Planning for Health Promotion in Low-Income Preschool Child Care Settings: Focus Groups of Parents and Child Care Providers

Taveras, Elsie M.; LaPelle, Nancy; Gupta, Ruchi S.; Finkelstein, Jonathan A.

doi:10.1016/j.ambp.2006.07.004

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Volume 6, Issue 6 , Pages 342-346, 1 November 2006

Planning for Health Promotion in Low-Income Preschool Child Care Settings: Focus Groups of Parents and Child Care Providers

Elsie M. Taveras, MD, MPH
- Center for Child Health Care Studies, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care and the Division of General Pediatrics, Children’s Hospital, Boston, Mass USA
- Address correspondence to Elsie M. Taveras, MD, MPH, Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, 133 Brookline Avenue, 6th Floor, Boston, MA 02215
Nancy LaPelle, PhD
- University of Massachusetts Medical School, Worcester, Mass USA
Ruchi S. Gupta, MD, MPH
- Institute for Health Services Research and Policy Studies and Children’s Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Ill USA
Jonathan A. Finkelstein, MD, MPH
- Center for Child Health Care Studies, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care and the Division of General Pediatrics, Children’s Hospital, Boston, Mass USA

Received 21 March 2006; accepted 28 July 2006.

Objective

To identify potentially successful strategies, barriers, and facilitators for health promotion in preschool child care settings.

Methods

We conducted 6 focus groups including each of the following: parents of children attending child care centers and home-based family child care (2 in English, 1 in Spanish) and directors of child care centers and family child care providers (2 in English, 1 in Spanish). Systematic thematic analysis was conducted to generate themes to address study questions.

Results

A total of 24 parents and 45 child care providers, serving predominantly urban, low-income children in Boston, participated. Parents and child care providers agreed that in-person group discussions would be the most effective strategy for providing health education information to parents. Several barriers that could affect implementation emerged. First, some providers expressed frustration toward parents’ attitudes about child safety and health. Second, there was diversity of opinion among providers on whether conducting health promotion activities was consistent with their training and role. In addition, literacy, language, and cultural barriers were identified as potential barriers to health promotion in child care.

Conclusions

In order to be successful, health promotion strategies in child care settings will need to overcome tensions between providers and parents, allow professional growth of child care providers to serve in a health promotion role, and better integrate external health resources and personnel. Group sessions and peer learning opportunities that are culturally and linguistically sensitive are potentially successful strategies for implementation of health promotion interventions for many parents.

Key words: child care, health promotion, qualitative research