Improvement of Child Care Programs’ Health and Safety Policies, and Practices, and Children’s Access to Health Care, Linked to Child Care Health Consultation


  • Patricia Isbell University of North Carolina at Chapel Hill
  • Jonathan Kotch University of North Carolina at Chapel Hill
  • Eric Savage University of North Carolina at Chapel Hill
  • Elizabeth Gunn University of North Carolina at Chapel Hill
  • Lydia Lu Centers for Disease and Prevention
  • David Weber University of North Carolina at Chapel Hill


Child care health consultation is a partnership between a health professional and a child care program that promotes a healthy and safe child care environment. This partnership involves on-site, internet and telephone consultation, health education, health promotion, and training and technical assistance. The objective of this study was to determine the impact of this partnership on the health and safety of children in 77 child care programs in one state. Data were collected on each child care program’s written health and safety policies, children’s health records, and staff health and safety behaviors.

The results demonstrate a statistically significant increase in the quality of written health and safety policies and health practices (sanitation/hygiene, nutrition/food service, playground safety and emergency preparedness). These improvements in policies and practices (defined by Alkon et al., 2006, as precursors of child health outcomes) led to improvements in children’s access to a medical home, enrollment in health insurance, immunization status, and documented oral, developmental, vision, and hearing screenings.






Research Articles