title: Child care health consultation improves health and safety policies and practices.
abstract: OBJECTIVE
  To evaluate the effects of county-level child care health consultation intervention programs on child care centers' health and safety policies and practices.
  
  
  METHODS
  A 3-year experimental study was conducted in 5 California counties and 111 licensed child care centers (73 intervention, 38 comparison) participated at the baseline and postintervention times. Trained research assistants conducted objective observations with a Policies Checklist and Health and Safety Checklist, which were composed of key national health and safety standards.
  
  
  RESULTS
  At baseline, both groups were not significantly different on the Policies Checklist and the Health and Safety Checklist. At the post-intervention time, intervention centers had significantly more and higher-quality written health and safety policies on 9 of the 10 policies rated (medication administration, care of mildly ill children, exclusion of ill children, cleaning and sanitizing, handwashing, daily health checks, inclusion of children with special needs, emergency preparedness, staff health) than comparison centers. At the postintervention time, intervention centers improved their health and safety practices in the areas of emergency preparedness and handwashing, controlling for consultation model, time in study, and director turnover. Both groups improved their indoor and outdoor facilities and overall Health and Safety Checklist means.
  
  
  CONCLUSIONS
  Child care health consultation programs can improve the written health and safety policies and may improve practices in child care centers.
authors.affiliation: Department of Family Health Care Nursing, San Francisco School of Nursing, University of California, San Francisco, California 94143-0606, USA. abbey.alkon@nursing.ucsf.edu
authors.forename: Abbey
authors.initials: A
authors.lastname: Alkon
authors.forename: Jane
authors.initials: J
authors.lastname: Bernzweig
authors.forename: Kim
authors.initials: K
authors.lastname: To
authors.forename: Mimi
authors.initials: M
authors.lastname: Wolff
authors.forename: Joanna F
authors.initials: JF
authors.lastname: Mackie
mesh_terms: D000328:Adult; D002648:Child; D002656:Child Day Care Centers / Q000458:organization & administration*; D002662:Child Health Services; D002675:Child, Preschool; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016134:Organizational Policy; D015397:Program Evaluation; D012017:Referral and Consultation; D012449:Safety