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Completed

NCT Number: NCT03319927

Reducing Pesticide Exposures in Child Care Centers

A randomized control study was conducted to reduce the exposure to pesticides in child care centers. A 7-month child care health consultant-led integrated pest management (IPM) intervention was conducted in 85 child care centers serving preschool-age children in five California counties. Changes in IPM knowledge, self-efficacy, policies, IPM practices, pests, and pesticide exposure were assessed in the IPM centers and the control centers.

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Key information

Age range

3 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of California, San Francisco

San Francisco, California, 94143, United States

About this study

The goal of the study was to reduce children's exposure to pesticides in child care centers to improve their long-term health. A randomized-control trial in five northern California counties compared changes in director's IPM knowledge and self-efficacy, written IPM policies, IPM practices, number of pests and concentration of pesticides between child care centers assigned to an IPM intervention versus an attention control intervention on physical activity. Eighty-five child care center directors working in centers serving preschool-age children were enrolled. The child care health consultant-led intervention included an educational workshop, materials and tools, and center-specific consultation over seven months. In addition, the study included novel methods of measuring pesticide concentrations in child care centers (dust) and individual children (silicone wristbands). The study aims were to determine if an IPM intervention (1) increases child care center's director's IPM knowledge and self-efficacy, (2) improves center's IPM practices and policies, (3) reduces the number of pests present, (5) reduces pesticide exposures in child care center environments in the intervention IPM child care centers compared to the control centers.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

The centers must meet the following criteria:

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

The child care providers must meet the following criteria:

  • Work in the participating child care centers
  • Work in the classroom of the participating children
  • Work at least 30 hours a week
  • 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:

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

Exclusion criteria

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

Treatment and study plan

Changes in pesticide exposure

Behavioral

In the IPM centers the child care health consultant reviews the IPM baseline assessments and provides 7 monthly consultation visits to decrease the centers exposure to pesticides. Pre- and post- carpet dust samples and children's individual silicone wristbands are collected to identify changes in pesticide detection limits and concentrations at the child care center-level in both the IPM and PA centers pre- and post-intervention.

Other names: Child care health consultant assessment and intervention

IPM Practices

Behavioral

In the IPM centers, a research assistant completed the IPM Checklist which identifies the IPM practices that the center meets and doesn't meet. The child care health consultant reviews the IPM Checklist findings with the child care center director after the baseline Checklist is completed. The IPM Checklist is completed pre- and post-intervention in the IPM and PA centers. The post-intervention IPM Checklist findings are compared to the baseline IPM Checklist findings to identify changes in IPM practices in both the IPM and PA centers.

Educational Workshops

Behavioral

The IPM center directors and providers attend an IPM workshop and complete a survey to assess their knowledge of IPM practices pre- and post-workshop. The level of knowledge change is assessed by comparing the number of correct responses on the post-workshop survey compared to the pre-workshop survey.

Primary outcomes

  1. Decrease in Child Care Center Pesticides

    Time frame: Pre-intervention, 9 months after the workshop

    Change in the levels of pesticide exposures collected in carpet dust samples in the child care centers from baseline to 9 months later. Pesticides are summarized as geometric mean concentration (ng/g) and then the log10 is applied to the data. Carpet dust samples were collected in each child care center at pre-intervention and post-intervention. A decrease in pesticide concentration from pre-intervention to post-intervention is represented as a negative value. A negative change score would be a positive finding with a decrease in pesticide concentration post-intervention.

  2. Decrease in Children's Exposure to Pesticides

    Time frame: Pre-intervention and 9 months later (post-intervention)

    Change in the levels of pesticide exposures collected in personal silicone wristbands worn by 3 to 5 of the preschool-age children in each child care center. They wore the wristbands for ~30 hours pre-intervention/baseline and 9 months later. Pesticides are summarized as geometric mean concentration (ng/mL) and then log10 is applied to the data. A decrease in pesticide concentration from pre-intervention to post-intervention is represented as a negative value. A negative change score would be a positive finding with a decrease in pesticide concentration post-intervention.

  3. Increase in Integrated Pest Management (IPM) Practices

    Time frame: Pre-Intervention and 9 months later

    The IPM practices were measured objectively with a standardized IPM Checklist during a 2-hour observational assessment at baseline/pre-intervention and then 9 months later using a standardized measure (Alkon etal, JPHC, 2016). The IPM practices observed included having garbage cans with liners and lids, using bait stations if there are pests, having window screens with no holes, no water leaks, and outside garbage bins on cement surfaces. Each item on the Checklist is marked as 1 (yes) or O (no). The mean ranged from 0 (no practices observed) to 1 (all of the items were observed). An increase in IPM practices would be positive change in the mean score post-intervention compared to pre-intervention.

Secondary outcomes

  1. Decrease in the Presence of Pests

    Time frame: Pre-intervention and 9 months later

    The # of pests were observed as part of the IPM Checklist assessment in different places in the child care center: kitchen, outside garbage area, playground, landscape outdoor area, and classroom at the pre-intervention period and 9 months later. Pre- and post-intervention, the # of pests observed is a number on a scale of 0 to infinity. A positive outcome would be a negative change score showing be a decrease in the # of pests observed post-intervention compared to pre-intervention.

  2. Director's Self-Efficacy

    Time frame: The Self-Efficacy Survey is completed by the directors pre-intervention and after the intervention (7 to 9 months later).

    The director's sense of self-efficacy provides information about their sense of control of their work environment and impact on the families and children that they serve. The intervention is designed to help the director's feel empowered (e.g., increase in self-efficacy) to make changes in their work environment and provide a healthy environment for children and families served in their center. The Self-Efficacy survey was modified from a standardized measure by Bandura, A (1977) to fit the intervention and child care center's environments. There are 8 items with responses rated on a likert scale from 1 to 4 as strongly disagree (1) to strongly agree (4). Mean self-efficacy scores were calculated for each director. The minimum and maximum mean scores were 2.8 to 4.0. Higher mean score shows higher self-efficacy.

  3. Number of Child Care Centers With Written IPM Policies

    Time frame: 9 months

    The presence of IPM policies was reviewed as (1 for "Yes") and (0 for "No") no both pre- and post-intervention in the IPM centers. Licensed child care centers are required to have written policies, but a specific policy on IPM is not required. Policies provide best practices for the child care administrators, providers and parents to follow when working or spending time in the center.

Other outcomes

  1. Change in Knowledge

    Time frame: pre- and immediately after the workshop is completed

    An 8-item multiple choice knowledge survey was completed by participants who attended the IPM workshop pre- and post-workshop. The survey was developed by the PI and contained key content covered in the IPM workshop. There were 70 child care providers who attended the workshops and completed the knowledge and demographic surveys. Correct answers were coded as 'correct' and given a score of '1'. The range of scores for each participant were from 0 to 8 (all correct answers). The scores for each participant were calculated and then aggregated by center. Positive changes in scores showed an increase in IPM knowledge post-workshop compared to baseline.

Sponsors and collaborators

Lead sponsor

University of California, San Francisco

Other

Collaborators

  • National Institute of Environmental Health Sciences (NIEHS)
  • Oregon State University
  • University of California, Berkeley

Registry information

Official study title

Reducing Pesticide Exposures to Preschool-age Children in California Child Care Centers

Acronym: HCES

Important dates

Study start
2017
Primary completion
2024
Study completion
2024
First posted
Oct 24, 2017
Registry last updated
Feb 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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