Barriers to the implementation of continuity-of-care practices in child care centers

This study examined barriers to the implementation of continuity-of-care practices in child care centers. We collected qualitative and quantitative data for 52 children at four centers that advertise their programs as continuity programs. Of the 52 children, only 7 of the children had been cared for in a single child–caregiver dyad between the time of their entry into child care and either their third birthday or the time of data collection. During their infant–toddler period, the remaining 45 children had experienced 71 cumulative transitions to new child–caregiver dyads. We found that the barrier frequently suggested in the literature and by practitioners, caregiver turnover, was not a significant cause for the non-continuity transitions. The primary barrier that we found was infant caregiver unwillingness or inability to care for children who had developed toddler abilities. A secondary barrier was directors’ reluctance to replace unwilling or unable caregivers with willing and able ones.     

Head Start and child care providers’ motivators,barriers and facilitators to practicing family-style meal service

This paper presents a qualitative investigation of the motivators, barriers, and facilitators for practicing family-style meal service (FSMS) from the perspective of 18 child care providers serving preschool children in Head Start (HS), Child and Adult Care Food Program (CACFP) funded, and non-CACFP child-care centers. Providers were selected based on maximum variation purposive sampling and semi-structured interviews were conducted until saturation was reached. Provider responses were systematically coded using thematic analysis. HS and CACFP providers reported being motivated to practice FSMS because it created pleasant mealtimes, opportunities to role model healthy eating, and healthful child development. CACFP and non-CACFP providers reported not using FSMS because it was resource intensive, messy, and seemed to violate CACFP policy. HS and CACFP providers offered suggestions to overcome these barriers. They suggested that FSMS eventually becomes easier with practice, children can self-regulate their energy intake, and teaching children self-help skills during play time can avoid messes during mealtimes. Findings from this study have implications for programming, policy, and research.     

Assessing the Development of Young Children in Child Care: A Survey of Formal Assessment Practices in One State

With the current emphasis on program accountability and appreciation of the importance of early learning and timely identification of delays, early childhood developmental assessment in child care centers is crucial. In Florida, a state that supports local control of child assessment decisions, counties were surveyed to determine the specific tools and formal assessment procedures for children birth to 5 in subsidized child care. Sixty-one counties responded for a 91% return rate. Survey results were examined according to experts’ recommendations for best practices in child assessment. Most counties used multiple tools to assess multiple domains of child development with age-appropriate instruments. Many did not involve parents in the assessment process or use tools connected to the child care curriculum. The survey results underscore the complexity of implementing assessment systems for young children in child care.     

Children’s Perspectives on Their Everyday Lives in Child Care in Two Cultures: Denmark and the United States

The purpose of this study was to investigate young children’s perspectives related to their experiences in child care. Researchers used individual interviews and drawings in an early childhood program in Denmark and one in the United States as the basis for examining children’s perspectives on their everyday lives in child care. Observations documented the everyday cultural practices for the children in the two child care centers and provided a foundation for interpreting the interviews and the drawings. The information collected was analyzed to determine what aspects of child care young children like best and least, as well as their thoughts on the adults and peers in their center.     

Action groups as a participative strategy for leading whole-school health promotion: Results on implementation from the INCLUSIVE trial in English secondary schools

Education policy increasingly promotes action groups as a key strategy for student and/or staff participation in school improvement and whole-school health promotion. Such groups can coordinate multi-component interventions, increase participation and engagement, and enable local adaptations, but few process evaluations have assessed this. We evaluated fidelity, feasibility and acceptability of action groups as part of a trial of a whole-school intervention to reduce bullying and aggression and promote health in English secondary schools, which reported multiple health and educational impacts. Action groups involved students and staff, supported by external facilitators, and drew on data on student needs. They aimed to: coordinate implementation of restorative practices and a social and emotional competencies curriculum; review policies and rules; and enact local decisions to modify school environments. Our process evaluation used interviews, focus groups, observations and questionnaires to assess action groups’ fidelity, role in coordination, role in local adaptation, support from external facilitators and data on student needs, and acceptability in engaging members. Fidelity was high in the first two years but lower in the third year when external facilitators withdrew. Student needs data were perceived as useful, but views on external facilitators were mixed. Groups successfully reviewed policies and rules, planned activities and coordinated restorative practices, but were less successful in implementing the curriculum. Success was facilitated by the involvement of school leaders. Members reported high satisfaction and empowerment. Action groups are a promising strategy for leading whole-school health promotion. Implementation is supported by external facilitation, local data and involvement of senior managers.     

Design,implementation and evaluation of school-based sexual health education in sub-Saharan Africa: a qualitative study of researchers’ perspectives

This study investigated facilitators and challenges to designing, implementing and evaluating school-based sexual health education in sub-Saharan Africa, using interviews with intervention designers and researchers. At the pre-planning and planning stages, participants reported that facilitating factors included addressing the reproductive health needs of participants, contextual (culture, religion, economic and social) considerations and the adoption of holistic approach to sexuality education. Lack of open communication about sexual health matters between young people and adults; concerns that sexual health education could encourage sexual activity; and inadequate funding, were key barriers. Implementation was facilitated by the involvement of relevant stakeholders, the training of facilitators and adopting strategies to overcome resistance to sexual health education. The provision of structured, detailed lessons plans and monitoring with supportive supervision optimised fidelity of delivery. Barriers to implementation included facilitators’ resistance to teaching safe sex promotion and logistical challenges in school environments. Participants also reported that the validity of self-reported adolescent sexual behaviour (as part of evaluation) may be improved by complementing well-designed self-report surveys with computerised audio devices for data collection, qualitative interviews and participant observation. Study findings generate recommendations to improve future forms of school-based sexual health education in sub-Saharan Africa.     

‘You’re 18 now,goodbye’: the experiences of young people with attention deficit hyperactivity disorder of the transition from child to adult services

The term ‘transition’ is used to refer to the process of moving from child to adult services. Among child and adolescent mental health services attenders, young people with Attention Deficit Hyperactivity Disorder (ADHD) are less likely to transition successfully, but there is a gap in understanding their views and why they might disengage from services. The aim of this study was to explore the experiences of transition of young people with ADHD in Southwest England using semi-structured interviews and thematic analysis. Seven young people aged 17–19 years participated. Four key themes were identified: professionals’ roles and relationships with young people; the role of ADHD medication, uncertainties around transition and medication management, and identified needs and increasing independence. Although this study presents the experiences of a small number of people, their stories suggest that best practice around transition is not always being followed. There is consequently a need to better understand the facilitators and barriers to best practice implementation.     

What difference could in-service training make? Insights from a public school of Pakistan

In-service courses have been used as a common strategy to build the capacity of teachers to meet the constantly changing demands of modern schooling. But how the teachers implement the ideas and strategies acquired from such in-service training and what conditions influence the implementation process is the least examined area in Pakistan, especially in the rural context. Using a case study approach, the current study explored the possibilities and challenges of implementing strategies, learnt through in-service training, in a public school in rural Pakistan. It was found that in-service courses have a positive impact upon the attitude and practices of the trainee teacher. However, due to various structural and cultural barriers, the teacher is not able to implement many of the strategies and ideas in the school context. The hierarchical structure of schools, teachers’ workload, lack of resources and insufficient support from colleagues and management hinder the process of implementation. The study suggests that in-service training should provide the trainees with ideas and skills to cope with the structural and cultural challenges at school. Moreover, ongoing support and encouragement from colleagues, course facilitators and management is required to sustain the implementation of strategies learnt during training.     

Implementing New York's Universal Pre-Kindergarten Program: An Exploratory Study of Systemic Impacts

This exploratory study examined the impacts of New York's Universal Pre-kindergarten (UPK) program as perceived by directors at child care centers and preschools not receiving state funds. Although only partially implemented, UPK's mixed-delivery system grants monies to a substantial number of qualifying community-based early care and education centers, resulting in a funding imbalance between participating and nonparticipating centers. Phone interviews were conducted with the directors of non-UPK programs across New York State (N = 46). Quantitative and qualitative analyses suggest perceived decreases in 4-year-old and total enrollment and increased teacher recruitment difficulty and competition for teachers since UPK was introduced. Larger centers and those offering full-day programming more often reported changes in teacher recruitment and retention than smaller centers and those offering part-day programming only. Implications for state pre-K policy are discussed.     

Social capital and geography of learning: Roles in accelerating the spread of integrated pest management

This paper aims to show the relevance of spatial proximity and social capital in accelerating the spread of agricultural technologies such as integrated pest management (IPM). The research was done in response to the problem of slow diffusion of agricultural technologies. Both quantitative and qualitative methods were used in investigating the process of sharing and learning of IPM. Results show that social capital in terms of kin networks and spatial proximity such as found among farm neighbours are essential in the learning process and hence, diffusion of IPM among Filipino farmers. Kin networks and farm location are then important considerations in sampling participants strategically for the long-season IPM farmer field schools (FFS).     

Implementing New York's Universal Pre-Kindergarten Program: An Exploratory Study of Systemic Impacts

This exploratory study examined the impacts of New York's Universal Pre-kindergarten (UPK) program as perceived by directors at child care centers and preschools not receiving state funds. Although only partially implemented, UPK's mixed-delivery system grants monies to a substantial number of qualifying community-based early care and education centers, resulting in a funding imbalance between participating and nonparticipating centers. Phone interviews were conducted with the directors of non-UPK programs across New York State (N = 46). Quantitative and qualitative analyses suggest perceived decreases in 4-year-old and total enrollment and increased teacher recruitment difficulty and competition for teachers since UPK was introduced. Larger centers and those offering full-day programming more often reported changes in teacher recruitment and retention than smaller centers and those offering part-day programming only. Implications for state pre-K policy are discussed.     

Serving Children With Special Social and Emotional Needs: A Practical Approach to Evaluating Prevention Programs in Schools and Community Settings

Prevention programs for young children are becoming more prevalent in schools and community centers. Practical evaluation methods are needed that can inform program design and implementation as well as assess a program's overall success. An evaluation model is presented that provides both program process and outcome information. The institutional and program conditions supportive of this type of evaluation and the limitations of this approach are discussed. A case example illustrates practical issues related to designing and implementing evaluations for prevention group projects for young children at risk for child abuse and neglect. Implications for educational and psychological consultation are discussed.     

Older Adult Participation in Health Promotion Programs: Perspectives of Facility Administrators

Administrators of older adult-centered facilities must identify barriers to the planning and implementation of health promotion programs. In this qualitative research those barriers were identified through in-depth interviews with administrators of older adult-centered facilities. As identified by administrators, the predominant barriers to the participation of older adults in health promotion programs were scheduling conflicts, physical and mental health issues, a lack of comfort with the health content, and insufficient program information.     

Classroom teachers’ experiences implementing a movement integration program: Barriers,facilitators, and continuance

This study was designed to qualitatively examine fifteen classroom teachers' experiences in implementing a movement integration (MI) program, TAKE 10!^®, using the comprehensive school physical activity program framework. Data were collected through observations, semi-structured interviews, and questionnaires. Barriers to MI implementation included time and space constraints, whilst facilitators were gaining knowledge during training and developing competencies through experience. Reasons for program continuance included scheduling MI into weekly routines, children's request for the program, and collaboration among teachers. Suggestions for teachers' professional development related to MI are provided in view of the study's findings.     

Qualitative Investigation of RtI Coaches Roles,Responsibilities, and Experiences Supporting Schools Participating in a State Level RtI Implementation Project

ABSTRACT

Systems coaching is a professional development approach focusing on the implementation fidelity of evidence-based practices and whole school reform efforts such as Response to Intervention (RtI). However, the roles, responsibilities, and supports required by systems coaches, and how the work of those tasked with facilitating capacity for RtI implementation manifests within complex and multifaceted school environments remains unclear. The purpose of the current exploratory study was to investigate coaches’ perspectives and experiences related to RtI implementation to illustrate systems coaching in context. Ten coaches providing job-embedded support for RtI implementation across 34 schools in one state participated in semi-structured interviews. A constant-comparative and matrix analysis approach was used to generate codes and themes. Results indicated systems coaches experience a number of systemic and contextually dependent facilitators and barriers to their work, providing implications for RtI coaches’ preparation, ongoing support, and current practices, as well as directions for future research.     

Bridge over troubled water: using implementation science to facilitate effective services in child welfare

To maximize benefits to children and their families, effective practices need to be used competently in child welfare settings. Since the 1990s, researchers and policy makers have focused attention on empirically supported interventions (ESIs). Much less attention has been paid to what is needed to implement these in a range of real-world settings. Without proper implementation, which includes an evaluation strategy from feasibility to fidelity to on-going work on moderators and mediators of program effects, established effective programs can be rendered ineffective in practical application. The paper will touch on progress, to date, of implementation science, its application to child welfare programs and practices, and will highlight a set of practical strategies for implementing empirically supported interventions in child welfare.     

Longitudinal reading outcomes in response to a book-based,whole class intervention for students from diverse cultural,linguistic and socio-economic backgrounds

A learning disabilities coping program was implemented in the final year of two primary schools within the context of a whole class coping program and whole school learning disabilities professional development. Using data collected over three years from school surveys, reports, interviews, school documents and a field diary, this paper reports on the feasibility of implementing and sustaining this intervention. The schools successfully implemented the program and continue to use components of it. Facilitators were: priority given by the school, usefulness and ease of use of the coping program, teacher skill and interest and maintenance of the connection between the universal and withdrawal aspects of the program. It is likely there is a need for increased presence of the above facilitators for continued implementation of all components of the intervention to be sustained.     

A small-scale randomized efficacy trial of Carescapes: Enhancing children’s social development in child care homes

The quality of the child care environment and caregiver practices can potentially have significant, lasting impact on children’s social development. This study involves the development and a small-scale efficacy trial of the Carescapes program, a video-based training program that focuses on promoting positive social development in young children attending family child care. Fifty-seven caregivers who provided child care in their homes were randomly assigned to immediate intervention or waitlist control groups. Random coefficients analyses showed significant increased use of effective behavior management practices and decreased overall children’s problem behavior for the intervention group. A mediation model demonstrated that increases in effective behavior management practices were associated with decreases in problem behavior. A medium intervention effect was found for caregiver’s monitoring and a small effect for use of positive attention. These effects declined 5 months following the intervention. Implications for future efficacy and effectiveness studies in family child care settings that involve strategies to facilitate maintenance are discussed.