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Center-Based Childcare Access to Health Screenings and Developmental Assessments in U.S. Children from Birth to Five
1Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois Chicago, 1919 West Taylor Street, AHSB 329, Chicago, IL, 60612, USA. srizk@uic.edu.
Insights
Center-based childcare programs with staff mentorship and regulatory oversight increased referrals for child health screenings and developmental assessments. Hispanic children had lower referral odds, highlighting a need for equitable access.
Area of Science:
- Child Development
- Public Health
- Early Childhood Education
Background:
- Center-based childcare programs play a crucial role in early childhood development.
- Timely health screenings and developmental assessments are vital for identifying and addressing potential issues in young children.
- Disparities in access to these essential services can impact long-term child outcomes.
Purpose of the Study:
- To investigate factors influencing referral rates for health screenings and developmental assessments among children aged 0-5 in center-based childcare.
- To control for child race/ethnicity, provider characteristics, and program-specific factors in the analysis.
- To identify program elements that may promote or hinder referrals for essential child services.
Main Methods:
- Secondary analysis of the 2019 National Survey for Early Care and Education (NSECE) Center-based Provider survey data.
- Multivariate logistic regression models were employed to estimate referral odds.
- Adjustments were made for provider (e.g., language) and program factors (e.g., mentorship, regulatory visits, staff-to-child ratio).
Main Results:
- Programs with staff mentorship (OR=2.15) and regulatory oversight (OR=1.85) demonstrated significantly higher odds of making referrals.
- Hispanic children exhibited lower odds of referral (OR=0.99) compared to other racial groups, even after controlling for covariates.
- The study included 1,306 U.S. center-based childcare providers who did not offer onsite screenings or assessments.
Conclusions:
- Staff mentorship and regulatory oversight in childcare settings are positively associated with increased referrals for child health screenings and developmental assessments.
- These program components may enhance the timely provision of necessary services for young children and their families.
- Findings underscore potential ethnic disparities in referral access, warranting further investigation and targeted interventions.
Objective:
To examine the odds of children aged 0-5 in center-based childcare programs receiving referrals for health screenings and developmental assessments, controlling for children's races/ethnicities and provider and program factors.
Methods:
We conducted secondary analyses using the 2019 National Survey for Early Care and Education (NSECE) Center-based Provider survey. We used multivariate logistic regression models to estimate referral odds for health screenings and developmental assessments from centers without these services onsite. We adjusted for provider (e.g., language spoken when working with children) and program factors (e.g., staff mentorship, regulatory agency visits, and the teacher-to-child ratio).
Results:
The sample included U.S. center-based childcare providers (n = 1,306) whose programs did not offer onsite health screenings or developmental assessments. The findings suggest that programs providing staff mentorship (OR = 2.15, 95% CI [1.36-3.41], P =.001) and regulatory oversight (OR = 1.85, CI [1.13 = 3.02], P =.014) had greater odds of making referrals for children under 5 years old. After adjusting for various provider and program factors, Hispanic children had lesser odds of being referred compared to other racial groups (OR = 0.99, 95% CI [0.98-0.99], P =.030).
Conclusions:
Mentorship and regulatory oversight in center-based childcare programs were associated with greater odds of referral for health screenings and developmental assessments for children under five years old. Mentoring and regulatory oversight may facilitate the provision of timely referrals for screenings and assessments for children and their families in center-based childcare programs.
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