Improving Surveillance and Epidemic Response in Ohio Childcare Settings.

At the start of the Coronavirus Disease of 2019 (COVID-19) pandemic, the risk of cases in childcare programs was unknown. Thus, a rapid-response research approach was launched in Ohio childcare settings. Passive surveillance data from a state-operated incident reporting system were evaluated to estimate the number of COVID-19 cases from 15 August 2020 to 1 January 2021. Additionally, active surveillance with self-administered reverse transcriptase-polymerase chain reaction (RT-PCR) tests were conducted among staff at 46 childcare programs. Finally, six zoom-based focus groups with program administrators were used to gain feedback. Staff and children in childcare settings contributed 0.38% and 0.15% of the COVID-19 cases in Ohio during this timeframe, respectively. RT-PCR testing identified 3 unrecognized cases (0.88% of tests), and all occurred when the statewide positivity rate was >5%. Focus groups revealed that access to affordable cleaning supplies, masks, and reliable staffing were critical. Perhaps most importantly, we conclude that expanding the incident reporting system to include a childcare census would allow for the tracking of future health problems with highly valuable incidence rate estimations.

"A win-win for all of us": COVID-19 sheds light on the essentialness of child care as key infrastructure.

Child care centers in the United States allow many parents and caregivers to work in and outside of the home and support the growth and development of children. Child care closures and COVID-19 mitigation measures at the onset of the pandemic heightened the need for and awareness of the role of child care as core infrastructure. The purpose of our study was to examine the perceived role and benefits of child care based on the lived experiences of parents/caregivers and staff navigating child care during the pandemic. We conducted in-depth qualitative interviews with parents/caregivers (n = 20) of children who attended child care and staff (n = 12) who were working at child care programs in Ohio from September to November 2020. Qualitative data were coded and analyzed through the lens of four frameworks (i.e., capabilities, developmental, economics, and mutualism) related to child well-being. Our results highlight the perceived value of child care (a) for fostering capabilities and developmental growth in children; (b) for providing economic benefits for children, parents, and staff of child care programs; and (c) as an essential infrastructure that mutually benefits children, parents, families, staff, and the community. Findings support existing evidence regarding the broader impacts of child care and further investigation into the role of child care. We highlight the potential need for further investments in policies, resources, and supports for child care that reflects its essentialness and generative role.

“A Win-Win for All of Us": COVID-19 Sheds Light on the Essentialness of Child Care as Key Infrastructure

Child care centers in the United States allow many parents and caregivers to work in and outside of the home and support the growth and development of children. Child care closures and COVID-19 mitigation measures at the onset of the pandemic heightened the need for and awareness of the role of child care as core infrastructure. The purpose of our study was to examine the perceived role and benefits of child care based on the lived experiences of parents/caregivers and staff navigating child care during the pandemic. We conducted in-depth qualitative interviews with parents/caregivers (n=20) of children who attended child care and staff (n=12) who were working at child care programs in Ohio from September to November 2020. Qualitative data were coded and analyzed through the lens of four frameworks (i.e., capabilities, developmental, economics, and mutualism) related to child well-being. Our results highlight the perceived value of child care (a) for fostering capabilities and developmental growth in children;(b) for providing economic benefits for children, parents, and staff of child care programs;and (c) as an essential infrastructure that mutually benefits children, parents, families, staff, and the community. Findings support existing evidence regarding the broader impacts of child care and further investigation into the role of child care. We highlight the potential need for further investments in policies, resources, and supports for child care that reflects its essentialness and generative role.

Understanding SNAP Recipient Characteristics to Guide Equitable Expansion of Nutrition Incentive Programs in Diverse Food Retail Settings

Structural barriers, such as food costs, reduce access to healthy foods for populations with limited income, including those benefitting from the Supplemental Nutrition Assistance Program (SNAP). Nutrition incentive programs seek to address this barrier. Evaluations of SNAP-based incentive programming often focus on one setting (i.e., either farmers’ markets or grocery stores). We examined use patterns, characteristics, and preferences among 253 SNAP consumers with access to incentive programming at both a farmers’ market and a grocery store located within five miles of their home. Cross-sectional survey data were collected in 2019 in two Ohio cities. Despite geographic access, 45% of those surveyed were not using the incentive program;most non-users (80.5%) were unaware of the program. Program users compared to non-users had higher household incomes (p < 0.001) and knew more people using the program (p < 0.001). Grocery stores were the most common setting of use (59%);29% used at farmers’ markets;11% used in both settings. User characteristics varied by store setting based on demographics, program experience, fruit and vegetable purchasing and consumption patterns, and social dynamics related to use. Our findings support comprehensive awareness-raising efforts and tailored implementation of incentive programming that attends to diverse segments of SNAP consumers to promote equity in program reach.

Health outcomes in redlined versus non-redlined neighborhoods: A systematic review and meta-analysis.

BACKGROUND: Redlining was a racialized zoning practice in the U.S. that blocked fair access to home loans during the 1930s, and recent research is illuminating health problems in the current residents of these historically redlined areas. However, this work has not yet been holistically summarized. Here, we present the first systematic review and meta-analysis comparing health outcomes in redlined versus non-redlined neighborhoods in U.S. cities. METHODS: We extracted relevant articles in PubMed, Web of Science, Cochrane and Science Direct databases published from January 2010 to September 2021. RESULTS: The search revealed 12 studies on preterm births (n = 3), gunshot-related injuries (n = 2), cancer (n = 1), asthma (n = 1), self-rated health (n = 1), multiple health outcomes (n = 2), heat-related outcomes (n = 1) and COVID-19 incidence and mortality (n = 1). A meta-analysis of three studies found the odds of having preterm birth was significantly higher (OR = 1.41, 95% CI: 1.05, 1.88; p = 0.02) among women living in redlined areas compared to those in non-redlined areas. Review of other outcomes revealed that gunshot-related injuries, asthma, heat-related outcomes, and multiple chronic conditions were worse in redlined areas, while associations with cancer varied by cancer type. In terms of cause-specific mortality, one study revealed no link between residential redlining and infant mortality rate, while one study on COVID-19 outcomes was inconclusive. CONCLUSIONS: Overall, this review presents evidence that living in historically redlined areas is associated with increased risk of multiple serious adverse health outcomes. Further research on mechanisms, remediation, and neighborhood-level interventions is needed to strengthen the understanding of the impacts of redlining on health.

The effects of COVID-19-related stress among parents and children in Ohio child care programs: a mixed-methods study

COVID-19-related stress effects on the caregiver and child are largely unexplored. Caregivers (N = 114) of children between the ages of 3 months and 10 years accessing Ohio child care completed a parent survey (fall 2020), and additional caregivers (N = 20) completed an interview. Caregivers reported a mean of 70 (SD = 19;scale 1–100) on COVID-19-related stress. In adjusted regression models, higher caregiver-reported COVID-19-related stress was associated with increased odds of child aggression and poor social skills. Exploratory analyses indicated that these associations may be partly mediated by the caregiver working from home and losing their temper. Qualitative findings reflect caregiver COVID-19 stress and complement quantitative findings. Caregivers and children who experience COVID-19 stress should be monitored for persistent problems. [ABSTRACT FROM AUTHOR] Copyright of Children's Health Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)