Child care health consultation: the Connecticut experience.

OBJECTIVES: The quality of child care is of increasing national concern. Federal initiatives are recommending child care health consultation to promote healthy, safe, and developmentally appropriate care. However, few studies have investigated the implementation of this recommendation. The purpose of this study was to explore the experience of Connecticut child care center directors and their health consultants who were engaged in mandated, weekly, on-site health consultation. METHODS: One hundred Connecticut child care center directors and their health consultants participated in a mailed, self-administered survey. The centers were stratified by region and selected by random probability sampling. Descriptive analyses of the data examined the perspectives of both groups. RESULTS: Eighty-four percent of the child care center directors reported that health consultation visits were important or very important for the management of their programs. Eighty-one percent of the health consultants believed that their directors considered the visits important or very important. The reported tasks of the health consultants were consistent with regulatory requirements. Cost was cited as a factor that negatively influenced access to services by at least 37% of the director sample. Demographics of the sample, description of the role, and recommendations by directors and health consultants are included. CONCLUSIONS: Health consultation visits were highly valued among this sample as an effective means of promoting children's health and development in child care centers. Future initiatives should promote child care health consultation through training, infrastructure development, and funding of health consultation services.