Health Consultation Services to Family Day Care Homes in Minneapolis, Minnesota

By Lie, Letty | Journal of School Health, January 1992 | Go to article overview

Health Consultation Services to Family Day Care Homes in Minneapolis, Minnesota


Lie, Letty, Journal of School Health


Increased attention to health and safety issues in day care centers in evident in recent literature.[1-11] However, little data are available regarding health consultation services to family day care homes, which provides child care to most children below school-age in group settings outside the home.[12,13] The Minneapolis Health Dept., providing health consultation services to day care centers since 1969, presently has five public health nurses conducting health consultation and training for center-based child day care programs in Minneapolis. A need existed for similar services for family day care programs, and in 1985 the Minneapolis Health Dept. initiated such a program.

Two main objectives of the family day care program were 1) determine the needs of the family day care providers, and 2) inform providers of public health nursing services. To accomplish the first objective, public health nurses attended family day care neighborhood group meetings seeking input about needed services. A survey requesting information on services was distributed at workshops and other family day care meetings. Public health nurses also spent time observing in family day care homes. Information about availability of public health nursing services was disseminated through the media, including appropriate newsletters and a local radio station. A slide-tape presentation describing services was developed for the family day care licensing agency to be shown to newly licensed providers. Flyers also were distributed to family day care providers. Given this outreach and data collection, it was decided to begin providing services to family day care providers in three areas:

General Health Consultation. A major role of family day care public health nurses involves providing health consultation to individual providers via telephone calls and home visits as appropriate. During the program's first year, nurses recorded the number of telephone calls they received related to family day care issues. Calls increased from 31 during the program's first month to 177 calls per month six months later. Most calls related to training requests and infection control issues. Home visits to family day care providers were offered when the nurse determined the service was needed.

Health and Safety Consultation. Home visits are offered to all licensed family day care providers to discuss health and safety issues in their family day care setting. Through discussion and observation of health and safety practices, the family day care provider receives suggestions for improving these areas. Though many health areas are addressed during the visit, special attention is given to four areas: diapering procedures, completion of first aid training, sick care policies, and hot water temperature. Participants receive a form with written recommendations following the visit.

Between 1985 and June 1989, all licensed family day care providers were contracted by letter and telephone and offered a home visit; 336 (39%) agreed to participate. A return visit was offered to check on follow-up of recommendation. Of those available, (49% were no longer providing family day care and five had moved from the area), 65% agreed to a second visit. Of those visited, 77% showed improvement over the first visit in one or more of the following areas: improving sanitation aspects of diapering procedures, lowering hot water temperature to 120 [degrees] F or lower, completing a first aid course, or showing improvement in written policies to provide care for sick children.

Group Training. Health education classes for family day care providers are taught on various topics. In the program's first year, public health nurses taught 14 classes for 241 family day care providers on such topics as infectious diseases, diapering safety, and childhood stress. An additional 192 family day care providers attended the agencies' day-long first aid courses.

Health education classes were organized for preschoolers in family day care homes. …

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