Child Care Providers Research Articles

CROSS-NATIONAL DIFFERENCES IN ATTITUDES TOWARD FAMILY AND GOVERNMENTAL SUPPORT FOR ELDER AND CHILD CARE

Abstract Population aging in wealthy western nations has raised concerns about who will provide care to older adults. At the same time, the rise of single parenthood and dual-career families has heightened the need for childcare. As governments and families face challenges in meeting these dual needs, this study compares responses to the question of “who should primarily provide” eldercare and childcare across three countries: the US, Germany and Israel. Analysis of 2012 International Social Survey Programme data reveals that while persons in the US endorse family as care providers to both older adults and children, Israelis endorse government as eldercare providers yet family as the source of childcare provision. German respondents prefer both government and family as childcare providers, yet believe the government should provide eldercare. The paper discusses how cross-national differences in attitudes toward care are associated with cultural and socio-economic characteristics, and highlights implications for policy and practice.

Improving Inclusion for Children With Special Health Care Needs in Childcare Settings: Results From a Statewide Survey of Childcare Professionals

Familiesof children with special health care needs (CSHCN) routinely struggle to find suitable childcare. These families value childcare capable of supporting their child's needs, known as inclusive care, that requires trustworthy staff trained to safely care for CSHCN. This study aimed to understand the training, experience, confidence, and perceived barriers to providing inclusive care for CSHCN from the perspective of childcare providers and directors. Childcare providers (n=263) and directors (n=418) responded to a statewide survey in Wisconsin in 2019. Results show that both childcare providers and directors perceive that the providers lack confidence in providing inclusive care. Lack of staffing, training, and expertise of childcare providers were the most frequently reported barriers to provide inclusive care. These findings confirm the need for additional education, training, resources, and research to create and maintain more inclusive childcare settings for CSHCN.

Grandmothers and the gender gap in the Mexican labor market

This paper estimates the effect of childcare availability on parents’ employment probability using the timing of the grandmothers’ death – the primary childcare provider in Mexico – as identifying variation. I use a triple-difference to disentangle the effect of coinhabiting grandmothers’ deaths due to their impact on childcare from their effects due to alternative mechanisms. Through their impact on childcare availability, grandmothers’ deaths reduce mothers’ employment rate by 12 percentage points (27 percent) and do not affect fathers’ employment rate. The negative effect on mothers’ employment is smaller where public daycare is more available, or private daycare or schools are more affordable.

Does the early bird catch the worm? Evidence and interpretation on the long-term impact of school entry age in China

The long-term impact of children's age at primary school entry on educational attainment and labor market outcomes is one of the primary concerns to families, educators, and policymakers. Using a nationally representative survey of families and individuals, this paper is among the first to explore these effects in a causal sense in the Chinese context and understand the underlying mechanisms. We use a regression discontinuity (RD) design that employs the threshold date for primary school entry set by the 1986 Compulsory Education Law of China as a source of exogenous variation in the timing of school entry. We first document a salient and robust compliance rate of school entry requirement. RD estimates indicate that being born right after the cutoff date significantly increases years of schooling and annual earnings for non-agricultural jobs for the full sample. We also observe remarkable heterogeneous effects on labor market performance by gender. Being born right after the cutoff increases the probability of being in the labor force for men, but decreases that for women. We find that the decline in female labor force participation is mainly driven by women who come from economically and socially disadvantaged families. Further evidence suggests that this decline can be explained by supply-side factors including fertility decision and childcare provisions.

Trying to Reverse Demographic Decline: Pro-Natalist and Family Policies in Russia, Poland and Hungary

During the early 2000s governments in Russia, Poland and Hungary declared demographic crises and adopted pro-natalist programmes to increase fertility, as well as policies to support families with children. Our article compares their ‘flagship’ pro-natalist programmes: Russia’s Maternity Capital, Poland’s Family 500+, and Hungary’s enhanced earned income tax credit, all framed by governments’ neo-familialist discourses. We confirm these policies had limited impacts on fertility, finding that their most significant and disparate effects were instead on childhood poverty. Provision of preschool public childcare and parental leaves with levels of mothers’ employment across the cases were compared. We find no relationship between coverage of childcare institutions and employment rates of mothers with young children. Data show a weak relationship between length and compensation for parental leaves and maternal employment. We conclude that post-communist governments’ flagship pro-natalist incentives, family policies and traditionalist rhetoric have had limited effects in reversing demographic decline or in re-traditionalising contemporary women’s lives.

The Relationship between Childcare Services Participation and Parental Subjective Well-Being under China’s Three-Child Policy—Based on the Mediation Effect of Parenting Stress

This study examined the relationship between children’s participation in childcare services from birth to 3 years of age and their parents’ subjective well-being, as well as the mediating role of parenting stress. In total, 990 parents of children aged 0–3 years from Beijing were surveyed. First, independent samples t-tests after propensity score matching revealed that parents who participated in childcare services may have significantly higher overall subjective well-being and life satisfaction than those who did not participate. Second, a descriptive analysis and an analysis of variance results indicated that remote location, low quality, and high price may be the major reasons for parents’ dissatisfaction with childcare services, and a regression analysis of childcare dissatisfaction showed that high-priced childcare services had a significant negative relationship with parent’s subjective well-being. Third, the results of a mediation analysis of parenting stress revealed that childcare services have significant direct effects on parents’ subjective well-being, and a small mediating effect of parenting stress on parent’s childcare service participation and parental subjective well-being. The findings demonstrate the importance of childcare services, especially for the provision of affordable childcare to improve parents’ subjective well-being and relieving pressure on parents.

Experiences pertaining to child nutrition and care provision among early care and education stakeholders, sponsors, and center directors during the COVID-19 pandemic: A multi-method study.

This study used multiple methods (interviews, survey) to assess experiences of stakeholders, sponsors, and center-based early care and education (ECE) program directors pertaining to child nutrition (e.g., provision of nutritious foods, mealtime practices, CACFP administration/use) and the provision of child-care (i.e., day-to-day ECE operations and programming) during the COVID-19 pandemic. Participants included stakeholders from 22 national and state agencies associated with the Child and Adult Care Food Program (CACFP) who also work to promote nutrition and quality child-care, representatives of 17 CACFP sponsor organizations, and 40 center-based ECE program directors who participated in interviews, as well as 100 ECE directors who completed surveys. Data were collected across four states. Thematic analyses of interviews and descriptive methods were used to analyze data collected. Six main themes emerged from stakeholders, sponsors, and ECE program directors' focusing on: experiences during the temporary closure of several ECE programs; additional responsibilities and unanticipated expenses for ECE programs; difficulty in keeping up with constantly changing COVID-19 guidance; encounters during shifts from in-person to virtual training and monitoring; changes to nutrition practices at ECE; and the need to prioritize ECE funding. Findings highlight challenges and supports to ECE programs and could inform future efforts to enhance child-care quality and child nutrition in the U.S. during pandemic situations.

Staff perception of the implementation, enablers and barriers to pediatric intensive care unit diary writing: A qualitative study

ObjectivesTo explore how the multi-professional pediatric intensive care unit staff experienced the implementation of the diary. Research Methodology/DesignQualitative study using the implementation research approach.Setting: a six-bed pediatric intensive care unit at a large Italian tertiary care pediatric hospital, treating patients with acute conditions from the Emergency Department or hospital wards. Main outcome measuresHealthcare providers’ experiences of the implementation of the diaries. Data was collected by focus groups and interviews and thematic analysis was performed. FindingsThree focus groups and four interviews with staff were conducted after the implementation of thediaries from August 2020 to June 2021. Staff describe an initial disbelief towards the effectiveness of diaries followed by an increasing perception of their relevance for parents’ emotional expression through shared narration. Diaries are reported as a beneficial communication tool between the family, the child, and health care providers, increasing staff understanding of parents’ experiences of their child’s admission and parents’ sense of the care received by their child. For staff, barriers for diary writing were logistics, lack of time, limited sense of ownership, fear of legal retaliation and fear of emotional labor. ConclusionHealth care providers perceived diaries as beneficial for parents and the healthcare team, potentially supporting their partnership as recommended by Family Centered Care models. The enablers and barriers that emerged for diary writing can support the development of implementation strategies to prevent the reported challenges to diary writing in the healthcare team, enhancing their uptake in the pediatric intensive care unit setting.

The effect of “pediatric peripheral intravenous access (PPIVA) pathway” on the success of vascular access in children

PurposeDetermine the affects of the developed “Pediatric Peripheral Intravenous Access (PPIVA) Pathway” on the success of the vascular access in children. Design and methodsA quantitative approach was used using a quasi-experimental single-group post-test design involved pediatric patients. The patients who were first attempted for peripheral vascular access were subjected to the procedure in accordance with the “PPIVA Pathway”. The data was collected via a form on which we recorded down the patients' characteristics alongside their procedural data, as well as the Difficult Intravenous Access (DIVA) Score. For statistical analysis, the R vers. 2.15.3 program was utilized. ResultsThe patients who applied to the pediatric observation clinic had a mean age of 8.14 ± 5.01 years. The DIVA total mean score of the patients was 1.73 ± 1.79. 89.1% (n = 163) of pediatric peripheral intravenous procedures were successfully completed on the first access. The logistic regression analysis model was found to be statistically significant to identify the factors that affect pediatric peripheral intravenous success on the first attempt (χ2 = 24.701; p < 0.001). A one-point increase in the DIVA score was found to reduce the likelihood of success on the first attempt by 56.1% [OR (95% CI) = 0.439 (0.280, 0.686), p < 0.001]. ConclusionsUsing an algorithm to perform a peripheral intravenous intervention in children increases the likelihood of success on the first attempt. Practice implicationsUsing PPIVA Pathway shall improve the provision of atraumatic care for children, as the success rate of pediatric peripheral intravenous access on the first attempt is high.

Preventive Oral Health in Pediatric Primary Care

Oral health is an integral part of every child's overall wellness and affects their development, family, and social life, as well as school performance; it should be addressed at every well-child visit. Tooth decay continues to be the most prevalent yet preventable chronic disease of childhood; it leads to unnecessary pain, infections, poor academic performance, and frequent school absences and adds an unnecessary financial burden to the health care system. Despite improvements in oral health, disparities continue to exist for children from minority backgrounds and lower socioeconomic status. As primary care providers for children, it is important to understand factors that lead to oral disease and be able to anticipate, treat, and, most important, prevent oral disease in children early in their development. [Pediatr Ann. 2022;51(12):e474-e479.].

Patient journey mapping to investigate quality and cultural safety in burn care for Aboriginal and Torres Strait Islander children and families – development, application and implications

BackgroundQuality and safety in Australian healthcare is inequitably distributed, highlighted by gaps in the provision of quality care for Aboriginal and Torres Strait Islander children. Burns have potential for long-term adverse outcomes, and quality care, including culturally safe care, is critical to recovery. This study aimed to develop and apply an Aboriginal Patient Journey Mapping (APJM) tool to investigate the quality of healthcare systems for burn care with Aboriginal and Torres Strait Islander children.Study designInterface research methodology, using biomedical and cultural evidence, informed the modification of an existing APJM tool. The tool was then applied to the journey of one family accessing a paediatric tertiary burn care site. Data were collected through yarning with the family, case note review and clinician interviews. Data were analysed using Emden’s core story and thematic analysis methods. Reflexivity informed consideration of the implications of the APJM tool, including its effectiveness and efficiency in eliciting information about quality and cultural safety.ResultsThrough application of a modified APJM tool, gaps in quality care for Aboriginal and Torres Strait Islander children and families were identified at the individual, service and system levels. Engagement in innovative methodology incorporating more than biomedical standards of care, uncovered critical information about the experiences of culturally safe care in complex patient journeys.ConclusionBased on our application of the tool, APJM can identify and evaluate specific aspects of culturally safe care as experienced by Aboriginal and Torres Strait Islander peoples and be used for quality improvement.

Children, COVID, and confusion: How frontline workers cope with the challenges of vaccine mandates

AbstractWith the emergence of COVID‐19, many governments around the world co‐oped non‐health actors into enforcing comprehensive mandatory vaccination policies. Implementing these policies can be challenging, creating irreconcilable goals and problems with knowledge and understanding of areas outside the implementers’ direct field of expertise or scope of work. We know very little about how such frontline workers cope with these challenges associated with implementing policies whose goals lie well outside their remit (which we describe as generating exogenous policy pressures), and what this means for the operation of the policies. This article uses policies in place prior to the pandemic to fill this gap. It examines attitudes and experiences of frontline childcare educators who implement Australia's No Jab, No Play childhood vaccine mandate policies within the states of New South Wales, Queensland, and Victoria. Through qualitative analysis of interview and focus group data, we find that these frontline workers cope with moral conflict, confusion, and a lack of knowledge by moving against clients: they rigidly follow the rules beyond legislative requirements, and sometimes break them, generating a new coping category we call ‘rigid rule breaking’. However, their need to employ coping strategies is informed by the extent to which government has designed the policy to coerce the behaviour of the providers, families, or both. The implementation of more coercive variants of No Jab, No Play policies deviates more from what legislators intended, while providers given scope to make their own decisions about enrolling unvaccinated children report satisfaction in their decision‐making.Points for practitioners Australian state mandatory vaccination policies generally require childcare providers to exclude unvaccinated children. Street level bureaucrats face pressures when implementing coercive policies exogenous to their remit. They may simplify policy implementation in ways that counter governments’ goals. Actors given more discretion about passing on coercion to policy targets demonstrate better understanding and ownership of policies.

Regional experience in the treatment of children with short bowel syndrome

Short bowel syndrome is a rare, chronic, debilitating, and potentially life-threatening condition in which loss of intestinal absorption capacity deprives children of the ability to absorb sufficient nutrients from the food they consumed. The authors describe regional experience of treating children with short bowel syndrome, which includes conservative and surgical approach, with an analysis of the leading causes, prognostic factors, timing of achieving intestinal autonomy, complications and catamnesis.Purpose. The study aims at analyzing cases of short bowel syndrome in children in order to improve the provision of medical care for children in the Republic of Tatarstan and the nearest regions.Material and methods. Single-center, retrospective study was conducted of 22 cases of children with short bowel syndrome who received treatment in the surgical department for young children in the State Autonomous Healthcare Institution Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan for the period September 2014 till November 2021.Results. The most common cause of intestinal resection in the study group were: congenital malformations in 7 children (32%), necrotizing enterocolitis in 5 children (23%), small intestine malrotation (Ladd’s bands) in 4 children (18%), mesenteric thrombosis in 4 (18%), Hirschsprung’s disease in 2 children (9%). By the end of the first year after diagnosis, intestine self-regulation was achieved in 17 children. The mortality rate was 9%.

Health, education, and social care provision after diagnosis of childhood visual disability

AbstractAimTo investigate the health, education, and social care provision for children newly diagnosed with visual disability.MethodThis was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vision. Data collection was performed by managing clinicians up to 1‐year follow‐up, and included health and developmental needs, and health, education, and social care provision.ResultsBCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two‐thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2 p &lt; 0.001), or had an EHCP (11% vs 7%, χ2 p &lt; 0.01).InterpretationFamilies need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.What this paper adds One year after visual disability diagnosis, one in three children had not received the recommended care from a multidisciplinary team. Two‐thirds had not yet received the recommended Education, Health, and Care Plan. There is an under‐provision of recommended care, despite significant and complex need.

Spatial aspects of the supply-demand gap and its change in childcare services in Naha City, Japan.

Given the recent increase in the number of working mothers, Japanese cities face a shortage of childcare services. In response to this problem, Japan's central government has attempted to expand childcare facilities by implementing a comprehensive support system for children and child-rearing. However, a geographical approach is needed to evaluate the impact of the new system from the viewpoint of territorial justice in order to reconcile efficiency and equity in public service provision. Therefore, this study examines the spatial aspects of the supply-demand gap in childcare services following the implementation of the new system. The area studied was Naha City in Okinawa Prefecture, where the number of children awaiting enrollment in licensed childcare centers is exceptionally large. Since 2015, the city authorities have provided financial assistance to transform unlicensed childcare facilities into licensed ones to increase the provision of childcare services. As a result, the number of children awaiting enrollment in licensed childcare centers has reduced. Nevertheless, a spatial analysis of the supply-demand gap in childcare services using a geographic information system proves that a regional imbalance in childcare provision still exists in Naha City.

Athree-country comparison of mental health and treatment options of children and adolescents with mental health problems in times after the COVID-19 pandemic

The Austrian Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (ÖGKJP) is publishing aseries of articles in aspecial issue of Neuropsychiatrie dealing with the current provision of care in child and adolescent psychiatry. Aim of this article is to give an overview of provision of care for children and adolescents with mental health problems in Austria, Germany, and Switzerland and then draw conclusions for the Austrian child and adolescent psychiatric care landscape. First, epidemiologic data as well as different traditions and treatment philosophies and their effect for provision of care in child and adolescent psychiatry in Austria, Germany and Switzerland are presented. Subsequently, data of provided child and adolescent psychiatric care in Austria and Germany are presented and related to each other. On the basis of the data presented, the current deterioration of mental health in children and adolescents due to the pandemic as well as the deficit of available inpatient beds (0.03-0.09) there is an urgent need for action in Austrian provision of child and adolescent psychiatric care. An improvement of the structural deficits in the child and adolescent psychiatric research and care landscape, asignificant increase of capacities for inpatient treatment, day-care as well as outpatient treatment with establishment of modern treatment options such as home treatment is necessary.

Assessing Generalization During Professional Development in Child Care: A Pilot Randomized Controlled Trial.

Early childhood care and education providers provide instruction to diverse learners, including children with developmental delays, but often lack training in the use of evidence-based instructional strategies to support children's meaningful learning engagement. This preliminary study examined effects of the Early Achievements for Child Care Providers professional development program with and without generalization training on center-based child care providers (N = 12). Outcomes assessed included providers' implementation fidelity, knowledge, and self-efficacy as well as children's (N = 43) social-communication skills and engagement in shared book reading. Results demonstrated that providers trained in a generalization context made larger gains in implementation fidelity in a generalization context; no other significant between-group differences were found for providers. Children in both groups made comparable, significant gains. Findings suggest that explicit generalization training is needed for providers to achieve fidelity when transferring newly learned evidence-based practices to additional classroom instructional contexts, but a brief interval of implementation likely is insufficient to differentially benefit child outcomes. Researchers should elicit providers' perceptions when designing professional development programs to maximize feasibility of investing additional time and resources for generalization training.

Determinants and barriers to junior faculty well-being at a large quaternary academic medical center: A qualitative survey

BackgroundIncreasing levels of burnout among trainees and faculty members at all levels is a major problem in academic medicine. Junior faculty members may be at unique risk for burnout and have unique needs and barriers that contribute to attrition, job satisfaction, and overall workplace well-being. MethodsTwenty-seven faculty members at the assistant professor level at a large, quaternary referral academic medical institution were interviewed. A qualitative analyst with no reporting relationship to faculty was used as the proctor. Seven scripted questions targeting faculty well-being and institutional barriers to well-being were administered, and the responses were coded for common themes between respondents. ResultsRespondents most commonly identified clinical work (26%), research (19%), and teaching (19%) as the best aspects of their job. Among respondents, 3% stated they were not able to devote as much time as they would like to work they enjoyed and found most meaningful. Of these respondents, 44% cited “insufficient help” as the root cause. Also, 33% stated time spent writing and managing institutional review board requirements was a major contributor, and 22% cited both clinical volume/performance benchmarks and administrative responsibilities as significant barriers. The most common responses to departmental factors that can be improved included moving meetings to during the workday versus after hours, establishing a similar value system/metric for all faculty, and providing more opportunities to interact with faculty across divisions. The most common barriers to change identified were difficulty hiring research support, patient volume and clinical demands, and a pervasive culture of continuing to work after the workday has ended. At an institutional level, provision of childcare and promotion of basic science research were identified as areas for improvement. More actionable items were identified at the departmental rather than institutional level (53 vs 34). ConclusionsJunior faculty well-being is most affected at the department level. Qualitative data collection from junior faculty regarding barriers to well-being and academic/clinical productivity can be invaluable for departments and institutions seeking to make cultural or systemic improvements.

The Role of Maternal Grandmothers' Childcare Provision for Korean Working Adult Daughters.

Despite the Korean government's investment in childcare facilities for dual-earner households, maternal grandmothers are increasingly taking on the responsibility of caring for their grandchildren. This trend is examined in the current research. While many studies have been conducted on grandparents' experiences providing childcare for their grandchildren, significantly less research has been conducted on adult daughters' experiences with their mothers' childcare provision. This study utilized the concepts of intergenerational solidarity and a life-course approach to understand the experiences of 24 working adult daughters in Korea (ages 30-43) whose mothers provide childcare. Three major themes were identified following a grounded theory approach: gratitude vs. guilt, dependence vs. independence, and closeness vs. disagreement. The results indicated that adult daughters were found to have ambivalence toward their mothers, reflecting the lack of alternative options for childcare. The results from this study suggest that not only improving the quality of public childcare services, but also diversifying services to reflect the needs of dual-income families.

Correction to: Multiple Determinants of Interaction Quality among Childcare Providers

Correction to: Multiple Determinants of Interaction Quality among Childcare Providers