglect, abuse or vulnerability outside the care system. Recent findings from the UK’s Millennium cohort study have repeatedly demonstrated that social disadvantage in the early years accounts for more than 2/3 of health inequalities in adolescence. Professor Saxena is a practising GP with 25 years of experience of inner-city primary care and global expert on primary care of children. She will present dilemmas posed in clinical settings for health practitioners and professionals working in a broad range of areas including public health, education settings and social care. What responsibility do health professionals have when they encounter children living in social care settings? What should they be especially alert to? How can they make a difference to reduce health inequality faced by young people growing up in the care system.

Co-designed Health Literacy Activities for Children in Primary Schools

Abstract Early exposure to health literacy (HL) and fostering children’s HL development for health promotion purposes is believed to positively influence their ability to lead healthier lives during adulthood (WHO, 2021). Our qualitative study on children’s perspectives on health and HL showed that children perceive health in a broader context emphasizing aspects of everyday life. When engaging with health information, they often encounter irrelevant information and struggle to discern its trustworthiness (van Boxtel et al., in preparation). In this study, we aim to co-design HL activities with children in primary school for the context of health promotion. Children, aged 9-12 years, formed co-design teams and participated in six 1-hour sessions. Initially, they discussed what HL is and selected the most relevant HL skills to address. Through activities like body mapping, they explored ways to learn these skills. Subsequent sessions involved brainstorming ideas for the designing, and prototyping activities. A larger group of children tested these prototypes, followed by evaluations and improvements by the design team. Preliminary results indicate that children prefer designing HL activities that resonate with their everyday experiences. However, they often relied on familiar ideas unless aided to think creatively, therefore we used AI tools for ideation. The final designs, such as life-sized board game about healthy food, show potential to learn HL in schools. Results of the learning outcomes from these activities are pending and will be presented at the conference. Co-designing with children leads to meaningful HL activities that encourage active engagement with health information. This study inspired us to build a toolbox for learning HL skills for children aged 9-12-years-old in primary schools or childcare settings. We also aim to co-design other identified HL skills and competencies from our Delphi study (Van Boxtel et al., in preparation). Key messages • HL activities co-designed by children reflect daily life relevance, fostering deeper engagement and learning. • Using co-design, we enable children to actively engage with health information and learn specific HL skills.

Residential care settings for children in the Philippines: Examining their transnational and neocolonial characteristics and the implications for children’s social welfare

Residential care settings for children in the Philippines: Examining their transnational and neocolonial characteristics and the implications for children’s social welfare

Longitudinal Change in Physical Activity in Children 6 to 36 Months of Age

To describe the developmental pattern for physical activity (PA) in children 6-36months of age and to identify factors that are longitudinally associated with PA as children transition from infancy to preschool age. The study employed a prospective longitudinal design with baseline data collected when children were approximately 6months of age. Mothers and infants (n=124) were recruited through community and educational settings in South Carolina. Data were collected at 6-month intervals from 6 to 36months. PA was measured via accelerometry. Mothers completed questionnaires that assessed independent variables, including parent characteristics, the child's sex, race, and ethnicity, birth/delivery type, motor milestones, sleep habits, dietary practices, childcare setting, and home environmental factors. Trained research staff administered anthropometric measures and assessed motor developmental status. Growth curve models described the age-related pattern for PA and evaluated relationships between independent variables and change in PA. PA increased by approximately 45% between 6 and 36months of age and followed a curvilinear pattern, with most of the increase occurring between 6 and 24months. The child's exposure to television/electronic media was negatively associated with change in PA, and the presence of older siblings in the home was positively associated with change in PA. As children develop from infancy to early childhood, their PA increases substantially, with most of the increase occurring by 24months of age.

Do kindergartens mitigate or exacerbate socioeconomic inequalities in language exposure? The case of home-based and kindergarten-based shared book reading activities in China

Shared book reading is a well-established practice for boosting children’s language exposure and enhancing early development at home and in child care settings. The present study examined the socioeconomic gaps in home-based and kindergarten-based shared book reading practices in China. The participants were 1095 parents and 111 teachers in 69 classes from kindergartens in Chongqing, China. Differences in terms of the quantity of both home-based and kindergarten-based shared book reading across SES spectrums were tested. Multi-level modelling was conducted to examine the factors associated with the quantity of home-based and kindergarten-based shared book reading. The results revealed that the socioeconomic gap in home-based shared book reading and the resultant language exposure were significant. Family SES and home literacy resources were associated with the quantity of home-based shared book reading and the availability of literacy resources in the classroom is associated with the quantity of kindergarten-based shared book reading. Kindergartens did not mitigate the socioeconomic inequities of language exposure related to shared book reading. Intervention programs shall focus on improving access to both home-based and kindergarten-based literacy materials.

Multidimensional patterns of early care and education access through a family centered lens

Despite evidence of the benefits of early care and education (ECE) for child development and family employment, the supply of providers is scarce and variable; leading many families with young children to experience limited and inequitable access. To examine the multidetermined nature of access, this study leverages a multidimensional, family-centered definition and a nationally representative sample of families of preschoolers from the Early Childhood Longitudinal Study – Birth Cohort to examine (1) patterns of access-related features present in preschool-age children's ECE arrangements, and (2) child characteristics, household circumstances, and care setting type that may be related to patterns of access. Latent class analysis model enumeration revealed five latent classes of children's nonparental care arrangements along features of accessibility: High Across Most Access Features (26.4 %), Single, Long-Term Provider (30.1 %), Limited Across Most Access Features (11.6 %), Low Affordability, Multiple Providers (10.1 %), and High Affordability, Recent Transition (21.8 %). These results suggested many children were in ECE that met multiple dimensions of access, with others in care arrangements that reflected trade-offs. Children were also differentially classified into types of ECE arrangements in relation to care setting type, race/ethnicity, income, household urbanicity, and parental employment. The implications of investigating ECE access as a multidimensional construct, and recommendations for how ECE providers and policy can more closely align with family needs are discussed.

CELEBRATE Feeding: A Responsive Approach to Food and Feeding in Early Learning Settings.

Early learning and child care (ELCC) settings in Canada follow nutrition standards that outline food provisions, with many also encouraging responsive feeding practices that help to create a supportive environment for children. Caregivers who lack confidence in children's ability to regulate their own intake, or those who feel stressed about mealtime, may unknowingly engage in less responsive feeding practices. The CELEBRATE Feeding Approach is a flexible framework, driven by behaviour change theory, that builds on previous definitions and concepts of responsive feeding in ELCC environments. Through this approach, there is an intentional focus on supporting early childhood educators to implement feeding practices that are more responsive. The approach incorporates 13 target educator behaviours related to the three overlapping categories of CELEBRATE language, CELEBRATE Mealtime, and CELEBRATE Play. These practices recognize and support the development of a child's sense of autonomy, confidence, and self-regulation not only at mealtimes but also through play-based exploration and language that is used throughout the day around food and feeding. The goal is that children will be open to a wide variety of food, develop their self-regulation skills, and build the foundation for a positive relationship with food throughout their lifetime.

Paid Family Leave and Prevention of Acute Respiratory Infections in Young Infants

Acute respiratory tract infections are the leading cause of emergency department visits and hospitalizations in US children, with highest risks in the first 2 months after birth. Out-of-home childcare settings increase the spread of respiratory tract infections. The study team hypothesized that access to state-paid family leave could reduce acute care encounters (hospital admissions or emergency department visits) for respiratory tract infections in young infants by reducing out-of-home childcare transmissions. To determine if the 2018 introduction of paid family leave in New York state reduced acute care encounters for respiratory tract infections in infants 8 weeks or younger. This population-based study of acute care encounters took place in New York state and New England control states (Maine, Massachusetts, New Hampshire, Vermont) from October 2015 through February 2020. Participants included infants aged 8 weeks or younger. Controlled time series analysis using Poisson regression was used to estimate the impact of paid family leave on acute care encounters for respiratory tract infections, comparing observed counts during respiratory virus season (October through March) with those predicted in the absence of the policy. Acute care encounters for respiratory tract infections in 1-year-olds (who would not be expected to benefit as directly from the policy) were modeled as a placebo test. New York State Paid Family Leave policy, introduced on January 1, 2018, providing 8 weeks of paid leave for eligible parents. Emergency department visits or hospitalizations with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD) codes for upper or lower respiratory tract infections or associated symptoms (ie, fever, cough), excluding newborn hospitalizations. The secondary outcome was acute care encounters for respiratory syncytial virus (RSV) bronchiolitis. There were 52 943 acute care encounters for respiratory infection among infants 8 weeks or younger. There were 15 932 encounters that were hospitalizations (30%) and 33 304 of the encounters were paid for by Medicaid (63%). Encounters were 18% lower than predicted (relative percentage change = -17.9; 95% CI, -20.3 to -15.7) after the introduction of paid family leave. RSV encounters were 27.0% lower (95% CI, -30.9 to -23.5) than predicted. Similar reductions were not observed in 1-year-olds (relative percentage change = -1.5; 95% CI, -2.5 to -0.6). New York state's paid family leave policy was associated with reduced acute care encounters for respiratory tract infections in young infants. These findings may be useful for informing implementation of paid family leave federally and in the states that have not enacted paid family leave policies.

The direct effect of basic need services, and social support on positive mental health among institutionalized children: the mediating role of psychological capital

Previous research in Ethiopia mainly contemplated studying children’s mental distress and the negative effects of orphanages. However, there is a dearth of documented evidence on how positive psychological resources, social support, basic needs services, and mental health impact the well-being of children in childcare institutions and how care centers can benefit vulnerable children. This study aimed to investigate the direct impact of perceived social support (PSS), basic need services (BNS), and Psychological Capital (PsyCap) on the mental health of children in childcare settings. Additionally, the study sought to explore the mediating role of PsyCap between PSS, BNS, and children’s positive mental health (PMH). A total of 420 institutionalized Ethiopian children, comprising 187 females and 233 males, were selected by using a stratified multistage random sampling approach. Validated and standardized measures of psychological well-being (PWB), PsyCap, BNS, and PSS were employed to collect data from the study participants. The findings from the structural equation modeling (SEM) analysis revealed that BNS and PsyCap directly and significantly predicted the PMH of children. Moreover, both BNS and PSS exhibited a positive and significant effect on the higher-order PsyCap construct. Although PSS did not directly influence positive mental health, it indirectly predicted mental health outcomes through the presence of PsyCap. Furthermore, PsyCap played a mediating role between BNS and positive mental health outcomes. It is recommended that future research replicate and expand upon the current study’s findings to gain insights into the positive mental health of institutionalized children.

Facilitators and barriers to implementing successful exclusion among children with shiga toxin-producing Escherichia coli: a qualitative analysis of public health case management records

BackgroundShiga toxin-producing Escherichia coli (STEC) infections are a significant public health concern as they can cause serious illness and outbreaks. In England, STEC incidence is highest among children and guidance recommends that children under six diagnosed with STEC are excluded from childcare until two consecutive stool cultures are negative. We aimed to describe the barriers and facilitators to implementing exclusion and the impact of exclusion policies on young children and their families.MethodsIndividual level data was obtained from a wider study focusing on shedding duration among STEC cases aged < 6 years between March 2018 – March 2022. Data was extracted from England’s public health case management system. The case management system includes notes on telephone conversations, email correspondence and meeting minutes relating to the case. Collected data consisted of free text in three forms: (1) quotes from parents, either direct or indirect, (2) direct quotes from the case record by health protection practitioners or environmental health officers, and (3) summaries by the data collector after reviewing the entire case record. We analysed free text comments linked to 136 cases using thematic analysis with a framework approach.ResultsThe median age of included cases was 3 years (IQR 1.5-5), with males accounting for 49%. Nine key themes were identified. Five themes focused on barriers to managing exclusion, including (i) financial losses, (ii) challenges with communication, engagement and collaboration, (iii) issues with sampling, processing, and results, (iv) adverse impact on children and their families and (v) conflicting exclusion advice. Four themes related to facilitators to exclusion, including (i) good communication with parents and childcare settings, (ii) support with childcare, (iii) improvements to sampling, testing, and reporting of results, and (iv) provision of supervised control measures.ConclusionsQualitative analysis of public health case records can provide evidence-based insights around complex health protection issues to inform public health guidelines. Our analysis highlights the importance of considering wider social and economic consequences of exclusion when developing policies and practices for the management of STEC in children.

Process Quality in Early Childhood Education and Care in Australia: A Systematic Literature Review

AbstractThis review examines the extant Australian literature on process quality in ECEC, which is understood as children’s actual experience within a childcare setting such as interactions between educators and children. A thematic analysis of empirical evidence from the 21 qualified articles reveals key characteristics of ECEC process quality studies, the benefits of process quality to child outcomes, and some factors influencing process quality. The review highlights the increasing interest in ECEC process quality in Australia and that process quality can be linked to children’s outcomes in the early years. It also underscores that outdoor environments and educators’ attributes such as personal experiences and qualifications stood out as the key supporting factors of process quality. More importantly, the review found that most of the process quality studies in Australia were conducted in metropolitan areas, and there were only two studies focused on children from disadvantaged backgrounds. The paper calls for more actions to combine process quality with equity across types of ECEC services.

Centre-based childcare in early childhood and child obesity: systematic review and meta-analysis protocol

ObjectivesCentre-based childcare has been identified as a promising environment for obesity prevention in early childhood, but the longitudinal relationships between attending centre-based childcare and child obesity are not well understood....

Ventilation does not affect close-range transmission of influenza virus in a ferret playpen setup

Sustained community spread of influenza viruses relies on efficient person-to-person transmission. Current experimental transmission systems do not mimic environmental conditions (e.g., air exchange rates, flow patterns), host behaviors, or exposure durations relevant to real-world settings. Therefore, results from these traditional systems may not be representative of influenza virus transmission in humans. To address this pitfall, we developed a close-range transmission setup that implements a play-based scenario and used it to investigate the impact of ventilation rates on transmission. In this setup, four immunologically naive recipient ferrets were exposed to a donor ferret infected with a genetically barcoded 2009 H1N1 virus (H1N1pdm09) for 4 h. The ferrets interacted in a shared space that included toys, similar to a childcare setting. Transmission efficiency was assessed under low and high ventilation, with air exchange rates of ~1.3 h-1 and 23 h-1, respectively. Transmission efficiencies observed in three independent replicate studies were similar between ventilation conditions. The presence of infectious virus or viral RNA on surfaces and in air throughout the exposure area was also not impacted by the ventilation rate. While high viral genetic diversity in donor ferret nasal washes was maintained during infection, recipient ferret nasal washes displayed low diversity, revealing a narrow transmission bottleneck regardless of ventilation rate. Examining the frequency and duration of ferret physical touches revealed no link between these interactions and a successful transmission event. Our findings indicate that exposures characterized by frequent, close-range interactions and the presence of fomites can overcome the benefits of increased ventilation.

Language environment and early language production in Slovenian infants: An exploratory study using daylong recordings.

Daylong recordings provide an ecologically valid option for analyzing language input, and have become a central method for studying child language development. However, the vast majority of this work has been conducted in North America. We harnessed a unique collection of daylong recordings from Slovenian infants (age: 16-30months, N=40, 18 girls), and focus our attention on manually annotated measures of parentese (infant-directed speech with a higher pitch, slower tempo, and exaggerated intonation), conversational turns, infant words, and word combinations. Measures from daylong recordings showed large variation, but were comparable to previous studies with North American samples. Infants heard almost twice as much speech and parentese from mothers compared to fathers, but there were no differences in language input to boys and girls. Positive associations were found between the social-interactional features of language input (parentese, turn-taking) and infants' concurrent language production. Measures of child speech from daylong recordings were positively correlated with measures obtained through the Slovenian MacArthur-Bates Communicative Development Inventory. These results support the notion that the social-interactional features of parental language input are the foundation of infants' language skills, even in an environment where infants spend much of their waking hours in childcare settings, as they do in Slovenia.