Reducing Pesticide Exposures to Preschool-age Children in California Child Care Centers
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 987
- 试验地点
- 1
- 主要终点
- Decrease in Child Care Center Pesticides
研究概览
简要总结
A randomized control study was conducted to reduce the exposure to pesticides in child care centers. A 7-month child care health consultant-led integrated pest management (IPM) intervention was conducted in 85 child care centers serving preschool-age children in five California counties. Changes in IPM knowledge, self-efficacy, policies, IPM practices, pests, and pesticide exposure were assessed in the IPM centers and the control centers.
详细描述
The goal of the study was to reduce children's exposure to pesticides in child care centers to improve their long-term health. A randomized-control trial in five northern California counties compared changes in director's IPM knowledge and self-efficacy, written IPM policies, IPM practices, number of pests and concentration of pesticides between child care centers assigned to an IPM intervention versus an attention control intervention on physical activity. Eighty-five child care center directors working in centers serving preschool-age children were enrolled. The child care health consultant-led intervention included an educational workshop, materials and tools, and center-specific consultation over seven months. In addition, the study included novel methods of measuring pesticide concentrations in child care centers (dust) and individual children (silicone wristbands). The study aims were to determine if an IPM intervention (1) increases child care center's director's IPM knowledge and self-efficacy, (2) improves center's IPM practices and policies, (3) reduces the number of pests present, (5) reduces pesticide exposures in child care center environments in the intervention IPM child care centers compared to the control centers.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 3 Years 至 75 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •The centers must meet the following criteria:
- •Be a licensed child care center with a child care director who speaks English
- •Used pesticides (i.e., baits or sprays) in the last year
- •Operated for at least two years with no plans to close in the next 12 months
- •Enroll children between three to five years of age of diverse ethnic and racial backgrounds
- •Have at least 25% of enrolled children receiving a government subsidy (e.g., Child and Adult Care Food Program (CACFP), Head Start, Child Care Development Fund, Alternative Payment program).
- •Have a carpet or couch on-site.
- •The child care providers must meet the following criteria:
- •Work in the participating child care centers
- •Work in the classroom of the participating children
- •Work at least 30 hours a week
- •Plan to work at the center over the next 9 months
- •The families must have a preschool-age child enrolled in the participating child care center and meet the following criteria:
- •Three or four years of age
- •The child spends at least six hours per day in the center
- •Will be enrolled in the center for the next nine months
- •Has a parent present during enrollment who speaks either English or Spanish
- •Parents will complete surveys or interviews in English or Spanish in the Fall and Spring
排除标准
- •Centers that participated in an IPM intervention and training project
- •Families that have children who have special health care needs or disabilities who can not participate in physical activity at the child care center.
- •Center directors who do not read and write in English.
- •Child care providers who do not read and write in English.
研究组 & 干预措施
Integrated pest management
The intervention consists of an integrated pest management (IPM) educational workshop, providing IPM materials, and monthly consultation. The child care health consultants (CCHCs) conduct the educational workshop for child care center directors and providers on IPM practices including the providers' practices and beliefs. The workshop includes a slide presentation on pesticides and IPM practices and the directors receive an IPM Toolkit and IPM toolbox. After the workshop and baseline measures are completed, the CCHCs meet with center directors to review the results of the baseline observational Checklists and the directors identify center-specific intervention goals. Monthly child care health consultation visits are conducted with the director to review the center's progress towards the goals, discuss problems, and share resources.
干预措施: Changes in pesticide exposure (Behavioral)
Integrated pest management
The intervention consists of an integrated pest management (IPM) educational workshop, providing IPM materials, and monthly consultation. The child care health consultants (CCHCs) conduct the educational workshop for child care center directors and providers on IPM practices including the providers' practices and beliefs. The workshop includes a slide presentation on pesticides and IPM practices and the directors receive an IPM Toolkit and IPM toolbox. After the workshop and baseline measures are completed, the CCHCs meet with center directors to review the results of the baseline observational Checklists and the directors identify center-specific intervention goals. Monthly child care health consultation visits are conducted with the director to review the center's progress towards the goals, discuss problems, and share resources.
干预措施: IPM Practices (Behavioral)
Integrated pest management
The intervention consists of an integrated pest management (IPM) educational workshop, providing IPM materials, and monthly consultation. The child care health consultants (CCHCs) conduct the educational workshop for child care center directors and providers on IPM practices including the providers' practices and beliefs. The workshop includes a slide presentation on pesticides and IPM practices and the directors receive an IPM Toolkit and IPM toolbox. After the workshop and baseline measures are completed, the CCHCs meet with center directors to review the results of the baseline observational Checklists and the directors identify center-specific intervention goals. Monthly child care health consultation visits are conducted with the director to review the center's progress towards the goals, discuss problems, and share resources.
干预措施: Educational Workshops (Behavioral)
Physical activity
The attention control group is given an intervention covering physical activity (PA) for preschool-age children in child care centers. The PA intervention includes the same intensity as the IPM intervention provided by a child care health consultant (CCHC). The CCHC conducts a workshop on physical activity that includes a slide presentation and the directors receive a Physical Activity Toolkit and toolbox. After the workshop and baseline measures are completed, the CCHCs meet with center directors to review the results of the baseline observational Checklists and the directors identify center-specific intervention goals. Monthly child care health consultation visits are conducted with the director to review the center's progress towards the goals, discuss problems, and share resources.
干预措施: Changes in pesticide exposure (Behavioral)
Physical activity
The attention control group is given an intervention covering physical activity (PA) for preschool-age children in child care centers. The PA intervention includes the same intensity as the IPM intervention provided by a child care health consultant (CCHC). The CCHC conducts a workshop on physical activity that includes a slide presentation and the directors receive a Physical Activity Toolkit and toolbox. After the workshop and baseline measures are completed, the CCHCs meet with center directors to review the results of the baseline observational Checklists and the directors identify center-specific intervention goals. Monthly child care health consultation visits are conducted with the director to review the center's progress towards the goals, discuss problems, and share resources.
干预措施: IPM Practices (Behavioral)
结局指标
主要结局
Decrease in Child Care Center Pesticides
时间窗: Pre-intervention, 9 months after the workshop
Change in the levels of pesticide exposures collected in carpet dust samples in the child care centers from baseline to 9 months later. Pesticides are summarized as geometric mean concentration (ng/g) and then the log10 is applied to the data. Carpet dust samples were collected in each child care center at pre-intervention and post-intervention. A decrease in pesticide concentration from pre-intervention to post-intervention is represented as a negative value. A negative change score would be a positive finding with a decrease in pesticide concentration post-intervention.
Decrease in Children's Exposure to Pesticides
时间窗: Pre-intervention and 9 months later (post-intervention)
Change in the levels of pesticide exposures collected in personal silicone wristbands worn by 3 to 5 of the preschool-age children in each child care center. They wore the wristbands for \~30 hours pre-intervention/baseline and 9 months later. Pesticides are summarized as geometric mean concentration (ng/mL) and then log10 is applied to the data. A decrease in pesticide concentration from pre-intervention to post-intervention is represented as a negative value. A negative change score would be a positive finding with a decrease in pesticide concentration post-intervention.
Increase in Integrated Pest Management (IPM) Practices
时间窗: Pre-Intervention and 9 months later
The IPM practices were measured objectively with a standardized IPM Checklist during a 2-hour observational assessment at baseline/pre-intervention and then 9 months later using a standardized measure (Alkon etal, JPHC, 2016). The IPM practices observed included having garbage cans with liners and lids, using bait stations if there are pests, having window screens with no holes, no water leaks, and outside garbage bins on cement surfaces. Each item on the Checklist is marked as 1 (yes) or O (no). The mean ranged from 0 (no practices observed) to 1 (all of the items were observed). An increase in IPM practices would be positive change in the mean score post-intervention compared to pre-intervention.
次要结局
- Decrease in the Presence of Pests(Pre-intervention and 9 months later)
- Director's Self-Efficacy(The Self-Efficacy Survey is completed by the directors pre-intervention and after the intervention (7 to 9 months later).)
- Number of Child Care Centers With Written IPM Policies(9 months)