220691 Effect of child care health consultation on health policies, practices, and children's access to health care

Tuesday, November 9, 2010 : 8:45 AM - 9:00 AM

Jonathan B. Kotch, MD, MPH , Dept. of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Patricia Isbell, PhD , Dept. of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Eric Savage, MA , FPG Child Development Institute, UNC-Chapel Hill, Chapel Hill, NC
Elizabeth Gunn, BS , FPG Child Development Institute, UNC-Chapel Hill, Chapel Hill, NC
Pan Yi, MS , FPG Child Development Institute, UNC-Chapel Hill, Chapel Hill, NC
Viet Nguyen, MD, MPH , Department of Maternal and Child Health, UNC-Chapel Hill, Chapel Hill, NC
David Weber, MD, MPH , Division of Infectious Diseases, Bioinformatics, University of North Carolina at Chapel Hill, Chapel Hill, NC
Lydia Lu, MPH , Global AIDS Program, Centers for Disease Control, Atlanta, GA
As increasing numbers of young children are cared for in child care centers and family child care homes in the United States, concerns for health and safety of children in out-of-home care has grown. Child care health consultation, a relatively new child health profession, addresses these concerns by offering on-site consultation, training and technical assistance to child care facilities across the country. Fifteen (15) CCHCs in projects across North Carolina each collected data over a two year period. At baseline and four semi-annual follow-ups, the CCHCs assessed written child care health and safety policies and practices and abstracted children's health records in 264 child care facilities. Controlling for all the covariates and hierarchical error structure, we found consultation had significantly positive effects on health policies (RC=.015, p<.05), sanitation (RC=.017, p<.0001), safe play practice (RC=.015, p<.01), and emergency preparation (RC=.022, p<.0001). Also, consultation was effective in reducing the number of children who did not have medical home on file (RC= -.015, p<.05), number of children who did not have health insurance on file (RC= -.011, p<.0001), number of children who did not have well child physical (RC= -.014, p<.05), and number of children who did not have complete emergency contact on file (RC= -.014, p<.05). Child care health consultation can improve health policies and practices in out-of-home child care facilities as well as indicators of children's access to health care, but changes in illness and injury rates could not be demonstrated.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Protection of the public in relation to communicable diseases including prevention or control
Public health or related nursing
Public health or related public policy
Public health or related research

Learning Objectives:
1. Discuss the child care health consultant's role in promoting health and safety in child care. 2. Describe the impact of child care health consultants on child care care health and safety in a statewide study. 3. Identify the changes in health policies, health practices, and children's access to health care associated with child care health consultant services.

Keywords: Child Health, Child Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Public health faculty for over 30 years. Dr. Kotch is an expert on childcare issues including health and safety, child injury prevention and child abuse and neglect. He serves as the Director of the National Training Institute of Childcare Health Consultants, a organization dedicated to improving the quality of U.S. childcare
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4045.0: Healthy Child Care America