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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
987
In the IPM centers the child care health consultant reviews the IPM baseline assessments and provides 7 monthly consultation visits to decrease the centers exposure to pesticides. Pre- and post- carpet dust samples and children's individual silicone wristbands are collected to identify changes in pesticide detection limits and concentrations at the child care center-level in both the IPM and PA centers pre- and post-intervention.
In the IPM centers, a research assistant completed the IPM Checklist which identifies the IPM practices that the center meets and doesn't meet. The child care health consultant reviews the IPM Checklist findings with the child care center director after the baseline Checklist is completed. The IPM Checklist is completed pre- and post-intervention in the IPM and PA centers. The post-intervention IPM Checklist findings are compared to the baseline IPM Checklist findings to identify changes in IPM practices in both the IPM and PA centers.
University of California, San Francisco
San Francisco, California, United States
Decrease in Child Care Center Pesticides
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.
Time frame: Pre-intervention, 9 months after the workshop
Decrease in Children's Exposure to Pesticides
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.
Time frame: Pre-intervention and 9 months later (post-intervention)
Increase in Integrated Pest Management (IPM) Practices
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.
Time frame: Pre-Intervention and 9 months later
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The IPM center directors and providers attend an IPM workshop and complete a survey to assess their knowledge of IPM practices pre- and post-workshop. The level of knowledge change is assessed by comparing the number of correct responses on the post-workshop survey compared to the pre-workshop survey.
Decrease in the Presence of Pests
The # of pests were observed as part of the IPM Checklist assessment in different places in the child care center: kitchen, outside garbage area, playground, landscape outdoor area, and classroom at the pre-intervention period and 9 months later. Pre- and post-intervention, the # of pests observed is a number on a scale of 0 to infinity. A positive outcome would be a negative change score showing be a decrease in the # of pests observed post-intervention compared to pre-intervention.
Time frame: Pre-intervention and 9 months later
Director's Self-Efficacy
The director's sense of self-efficacy provides information about their sense of control of their work environment and impact on the families and children that they serve. The intervention is designed to help the director's feel empowered (e.g., increase in self-efficacy) to make changes in their work environment and provide a healthy environment for children and families served in their center. The Self-Efficacy survey was modified from a standardized measure by Bandura, A (1977) to fit the intervention and child care center's environments. There are 8 items with responses rated on a likert scale from 1 to 4 as strongly disagree (1) to strongly agree (4). Mean self-efficacy scores were calculated for each director. The minimum and maximum mean scores were 2.8 to 4.0. Higher mean score shows higher self-efficacy.
Time frame: 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
The presence of IPM policies was reviewed as (1 for "Yes") and (0 for "No") no both pre- and post-intervention in the IPM centers. Licensed child care centers are required to have written policies, but a specific policy on IPM is not required. Policies provide best practices for the child care administrators, providers and parents to follow when working or spending time in the center.
Time frame: 9 months