Potential Correlates of Child Injuries in Child Care Centers

This RIKINotes Post will provide a glimpse at a larger study involving an eastern state with exploring the relationship between child injuries in childcare centers and other regulatory compliance and demographic characteristics.  Regulatory compliance does not have many empirical demonstrations of outcome studies in determining if children are healthier and safer in childcare centers.  This post will attempt to begin to provide some guidance related to this question.   

The key variables in this study are the following: child injuries, complaints, program size, and regulatory compliance.  Child injuries are the outcome variable, what we are trying to impact via a reduced rate.  Complaints, program size and regulatory compliance are the independent variables that were collected by the respective state where this study is being conducted.  The number of programs reported upon in this abstract is 200.  The final study will involve over 400 childcare center programs.  However, the results in reviewing the first 200 programs are so statistically significant that it warranted sharing the results to date.  It is definitely something that all licensing and regulatory staff need to be looking at.

The results show some very interesting relationships.  For example, and this should not be overly surprising, there is not a very strong relationship between child injuries and overall regulatory compliance.  When you think about overall regulatory compliance, some rules could influence child injuries directly, such as overall supervision, group size, staff child ratios and the overall safety of the childcare center; but when you think of the other rules that make up regulatory compliance involving structural, or record documentation compliance, there is not as direct a relationship.  However, it is this more targeted rule identification that does have an effect, and this is very evident when one begins to look at the series of complaints and its relationship to child injuries (r = .20; p < .005). 

The strongest predictor of child injuries is not regulatory in nature but more demographic related to the size of the program.  Child injuries generally occur in larger childcare centers rather than in smaller centers (r = .41; p < .0001).  So, it appears that we really want to pay attention to the size of the childcare center, especially if the program has an enrollment of over 100 children.  And again, this makes sense in that the larger the center and the more children to supervise would provide greater opportunities for child injuries to occur. Remember that these data demonstrate relationships and are not cause and effect.

This brief RIKINote post is presented in the interest of attempting to get additional empirical evidence in the research literature related to regulatory compliance outcomes.  So far in this pilot study, it is demonstrating that overall regulatory compliance is not significantly related to preventing child injuries, but specific, targeted rules based upon the number of complaints have a significant relationship between child injuries and these complaints.  This is consistent with the theory of regulatory compliance in which it is finding the deep-rooted cause structure when it comes to regulatory compliance rather than a more generic regulatory compliance level.  This pilot study is being expanded to include all the childcare centers in the particular state and to expand the study to other jurisdictions to determine if these same relationships hold up under greater scrutiny.  Also, diving into family child care homes should provide an interesting comparison to center care.

At this point, the takeaway I would hope for licensing and regulatory staff is that the overall size of the center and the number of complaints demonstrate a statistically significant relationship to the number of child injuries at those respective child care centers. For any licensing or regulatory staff who have questions about this outcome study or would be interested to share their experiences related to child injuries in their particular jurisdiction, please reach out to Dr Fiene at RFiene@RIKInstitute.com.