Hand-washing and diapering equipment reduces disease among children in out-of-home child care centers
Abstract
OBJECTIVE: The objective of this study was to determine whether the installation of equipment for diaper-changing, hand-washing, and food preparation that is specifically designed to reduce the transmission of infectious agents would result in a decrease in the rate of diarrheal illness among children and their teachers in child care centers. METHODS: Twenty-three pairs of child care centers were matched on size and star-rated license level. One member of each pair was randomly assigned to an intervention group and the other to a control group. Intervention centers received new diaper-changing, hand-washing, and food-preparation equipment, and both intervention and control centers received hygiene and sanitation training with reinforcement and follow-up as needed. Families with children in participating classrooms were called biweekly to ascertain the frequency and severity of any diarrheal illness episodes. Staff attendance was monitored, and staff hygiene and sanitation behaviors were observed and recorded monthly. RESULTS: Although hygiene and sanitation behaviors improved in both intervention and control centers, there was a significant difference favoring the intervention centers with respect to frequency of diarrheal illness (0.90 vs 1.58 illnesses per 100 child-days in control centers) and proportion of days ill as a result of diarrhea (4.0% vs 5.0% in control centers) among the children. Staff in those same classrooms were reported to have a significantly lower proportion of days absent as a result of any illness (0.77% in treatment centers versus 1.73% in control centers). CONCLUSION: Diapering, hand-washing, and food-preparation equipment that is specifically designed to reduce the spread of infectious agents significantly reduced diarrheal illness among the children and absence as a result of illness among staff in out-of-home child care centers.
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- Authors
- Kotch, J. B., Isbell, P., Weber, D. J., Nguyen, V., Savage, E., Gunn, E., Skinner, M., Fowlkes, S., Virk, J., & Allen, J.
- Affiliations
- Departments of Maternal and Child Health
- Epidemiology, School of Public Health
- University of North Carolina at Chapel Hill (US)
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2007-07-01
- Volume
- 120
- Issue
- 1
- Pages
- e29-e36
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W1982429561
- Cited by
- 71
- References
- 29
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 7 · 2019: 4 · 2018: 1 · 2017: 6 · 2016: 4 · 2015: 8 · 2014: 4 · 2013: 7 · 2012: 5
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- North Carolina Department of Health and Human Services
- National Institutes of Health
- National Institute of Environmental Health Sciences (P30ES10126), P30ES010126)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Life Sciences › Agricultural and Biological Sciences › Food Science › Food Safety and Hygiene
- Health Sciences › Health Professions › Emergency Medical Services › Pediatric health and respiratory diseases
- Keywords
- diarrheal illness, daycare centers, food preparation equipment, infection control, absenteeism, infectious disease transmission, child health
- MeSH terms
- Child Day Care Centers, Child, Preschool, Communicable Disease Control, Diarrhea, Equipment and Supplies, Food Services, Hand Disinfection, Humans, Hygiene, Infant, Diapers, Infant
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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