Reducing Pesticide Exposures in Child Care Centers

NCT03319927 | Completed Results

• 2 other identifiers: 4000 317004 130129A 01 44R01ES027134
• Study Type: interventional
• Target: 987
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Children, Only; Risk Reduction; Environmental Exposure

Keywords

integrated pest management; environmental health; child care; preschool children; pesticides

Outcome Measures

Primary Outcomes (3)

• Decrease in Child Care Center Pesticides

  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.

  Pre-intervention, 9 months after the workshop

• Decrease in Children's Exposure to Pesticides

  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.

  Pre-intervention and 9 months later (post-intervention)

• Increase in Integrated Pest Management (IPM) Practices

  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.

  Pre-Intervention and 9 months later

Secondary Outcomes (3)

• Decrease in the Presence of Pests

  Pre-intervention and 9 months later

• Director's Self-Efficacy

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

• Number of Child Care Centers With Written IPM Policies

  9 months

Other Outcomes (1)

• Change in Knowledge

  pre- and immediately after the workshop is completed

Study Arms (2)

Integrated pest management

EXPERIMENTAL

The intervention consists of an integrated pest management (IPM) educational workshop, providing IPM materials, and monthly consultation. The child care health consultants (CCHCs) conduct the educational workshop for child care center directors and providers on IPM practices including the providers' practices and beliefs. The workshop includes a slide presentation on pesticides and IPM practices and the directors receive an IPM Toolkit and IPM toolbox. After the workshop and baseline measures are completed, the CCHCs meet with center directors to review the results of the baseline observational Checklists and the directors identify center-specific intervention goals. Monthly child care health consultation visits are conducted with the director to review the center's progress towards the goals, discuss problems, and share resources.

Behavioral: Changes in pesticide exposure; Behavioral: IPM Practices; Behavioral: Educational Workshops

Physical activity

ACTIVE COMPARATOR

The attention control group is given an intervention covering physical activity (PA) for preschool-age children in child care centers. The PA intervention includes the same intensity as the IPM intervention provided by a child care health consultant (CCHC). The CCHC conducts a workshop on physical activity that includes a slide presentation and the directors receive a Physical Activity Toolkit and toolbox. After the workshop and baseline measures are completed, the CCHCs meet with center directors to review the results of the baseline observational Checklists and the directors identify center-specific intervention goals. Monthly child care health consultation visits are conducted with the director to review the center's progress towards the goals, discuss problems, and share resources.

Behavioral: Changes in pesticide exposure; Behavioral: IPM Practices

Interventions

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.

Integrated pest management

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.

Also known as: Child care health consultant assessment and intervention

Integrated pest management; Physical activity

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.

Integrated pest management; Physical activity

Eligibility Criteria

• Age: 3 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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.

Sponsors & Collaborators

• University of California, San Francisco: lead
• National Institute of Environmental Health Sciences (NIEHS): collaborator
• University of California, Berkeley: collaborator
• Oregon State University: collaborator

Study Sites (1)

University of California, San Francisco

San Francisco, California, 94143, United States

Location

Related Publications (5)

• Alkon A, Nouredini S, Swartz A, Sutherland AM, Stephens M, Davidson NA, Rose R. Integrated Pest Management Intervention in Child Care Centers Improves Knowledge, Pest Control, and Practices. J Pediatr Health Care. 2016 Nov-Dec;30(6):e27-e41. doi: 10.1016/j.pedhc.2016.07.004. Epub 2016 Aug 20.

  PMID: 27553118 BACKGROUND

• Bradman, A, Gasper, F, Castorina, R, Tong-Lin, E, McKone, T, & Maddelena, R. (2012). Environmental exposures in early childhood education environments (Agreement Number 08-305). Retrieved from Berkeley, CA:

  BACKGROUND

• Vidi PA, Anderson KA, Chen H, Anderson R, Salvador-Moreno N, Mora DC, Poutasse C, Laurienti PJ, Daniel SS, Arcury TA. Personal samplers of bioavailable pesticides integrated with a hair follicle assay of DNA damage to assess environmental exposures and their associated risks in children. Mutat Res Genet Toxicol Environ Mutagen. 2017 Oct;822:27-33. doi: 10.1016/j.mrgentox.2017.07.003. Epub 2017 Jul 16.

  PMID: 28844239 BACKGROUND

• Alkon A, Gunier RB, Hazard K, Castorina R, Hoffman PD, Scott RP, Anderson KA, Bradman A. Preschool-Age Children's Pesticide Exposures in Child Care Centers and at Home in Northern California. J Pediatr Health Care. 2022 Jan-Feb;36(1):34-45. doi: 10.1016/j.pedhc.2021.09.004. Epub 2021 Oct 8.

  PMID: 34629233 RESULT

• Hazard K, Alkon A, Gunier RB, Castorina R, Camann D, Quarderer S, Bradman A. Predictors of pesticide levels in carpet dust collected from child care centers in Northern California, USA. J Expo Sci Environ Epidemiol. 2024 Mar;34(2):229-240. doi: 10.1038/s41370-022-00516-8.

  PMID: 36599924 RESULT

MeSH Terms

Conditions

Risk Reduction Behavior

Interventions

Methods

Condition Hierarchy (Ancestors)

Behavior

Intervention Hierarchy (Ancestors)

Investigative Techniques

Results Point of Contact

• Title: Abbey Alkon, Emeritus Professor, PI
• Organization: UCSF School of Nursing

abbey.alkon@ucsf.edu

415-476-4695

Study Officials

• Thaddeus Schug, PhD

  National Institute for Environmental Health Sciences

  STUDY CHAIR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This randomized control study included 85 child care centers in five CA counties and was conducted in 9-month cycles over six years. The counties were matched and randomized to the intervention group (integrated pest management) or attention control group (physical activity). Each study cycle included Recruitment, Baseline Assessments, Intervention, and Post-Intervention Assessments. Baseline Assessments were completed as director interviews and surveys, child care provider surveys, research assistant-completed objective observations using standardized Checklist, center dust samples to measure pesticides, and silicone wristband personal samplers worn by 5 children per center for 30 hours. During the 7-month Intervention phase, CCHCs conducted one workshop per center on the intervention topic (IPM or physical activity) and provided monthly consultations with the center directors. The Post-Intervention stage repeated all the baseline assessments.

Study Record Dates

• First Submitted: October 12, 2017
• First Posted: October 24, 2017
• Study Start: October 9, 2017
• Primary Completion: August 1, 2024
• Study Completion: August 1, 2024
• Last Updated: February 17, 2026
• Results First Posted: February 17, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)