Healthy Children and Environments Study

The goal of this study is to reduce children's exposure to pesticides in child care centers
to improve their long-term health. A randomized-control trial in four northern California
counties will compare changes in pesticide exposure among child care centers assigned to an
IPM intervention versus an attention control intervention on physical activity. Eighty-eight
child care centers serving socio-economically and ethnically diverse preschool-age children
will be enrolled. This study will be modeled on a successful nurse-led child care health
consultation intervention comprised of an educational workshop, materials and tools, and
center-specific consultation over seven months. In addition, the study will include novel
methods of measuring pesticide concentrations in child care centers (dust) and to individual
children in the child care settings (silicone wristbands). The study aims are to determine if
a nurse-led IPM intervention (1) increases child care center staff's IPM knowledge, (2)
improves center's IPM policies and practices, (3) reduces pest problems (i.e., pests present,
pest residue), (4) increases director's self-efficacy, (5) reduces pesticide exposures in
child care center environments, and (6) reduces child-level pesticide exposures in the
intervention child care centers compared to the control centers.

Inclusion Criteria:

The centers must meet the following criteria:

1. Be a licensed child care center with a child care director who speaks English

2. Used pesticides (i.e., baits or sprays) in the last year

3. Operated for at least two years with no plans to close in the next 12 months

4. Enroll children between three to five years of age of diverse ethnic and racial
backgrounds

5. 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).

6. Have a carpet or couch on-site.

The families must have a preschool-age child enrolled in the participating child care
center and meet the following criteria:

1. Three or four years of age

2. The child spends at least six hours per day in the center

3. Will be enrolled in the center for the next nine months

4. Has a parent present during enrollment who speaks either English or Spanish

5. Parents will complete surveys of interviews in English or Spanish in the Fall and
Spring

Exclusion Criteria:

1. Centers that participated in an IPM intervention and training project

2. Families that have children who have special health care needs or disabilities who can
not participate in physical activity at the child care center.