Exploring the supportiveness and preparedness of child care settings for children with asthma: a needs assessment.

BACKGROUND: The role of child care centers has increased to extreme importance as the majority of young children are in some form of child care setting. Child care centers are increasingly faced with providing health-related care to children with asthma. PURPOSE: The purpose of this study was to examine child care workers' perceived knowledge and confidence and their perceptions of their child care setting's preparedness to handle asthma-related issues. Methods. The study used a cross-sectional postal survey design that followed a modified Dillman's protocol. Questionnaires were sent to staff in 235 randomly selected child care centers across four Ontario public health regions. The questionnaire assessed several asthma-related areas: identifying and caring for children with asthma, emergency plans for asthma, and confidence in ability to handle asthma-related issues. RESULTS: A total of 489 (69% overall response rate) questionnaires were returned and 180 centers (76.6%) of the 235 child care centers participated. Most child care workers (67%) cared for a child with asthma, but only 21% ever received formal training on caring for a child with asthma. When asked about having an emergency plan for a child having an asthma flare-up/attack, 52.3% of the workers reported that their center lacked such a plan or they were unaware of it. Many (45%) reported feeling uncertain about how to manage worsening asthma. The area of trigger identification and management was also an issue regarding child center preparedness: 43.6% of centers had a plan or process and 48% of staff felt uncertain of their abilities in this area. Child care workers who reported receiving formalized training were more likely to have higher confidence scores in their ability to handle asthma-related issues compared with those who did not receive training in many areas. CONCLUSIONS: Gaps in asthma care preparedness exist within the child care system. The provision of formalized learning opportunities is one strategy that could narrow these gaps.