Child care health consultation: A statewide collaboration to improve the health of Arizona's children

Child care providers are entrusted with young children for hours every day. While providing early education services, they must also keep children safe and protected from injuries and potentially serious infectious diseases. These providers are tasked to work with parents to promote good social, emotional and physical health for children, all generally without the benefit of medical expertise. Research has shown that child care providers who have access to a child care health consultant (CCHC), an expert health professional with training in child health issues, have improved health and safety outcomes for the children in their care. In Arizona, a collaboration of community partners has come together to try and reach the ultimate goal of providing a child care health consultant to every child care provider in the state. Working closely with the statewide child care quality improvement and ratings program, partners planned and began implementation of a statewide program that now has funding for approximately 46 child care health consultants located throughout the state. The collaboration partners met with a number of barriers to implementation along the way, including difficulty in recruiting CCHC's in rural regions and establishing a consistent mechanism to collect outcomes data. Though only in its first year of implementation early data suggest significant improvements in health and safety indicators in participating child care facilities, particularly related to personal hygiene and communicable and infectious diseases. Other public health professionals interested in establishing a child care health consultation program could utilize lessons learned from the Arizona program to avoid many of the barriers that slowed program implementation. Ultimately the involvement of a broad base of partners created unique barriers to implementation, but also increased visibility and support for a sustainable statewide program.