Doctoral Dissertations

Date of Award

12-1996

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Health Promotion and Health Education

Major Professor

Billy C. Wallace

Committee Members

Robert Kirk, Jack S. Ellison, Joan Uhl-Pierce

Abstract

Increased utilization of out-of-home child care in the United States has been accompanied by growing evidence of the health and safety implications for children, providers, and the community. Lack of standards to ensure a healthy and safe environment, an increased rate of infectious disease, and the incidence of childhood injury are major areas of concern. Child care settings have not been a traditional site for health education and health promotion, but the emergence of significant health and safety issues presents opportunities and challenges for health educators. The purpose of this study was to conduct an assessment of the health and safety concerns, health education needs, and current health education practices of child day care centers. The 15- item Child Care Health Education Assessment (CCHEA) was developed, reviewed by a national panel of experts, and pretested with child care directors in the study area. The instrument was found to be valid and reliable for assessment of health education needs with this target population. The CCHEA was distributed by mail to the directors of 453 child care centers. A 23% response rate (N=103) was obtained. Although health and safety concerns were reported infrequently, infectious disease, behavior and discipline and chronic health problems were identified as the primary concerns in most centers. Health education for staff, children, and parents was rated as very important by the majority of directors, and a significant number of centers were providing health education for each target group. The highest level of health education activity was focused on children, with 93% of centers reporting this as an integral component of their early childhood curriculum. Directors identified a number of priority health education topics for their center, including: behavior and discipline, growth and development, and infectious disease for both parents and staff; safety, fitness and exercise, and self-esteem for children. Directors also indicated the need for professional support and additional resources to enhance their current health education efforts.

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