Use Of Child Care Research Articles

Preschooler screen time and temperamental anger/frustration during the COVID-19 pandemic.

In the context of increased media use and family distress during the pandemic, we examine whether preschooler screen time at age 3.5 contributes to later expressions of anger/frustration at 4.5, while also considering the inverse association. Data are from a cohort of 315 Canadian preschool-aged children during the COVID-19 pandemic. Parent-reported measures included child h/day of screen time and child temperamental anger/frustration, both measured at 3.5 and 4.5 years of age. Indicators of family distress include use of childcare and child sleep, family income, parenting stress, and parent education, marital and employment status. We also consider child sex as a control variable. A crossed-lagged panel model revealed continuity in screen time between the ages of 3.5 and 4.5 (ß = 0.68) and temperamental anger/frustration from 3.5 to 4.5 (ß = 0.60). Child screen time at age 3.5 predicted increased proneness to anger/frustration at age 4.5 (ß = 0.14). Anger/frustration at age 3.5 did not predict screen time at age 4.5. Our results suggest that preschooler screen time during the pandemic may have undermined the ability to regulate negative emotions, a key component of social and academic competence. Supporting parents in implementing healthy media habits post pandemic may benefit young children's development. Key message: this study observes prospective bidirectional associations between preschoolers screen time and temperamental displays of anger or frustration during the COVID-19 pandemic. What does it add: we provide evidence that preschool screen time at age 3.5 prospectively contributes to the tendency to react in anger/frustration at age 4.5. In contrast, greater proneness to anger/frustration did not predict later exposure to screen time. What is the impact: health practitioners should enquire about media use habits during well-child visits to foster children's healthy development during the preschool years.

Regional Differences in Chinese Female Demand for Childcare Services of 0-3 Years: The Moderating and Mediating Effects of Family Childcare Context.

There are multiple reasons to consider the use of formal childcare: parental employment, child development, fertility choices, elderly health, generational relations, etc. This study explores the relationship between regional differences (urban/rural; eastern/central/western) and demand for childcare services (quantity, price, quality) from birth to three years of age, moderated and mediated by the family childcare contexts among Chinese women. Altogether, 1770 mothers of children aged 0-3 were selected from a national survey and analyzed. There are three major findings: (1) Urban mothers show a willingness to spend on the higher monetary cost of center-based childcare compared to rural mothers, as a result of more severe work-child conflicts faced by urban women. Urban-rural gaps in individual and household income also contribute to the differences in affordability. (2) Mothers in eastern China have a more substantial need to place their infants or toddlers in nurseries before the age of three than their counterparts in central and western China, primarily due to a lack of grandparental and paternal childcare support and an expectation of higher quality programs. (3) There is no significant regional disparity in terms of care-related or education-related quality preferences. The paper proposes regional prioritized strategies and targeted services to address the "3A" problems of childcare provision.

A Report on the Management and Use of After-school Childcare in Hilly and Mountainous Areas

In this report, we studied the management and use of after-school childcare （ASC） in hilly and mountainous areas （HMA）. The case areas of this research were depopulated towns and villages in Gunma Prefecture, particularly Nanmoku Village and Kanna Town, where depopulation is increasing rapidly. The results were as follows : 1）ASC was necessary not only in urban areas but also in HMA because many children return from school to an empty home in HMA. In particular, in areas that had fewer parks due to their steep hillsides and the long distance between the houses where children lived ; places providing ASC are highly valued as children can to go outdoors, interact, and play together. However, the towns and villages where childcare is not free and the ASC only allows registration for children whose parents are not at home when school hours end ; therefore, not all children enjoy the functions of ASC in HMA. In those areas, children use other institutions, including systems, such as after-school child classes. 2）In some towns and villages, regardless of their status with respect to depopulation, there was no fee for ASC to support families raise children. On the other hand, moderate to high fees in Gunma Prefecture would be needed for the use of ASC in towns and villages that were designated as depopulated areas. 3）In Nanmoku Village and Kanna Town, almost every child was registered with ASC. The reasons for this were the free provision of ASC for all children as there were fewer elementary school children than the capacity for ASC, and there are few parks in these areas, particularly in Nanmoku Village.

The educational gradient in formal childcare use – the role of employment opportunities and (in)formal childcare availability

ABSTRACT This paper investigates three potential mechanisms of educational differentials in formal childcare uptake in Belgium, a country characterised by high availability, but also pronounced gradients in childcare uptake. We investigate whether and to what extent educational differentials can be accounted for by (i) differences in employment opportunities of mothers with different educational backgrounds, (ii) variation in local childcare availability which may entail different access, or (iii) differential availability of grandparents as an alternative source of affordable and flexible care. We use data from the 2011 Belgian census, which provides us with information on the socio-demographic characteristics of the entire population legally residing in Belgium. The census was linked to tax register data which gives insight into the uptake of formal childcare as childcare expenses are tax-deductible, as well as municipality-level data on childcare availability. Using logistic regression analysis, we investigate the uptake of formal childcare among two-parent families with one child younger than 2.5 years old. Results indicate that educational gradients are mainly due to differences in employment opportunities rather than differential availability of formal childcare at the local level or informal childcare availability.

The association between non-parental childcare intensity and parental mental health across Europe.

Young children are spending an increasing amount of time in non-parental childcare. Despite this trend, few studies have examined how the intensity of non-parental childcare associates with mental health in parents, particularly taking the institutional context concerning childcare into account. Data from the European Union Statistics on Income and Living Conditions EU-SILC (2013) were used to develop a multi-level linear regression model. The sample was restricted to parents in dual-earner couples and with at least one child below the age of three (N=6709). Mental health was assessed using the Mental Health Inventory-5. Highest levels of mental health were found in parents who use a moderate level of non-parental childcare, while full-time childcare was associated with lower levels of mental health. Working parents reported better mental health in countries where spending on formal childcare was higher, or where using formal childcare use was more widespread for this age group. While this study does not allow to establish a causal relationship between the researched indicators, it does indicate that mental-health problems are not randomly distributed among parents but tend to cluster more densely within parents who use higher intensities of childcare and in countries with less supportive childcare policies. Research that ignores social contexts might therefore be limited in terms of generalisation.

How Is Instability in Child-Care Subsidy Use Associated with Instability in Child-Care Arrangements?

How Is Instability in Child-Care Subsidy Use Associated with Instability in Child-Care Arrangements?

Childcare and maternal employment: Evidence from Vietnam

Little literature currently exists on the effects of childcare use on maternal labor market outcomes in a developing country context, and the few recent studies offer mixed results. We attempt to fill these gaps by analyzing several latest rounds of the Vietnam Household Living Standards Survey spanning the early to mid-2010s. Addressing endogeneity issues with an instrumental variable/ regression discontinuity design estimator based on children’s birth months, we find sizable and positive effects of childcare on women’s own labor market outcomes and their household income and poverty status. The effects of childcare differ by women’s characteristics and are stronger for women in the ethnic majority group or women with daughters. These effects are also somewhat larger for areas with higher income levels. Furthermore, we also find that some positive effects last after two years.

Racial/Ethnic Disparity Trends in Children's Mental Health Care Access and Expenditures From 2010-2017: Disparities Remain Despite Sweeping Policy Reform.

To examine trends in mental health care use for Black and Latinx children and adolescents. Data from the Medical Expenditure Panel Survey for 2010-2017 were analyzed to assess trends among youth ages 5-17 in use and expenditures for any mental health care, outpatient mental health care, and psychotropic medication prescription fills. Unadjusted trends for all youth and the subpopulation of youth reporting need for mental health care and disparities adjusting for need were examined. Between 2010 and 2017, Black youth rates of any past year mental health care use decreased (from 9% to 8%), while White (from 13% to 15%) and Latinx (from 6% to 8%) youth rates increased. Among the subpopulation with need and in regression analysis adjusting for need, we identified significant Black-White and Latinx-White disparities in any mental health care use and any outpatient mental health care use in 2010-2011 and 2016-2017, with significant worsening of Black-White disparities over time. White youth were more than twice as likely as Latinx youth to use psychotropic medications, and Latinx-White and Black-White disparities in psychotropic medication prescription fills persisted over time. Black-White disparities existed in overall mental health expenditures (2016-2017) and outpatient mental health expenditures (2010-2011 and 2016-2017). Affordable, ubiquitous access to mental health care for Black and Latinx youth remains an elusive target. Significant disparities exist in receiving mental health care despite reforms and policies designed to increase mental health care access in the general population. Additional outreach and treatment strategies tailored to the cultural, linguistic, and structural needs of youth of color are required.

Maternal Employment and Childcare Responsibilities: Challenges and Coping Strategies of Working Mothers in Sekondi-Takoradi Metropolis, Western Region of Ghana

Women's engagement in the workforce has risen significantly and has been accompanied by greater challenges in balancing roles between paid work and childcare. This article identified the challenges confronting working mothers with children aged 0-3 years and examined how working mothers managed the challenges they encountered in the care of their children in Sekondi-Takoradi Metropolis. A cross-sectional descriptive survey research approach was adopted. A sample of (N = 150) working mothers comprising teachers, nurses, bankers, traders, hairdressers and seamstresses were conveniently sampled from four Reproductive and Child Health Centers to complete questionnaires. Findings revealed that challenges of working mothers were time constraints, safety and security of their children at care center, mother child relationship affected due to less time spent with children and increased financial cost as a result of using alternative childcare. The areas of childcare most affected by mothers work were eating routines and time of introducing weaning foods whereas areas the least affected by mothers’ work were breastfeeding and inculcating family values in kids. To cope with the challenges of maternal employment, working mothers worked shifts, alternated work hours, enjoyed maternity leave and used alternative childcare. Challenges and constraints of working mothers influenced their decision on the use of alternative childcare and invariably determined the coping strategies adopted. An effective child care arrangement for working mothers should be institutionalized and there should be an extension of the three month maternity leave to six months to help minimize the challenges working mothers encounter.

Understanding the immigrant-native gap in childcare use: An empirical exploration for 21 European countries

In this contribution, we examine whether and why there is a gap in the use of formal childcare services between immigrant and native families across 21 European countries. We focus on three sets of potential determinants: (1) social class, education and labour market position; (2) immigrant-specific factors such as norms in the region of origin, citizenship acquisition and length of stay in the country of residence; and (3) contextual factors such structural constraints impeding access to childcare and traditional norms on motherhood in the region of origin. Drawing on data from the 2010 ad hoc module of the EU Labour Force Survey, we find evidence for an immigrant-native gap in formal childcare use. Adjusted for social class position, education and maternal employment, immigrant families are less likely to use childcare compared to native families across European countries. However, there are important cross-country differences in the size of this gap. The study also provides evidence for immigrant-specific explanations: acquiring citizenship and staying longer in the country of residence increases the probability to use childcare, while the strength of traditional norms in the region of origin reduces the probability to use childcare. Finally, we find that structural barriers to childcare use negatively affect childcare use for both native and immigrant families. Removing barriers to childcare use in terms of availability and affordability will benefit everyone.

Pravo oca na roditeljski i očinski dopust u zemljama EU

Equality between men and women in the exercise of rights is one of the fundamental principles of the European Union, which is enshrined in the acts of primary legislation and in secondary legislation. However, the directive did not ensure full equality of fathers and mothers with regard to reconciling professional and family obligations, which was the reason for the adoption of the new Directive 2019/1158, which contains provisions aimed at striking a balance between work and family obligations, and which was adopted on 20 June 2019. This Directive repeals Council Directive 2010/18/ EU, that is, Member States have a period of time to comply with the new Directive within three years of its entry into force. In addition to the importance of involving the father in childcare at a young age, the paper also points to EU legal acts that regulate the reconciliation of fathers’ professional and family responsibilities. In addition, an overview of available data on the use of childcare leave by fathers is provided. The paper pays particular attention to existing solutions at EU level for the use of parental and paternity leave, comparing them to those contained in the new Directive 2019/1158.

Production System Evaluation Method Considering Worker Taking Childcare

It is becoming increasingly important for companies to accommodate childcare leave to support childbirth and childcare activities. It is important for them to raise the utilization rate of the maternity and childcare leave mechanisms. On the premise of the use of maternity and childcare leave, production planning and management are realizing that childbirth and childcare are important. We first analyzed female workers’ current situation in the manufacturing industry. Next, we proposed the production system simulation model while considering the production system in relation to maternity and childcare leave, and implemented the simulation while considering this premise. In addition, we proposed the cost evaluation method. To confirm the effectiveness of the proposed method, we carried out a case study that targeted an automobile parts production line.

Narcotic use and pain control after cesarean section

Opioid use and dependence have markedly increased in recent years which has led to an opioid epidemic. Various factors that have contributed to this crisis, one being the over prescription of opioid medication to post-surgery patients. In the United States cesarean section deliveries accounted for 31.8% of all births in 2020. Therefore, it is necessary to evaluate pain control and narcotic use in the postpartum period. Most studies on postpartum pain control focus primarily on the immediate inpatient postoperative period. This study investigates pain control and Percocet use in the 3-day post-discharge period of women who underwent Cesarean delivery at The Brooklyn Hospital Center (TBHC) from January to June 2021. This study evaluated 100 women; the data shows that patients took on average 4 out of 36 Percocet pills; only 11% of the total prescribed dose. Additional factors were taken into consideration including pain scale up to 3 days post-discharge, pain management alternatives, home childcare, family size, and prior opioid use. This study concludes that post cesarean delivery patients were overprescribed narcotics upon discharge from the hospital. Considerations should be made for smaller doses, spaced-out hourly doses, and shorter interval of days. Patients should be advised that if additional pain medication is required to contact their provider and be educated on the importance of properly disposing unused opioid medications.

The effectiveness of fiscal stimuli for working parents

Child care subsidies and in-work benefits are prominent policies used to promote the labor participation of parents. We study these policies in a structural model of labor supply and child care use for couples in the Netherlands. Major reforms in family policies benefit the identification. We use differences-in-differences to assess the reliability of the model predictions. In-work benefits for secondary earners that increase with income are shown to be the most cost-effective tool for stimulating parental labor supply. Child care subsidies are less effective, as substitution of informal for formal care drives up public expenditures. We also relate our findings to related policies in the UK and US.

The Impact of Nurse Home Visiting on the Use, Dose and Quality of Formal Childcare: 3-Year Follow-Up of a Randomized Trial.

We investigated whether nurse home visiting (NHV) affects the uptake and quality of formal early childhood education and care (ECEC) at child ages 2 and 3 years, and reasons for using ECEC at 3 years. Design: Secondary analysis of the "right@home" randomized trial of NHV. 722 pregnant Australian, English-speaking women experiencing adversity recruited from antenatal clinics across 2 states. 25 nurse home visits to 2 years; Control: universal well-child nursing service. Parents reported formal ECEC use (government approved and subsidized), comprising long or family day care (LDC), and reasons for use. ECEC quality was classified using the Australian government's national ratings. Eighty-three percent of parents provided data at 2 years (306 intervention/290 control); and 69% at 3 years (255 intervention/240 control). Intention-to-treat analyses were conducted using adjusted regression models, addressing missing data using multiple imputation and inverse probability weighting. There was no evidence of group differences in ECEC uptake or quality, although control families may have used more LDC at 3 years (mean difference 2.8 hours, 95% confidence interval, -0.2 to 5.8 hours). Intervention parents reported using ECEC to support their children's social development more frequently than controls (48% vs 33%) but less for work/study (39% vs 46%). The right@home NHV program did not impact ECEC uptake or quality, although it may influence parents' reasons for using ECEC. If supported by policy and provision, there is an opportunity for NHV programs to promote the transition to high-quality ECEC and evaluate the synergistic benefit on children's development.

Use of Child Care Attenuates the Link Between Decreased Maternal Sleep and Increased Depressive Symptoms.

Sleep disruption is common among postpartum women and is linked with depression. Child care may alleviate parenting stress and protect new mothers against symptoms of depression. Mothers from the NURTURE study, a birth cohort of 666 women of full-term infants, completed questionnaires during home visits when their infants were 3, 6, 9, and 12 months old. The Edinburgh Postnatal Depression Scale and the Perceived Stress Scale were used to measure depressive symptoms and stress, respectively. Mothers reported total nightly sleep duration for themselves and their infants, child care arrangements, marital status, and income. We used mixed-effects models adjusting for income, marital status, and child age to examine the indirect effect of infants' sleep on maternal mental health through mothers' sleep and assessed whether patterns differed depending on child care. Decreased maternal sleep mediated the association between infant sleep and maternal mental health. When infants slept 1 hour less than usual, mothers slept 7 fewer minutes (B = 0.19, 95% confidence interval [CI], 0.01 to 0.27) and reported more depressive symptoms (B = -0.27, 95% CI, -0.43 to -0.11) and stress (B = -0.33, 95% CI -0.58 to -0.09). Child care moderated the indirect effect; decreased maternal sleep was not associated with increased depressive symptoms (and was not a mediator) when mothers had child care (indirect effect = -0.001, 95% CI, -0.03 to 0.03). Use of infant child care reduced the link between maternal sleep and depressive symptoms. Regular access to child care may be a method to mitigate feelings of depression for new mothers.

Non-parental Care Arrangements, Parenting Stress, and Demand for Infant-Toddler Care in China: Evidence From a National Survey.

This study examined the patterns and characteristics of non-parental child care arrangements for Chinese very young children before they enter preschool and the extent to which families’ utilization of non-parental child care influenced parenting stress. A total of 3,842 Chinese parents of infants and toddlers were selected from 10 provinces to participate in this study. The results indicated that (1) Chinese families relied heavily on grandparents to care for their children; (2) a set of family demographics predicted the utilization of non-parental child care arrangements, including parents’ educational level, household income, labor force participation, and maternal age; (3) there existed a clear parental preference for publicly funded, affordable, and high-quality child care services; and (4) families’ use of non-parental child care was generally not linked to parenting stress. These findings shed light on the development of the infant-toddler non-parental child care system in the Chinese sociocultural context.

Differences in Child Care Participation Between Immigrant and Nonimmigrant Families

This study used data from the Survey on Early Learning and Child Care Arrangements (SELCCA) and the Longitudinal Immigration Database (IMDB) to examine patterns of child care use among Canadian immigrant and nonimmigrant families. Overall, children from immigrant backgrounds were less likely to be in child care. When considering only those in child care, children from immigrant families were more likely to be in licensed care than those from nonimmigrant families. Parents of children with immigrant backgrounds indicated various reasons for not enrolling their child in child care. Ensuring access to child care may have a positive impact on immigrant families.

Migrant-native differentials in the uptake of (in)formal childcare in Belgium: The role of mothers’ employment opportunities and care availability

Objective: we explore migrant-native differentials in the uptake of formal and informal childcare and whether this is induced by lower demand for childcare versus differential access to (in)formal childcare compared to natives.
 Background: The rise in female labour market participation in recent decades has challenged parents to negotiate work and family responsibilities and organise childcare. Belgium is among the European countries with the highest availability of formal childcare, but maternal employment and uptake of childcare are substantially lower in migrant populations.
 Methods: Combining linked microdata from the 1991 and 2001 censuses with contextual data on childcare availability at the municipality level, we use multinomial logit models to study childcare use and type of childcare arrangement among parents having a young child in 2001. As access to childcare and maternal employment are mutually endogenous, we use estimated employment opportunities.
 Results: We find considerable migrant-native differentials in childcare use, as well as substantial differences between first and second generation migrants. Second generation mothers of Turkish, Moroccan and Eastern-European background are less likely than natives to use childcare, and more likely to rely on informal arrangements if childcare is used. Controlling for socio-demographic characteristics and differential availability of (in)formal childcare largely accounts for differences in childcare use, but Turkish and Moroccan women remain less likely to use care and first generation Turkish mothers remain more likely to use informal care as opposed to formal childcare.
 Conclusions: While differences in socio-demographic characteristics, labour market opportunities and availability of (in)formal care provide a partial explanation, partial migrant-native differentials in childcare use persist for specific groups, suggesting that other factors inhibit the uptake of formal childcare.

Preventive oral health care use for children with special health care needs aged 6 through 12 years enrolled in Medicaid: A mixed methods study

BackgroundThe authors aimed to assess preventive oral health care (POHC) use for children with special health care needs (CSHCN) aged 6 through 12 years enrolled in Medicaid and identify intervention strategies to improve oral health. MethodsIn this sequential mixed methods study, the authors analyzed 2012 Medicaid data for children aged 6 through 12 years in Washington state. They used eligibility and claims data to identify special health care needs status (independent variable) and POHC use (outcome variable). They ran modified Poisson regression models to generate prevalence rate ratios. They coded data from 21 key informant interviews deductively using content analytic techniques. ResultsOf the 208,648 children in the study, 18% were identified as CSHCN and 140,468 used POHC (67.3%). After adjusting for confounding variables, the authors found no difference in POHC use by special health care need status (prevalence rate ratio, 1.00; 95% CI, 0.99 to 1.01; P = .91). In the qualitative analysis, the authors identified 5 themes: caries risk depends on a child’s specific health condition, caries complicates overall health, having a special need creates a bigger barrier to care, legislation alone is “not going to make much of a dent,” and improvements across all fronts are needed to promote the oral health of CSHCN in Medicaid. ConclusionsCSHCN enrolled in Medicaid are just as likely as children without special health care needs to use POHC, although barriers to oral health care access persist for CSHCN. Practical ImplicationsFuture efforts should focus on comprehensive strategies that address the varying levels of dental disease risk and difficulties accessing oral health care within the diverse group of CSHCN.