Reducing Pesticide Exposures in Child Care Centers (HCES)

University of California San Francisco (UCSF)

Status: Completed

Conditions: Environmental Exposure; Children, Only; Risk Reduction

Treatments: Behavioral: IPM educational workshop and consultation

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03319927

R01ES027134 (U.S. NIH Grant/Contract)

4000 317004 130129A 01 44

Details and patient eligibility

About

To reduce the risk of adverse health problems associated with chronic exposure to pesticides, a randomized control study will evaluate a nurse-led integrated pest management (IPM) intervention in 88 child care centers serving socio-economically and ethnically diverse preschool-age children in four California counties. Positive changes in IPM knowledge, policies, practices, pests, and pesticide exposure will be assessed.

Full description

The goal of this study is to reduce children's exposure to pesticides in child care centers to improve their long-term health. A randomized-control trial in four northern California counties will compare changes in pesticide exposure among child care centers assigned to an IPM intervention versus an attention control intervention on physical activity. Eighty-eight child care centers serving socio-economically and ethnically diverse preschool-age children will be enrolled. This study will be modeled on a successful nurse-led child care health consultation intervention comprised of an educational workshop, materials and tools, and center-specific consultation over seven months. In addition, the study will include novel methods of measuring pesticide concentrations in child care centers (dust) and to individual children in the child care settings (silicone wristbands). The study aims are to determine if a nurse-led IPM intervention (1) increases child care center staff's IPM knowledge, (2) improves center's IPM policies and practices, (3) reduces pest problems (i.e., pests present, pest residue), (4) increases director's self-efficacy, (5) reduces pesticide exposures in child care center environments, and (6) reduces child-level pesticide exposures in the intervention child care centers compared to the control centers.

Enrollment: 440 patients

Sex: All

Ages: 3 to 75 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

The centers must meet the following criteria:

1. Be a licensed child care center with a child care director who speaks English
2. Used pesticides (i.e., baits or sprays) in the last year
3. Operated for at least two years with no plans to close in the next 12 months
4. Enroll children between three to five years of age of diverse ethnic and racial backgrounds
5. 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).
6. Have a carpet or couch on-site.

The child care providers must meet the following criteria:

1. Work in the participating child care centers
2. Work in the classroom of the participating children
3. Work at least 30 hours a week
4. 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:

1. Three or four years of age
2. The child spends at least six hours per day in the center
3. Will be enrolled in the center for the next nine months
4. Has a parent present during enrollment who speaks either English or Spanish
5. Parents will complete surveys or interviews in English or Spanish in the Fall and Spring

Exclusion criteria

1. Centers that participated in an IPM intervention and training project
2. Families that have children who have special health care needs or disabilities who can not participate in physical activity at the child care center.
3. Center directors who do not read and write in English.
4. Child care providers who do not read and write in English.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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440 participants in 2 patient groups

Integrated pest management

Experimental group

Description:

The intervention consists of an integrated pest management (IPM) educational workshop and consultation. The child care health consultants (CCHCs) conduct the educational workshop for child care center directors and providers on IPM policies and practices including the providers' practices and beliefs. The workshop includes IPM videos, IPM Toolkit, and IPM toolbox. The (CCHCs) meet with center directors to review the results of the Baseline observational Checklists and to identify center-specific intervention goals. The intervention also includes 7 monthly child care health consultation visits where the CCHC and director review the center's progress towards the intervention goals, discuss problems, and share resources.

Treatment:

Behavioral: IPM educational workshop and consultation

Physical activity

Active Comparator group

Description:

The intervention consists of a physical activity educational workshop and consultation. The child care health consultants (CCHCs) conduct the educational workshop for the child care center directors and providers on physical activities center policies and best practices over 7 months. The workshop includes a Physical Activity Toolkit and toolbox. The (CCHCs) meet with center directors to review the results of the Baseline observational Checklists and to identify center-specific intervention goals. The intervention also includes 7 monthly child care health consultation visits where the CCHC and director review the center's progress towards the intervention goals, discuss problems, and share resources.

Treatment:

Behavioral: IPM educational workshop and consultation