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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Unnecessary child care exclusions in a state that endorses national exclusion guidelines.
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Unnecessary child care exclusions in a state that endorses national exclusion guidelines.

机译：在认可国家排除指南的州，不必要的儿童排除在外。

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OBJECTIVE: No study has evaluated the association between state endorsement of American Academy of Pediatrics (AAP) and American Public Health Association (APHA) national guidelines and unnecessary exclusion decisions. We sought to determine the rate of unnecessary exclusion decisions by child care directors in a state that endorses AAP/APHA guidelines and to identify factors that are associated with higher unnecessary exclusion decisions. METHODS: A telephone survey was administered to directors in metropolitan Milwaukee, Wisconsin. Directors were randomly sampled from a list of 971 registered centers. Director, center, and neighborhood characteristics were obtained. Directors reported whether immediate exclusion was indicated for 5 vignettes that featured children with mild illness that do not require exclusion by AAP/APHA guidelines. Weighted data were summarized by using descriptive statistics. Regression analysis was used to identify factors that were associated with directors' exclusion decisions. RESULTS: A total of 305 directors completed the survey. Overall, directors would unnecessarily exclude 57% of children. More than 62% had never heard of the AAP/APHA guidelines. Regression analysis showed fewer exclusions among more experienced compared with less experienced directors, among larger centers compared with smaller centers, and among centers that were located in areas with a higher percentage of female heads of household. Centers with < or =10% children on state-assisted tuition excluded more. CONCLUSIONS: High rates of inappropriate exclusion persist despite state endorsement of AAP/APHA guidelines. Focused initial and ongoing training of directors regarding AAP/APHA guidelines may help to reduce high rates of unnecessary exclusions.
机译：目的：尚无研究评估美国儿科学会（AAP）的国家认可与美国公共卫生协会（APHA）的国家指南与不必要的排除决定之间的关联。我们试图确定在认可AAP / APHA指南的州，儿童保育主任做出不必要的排除决定的比率，并确定与更高的不必要排除决定相关的因素。方法：对威斯康星州密尔沃基市的董事进行了电话调查。从971个注册中心的列表中随机抽取了董事。获得了导演，中心和社区特征。执董们报告说，是否有5个小插曲被立即排除，这些小插曲的特征是轻度疾病的儿童不需要按照AAP / APHA准则进行排除。加权数据通过使用描述性统计进行汇总。回归分析用于确定与董事排除决策相关的因素。结果：共有305位董事完成了调查。总体而言，导演会不必要地排除57％的儿童。超过62％的人从未听说过AAP / APHA指南。回归分析显示，与经验不足的导演相比，经验更丰富的导演，较大的中心与较小的中心以及位于女户主比例较高的地区的中心之间的排斥较少。子女少于或等于10％的中心接受国家资助的学费更多。结论：尽管州政府认可了AAP / APHA指南，但仍存在较高的不当排斥率。对董事进行有关AAP / APHA准则的有针对性的初步和持续培训可能有助于减少不必要的排除率。

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