Center-Based Childcare Access to Health Screenings and Developmental Assessments in U.S. Children from Birth to Five.

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.