Research
The Child Care Health Linkages Project included a three-year evaluation (September 2001 to June 2004) to study the effects of health consultation services provided by Child Care Health Consultants (CCHC) and Child Care Health Advocates (CCHAs) on the health and safety of children 0-5 years of age attending child care. The purpose of this evaluation was to describe the new health consultation services at the county level and the effect of health consultation services on the health and safety of infants and toddlers and preschool age children in early care and education settings.
Study Design
Objectives of Evaluation
Linkages Preliminary Evaluation Findings
Absence and Illness Log
Advocate Daily Encounter Form
The Child Health Record Review
Daily Encounter Form
CCHP Health and Safety Checklist--Revised
CCHP Health and Safety Policies Checklist
Health and School Readiness Literature Review
Study Design
The evaluation project included three components. First, an evaluation of the California Training Institute (CTI) for Child Care Health Consultants and Child Care Health Advocates. Training was assessed using pre and post knowledge-based tests and process evaluations following each training session. Second, a formative evaluation was conducted, which was be a descriptive study of the Child Care Health Consultant (CCHC) and Child Care Health Advocate (CCHA) roles in early care and education settings and the implementation of these new roles and programs at county and center levels. Third, an outcome evaluation was conducted in five of the 20 counties funded by the Child Care Health Linkages Project, to study the changes in health status of the children served by CCHCs and CCHAs. Baseline data was collected in year one and outcome measures was collected during years two and three.
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Objectives of Evaluation
The objectives of the formative evaluation will be to: describe the different health consultation roles and services provided, describe the barriers and facilitators that inhibit and enhance the implementation of health consultant services, and describe the knowledge gained by CCHCs and CCHAs who attended the California Training Institutes.
The objectives of the outcome evaluation will be to identify health status changes for children who attend the intervention early care and education settings during the 2-3 year intervention project, identify changes in child care health and safety, and identify linkages established during the intervention project that increased access to health services for the children, improved communication between agencies, and increased utilization of community services for families.
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Linkages Preliminary Evaluation Findings
Child Care Health Linkages Project Evaluation Summary (PDF; 141k; 4pp)
Specific Instruments
Absence and Illness Log
The Absence and Illness Log was created to record children's absences from child care and whether the absence was due to illness or other reasons. The logs are used to track 25 children per child care center for an eight-week period. Children's age in months is recorded and an identifier, such as initials, is recorded per child. Identity of children remains anonymous.
Absence and Illness Log (PDF; 104k, 2pp)
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Advocate Daily Encounter Form
In California, CCHCs work with Child Care Health Advocates (CCHAs). The CCHAs use a form that was modified from the DEF and is similar to the DEF. The form is called the Advocate Daily Encounter Form (ADEF). The ADEF documents the health and safety activities of the CCHAs. The ADEF was developed by the Child Care Health Linkages Evaluation Project, of the University of California, San Francisco School of Nursing.
Advocate Daily Encounter Form (PDF; 57k)
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The Child Health Record Review
Early Care and Education Program Health Assessment (Child Health Record Review) was developed to assess children's health status based on information in children's health records located on-site at early care and education (ECE) programs. They are based on the Child Care Evaluation Worksheet and Guidelines for Completion of form developed by the University of North Carolina of Chapel Hill Quality Enhancement Project for Infants and Toddlers Quality Enhancement Project for Infants and Toddlers, 2001; and researchers' and Child Care Health Consultants' experiences.
The Child Health Record Review (PDF; 11k)
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Daily Encounter Form
The Daily Encounter Form (DEF) was developed by the University of North Carolina Division of Child Development, Quality Enhancement Project for Infants and Toddlers (UNC QEP) and funded by the University of North Carolina Division of Child Development. The DEF has been used by child care health consultants (CCHCs) in North Carolina and other states to track their daily health consultation activities. A modified version of the UNC instrument is used as a component of the Child Care Health Linkages Project (CCHLP) outcome evaluation and is completed by CCHLP CCHCs in 20 California counties. The CCHLP health consultants completed DEFs to document their daily health consultation activities with children 0-5 years of age in child care settings. A variable to track the number of children served by each activity was added to the CCHLP DEF.
Daily Encounter Form (PDF; 87k, 5pp)
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Other Documents
CCHP Health and Safety Checklist--Revised
The CCHP Health and Safety Checklist-Revised is an 82-item observational measure that was developed to: 1) assess the health and safety status in early care and education (ECE) programs, 2) assess compliance with key National Health and Safety Performance Standards (American Academy of Pediatrics, American Public Health Association and National Resource Center for Health and Safety in Child Care, 2002), and 3) assist users to develop interventions to address the health and safety needs identified on the CCHP H&S Checklist.
The CCHP H&S Checklist was modified from the original CCHP Health and Safety Checklist based on several years of researchers' and Child Care Health Consultants' experiences using the measure. In addition, the new Health and Safety Checklist was modified to be more user-friendly, comprehensive and better organized than the original CCHP Health and Safety Checklist. An advisory group of experts met to review and prioritize the items.
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CCHP Health and Safety Policies Checklist
The California Childcare Health Program Health and Safety Policies Checklist (2005) was developed to objectively assess written health and safety policies in early care and education programs. The Checklist can be used by child care providers or directors, child care health advocates, child care health consultants, health professionals, and researchers. It assesses the quality of written health and safety policies and helps child care and health professionals identify how to improve written policies and target interventions. The Checklist is based on the University of North Carolina of Chapel Hills's Quality Enhancement Project and the National Health and Safety Performance Standards (AAP, APHA, NRC, 2002).
CCHP Health and Safety Policies Checklist (PDF; 239k; 13pp)
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Health and School Readiness Literature Review
The purpose of this literature review is to summarize the health components, initiatives, and outcomes of key School Readiness Programs in the United States, not including California. The intent of this review is to provide relevant information for county First 5 staff renewing their School Readiness Programs and developing health interventions and/ or outcomes to address the required 'health and social services' element of their programs. This literature review summarizes key findings of program components and outcomes related to health and School Readiness.
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