Rizk Sabrin, Barger Brian
Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois Chicago, 1919 West Taylor Street, AHSB 329, Chicago, IL, 60612, USA.
School of Public Health (Population Health Sciences), Mark Chaffin Ctr. for Healthy Development (Leadership in Disability), School of Public Health, Georgia State University, Atlanta, GA, USA.
Matern Child Health J. 2025 Jan;29(1):67-77. doi: 10.1007/s10995-024-04028-9. Epub 2025 Jan 28.
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.
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).
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).
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.
研究接受全日制儿童保育项目的0至5岁儿童接受健康筛查和发育评估转诊的几率，同时控制儿童的种族/民族以及提供者和项目因素。
我们使用2019年全国早期保育与教育调查（NSECE）的全日制提供者调查进行了二次分析。我们使用多元逻辑回归模型来估计没有现场提供这些服务的中心进行健康筛查和发育评估的转诊几率。我们对提供者因素（例如与儿童交流时使用的语言）和项目因素（例如员工指导、监管机构检查以及师生比例）进行了调整。
样本包括美国全日制儿童保育提供者（n = 1306），其项目未提供现场健康筛查或发育评估。研究结果表明，提供员工指导的项目（比值比[OR] = 2.15，95%置信区间[CI][1.36 - 3.41]，P = 0.001）和监管监督的项目（OR = 1.85，CI[1.13 = 3.02]，P = 0.014）为5岁以下儿童进行转诊的几率更高。在调整了各种提供者和项目因素后，与其他种族群体相比，西班牙裔儿童被转诊的几率较低（OR = 0.99，95% CI[0.98 - 0.99]，P = 0.030）。
全日制儿童保育项目中的指导和监管监督与5岁以下儿童接受健康筛查和发育评估转诊的几率更高相关。指导和监管监督可能有助于为全日制儿童保育项目中的儿童及其家庭及时提供筛查和评估的转诊服务。
