Just 7% of child care centers have taken steps to prepare for an influenza pandemic, and the rate increased only slightly after the 2009 H1N1 flu pandemic, a new study found.
Future efforts “should focus on increasing awareness and knowledge of pandemic influenza by developing more effective ways of distributing information and conducting training,” authors said in the study “Pandemic Influenza Preparedness Among Child Care Center Directors in 2008 and 2016,” (Shope TR, et al. Pediatrics. May 15, 2017, https://doi.org/10.1542/peds.2016-3690.
Roughly 25% of U.S. children under 5 years attend facilities such as child care centers, preschools or Head Start, according to the U.S. Census Bureau, and they tend to share germs in addition to toys.
To determine whether such facilities were prepared to handle an influenza epidemic, a multidisciplinary group that included AAP staff surveyed more than 2,000 child care center directors. The telephone surveys were conducted in 2008 and 2016, capturing preparedness before and after the 2009 H1N1 novel influenza pandemic. The questions covered six areas — general infection control, communication, seasonal influenza control, use of health consultants, quality of child care and perceived barriers.
The team found just 7.2% of the directors in 2008 had made preparation efforts through actions like using a checklist, developing a written plan, holding staff trainings or receiving assistance from a child care resource. In 2016, the number rose just slightly to 7.6%
Directors also were given a pandemic influenza preparedness (PIP) score based on how concerned they were about a pandemic, whether they had ever been contacted about one, if they or their staff had been involved in planning and if they felt their center was ready. The average score was 1.16 in both years on a scale of 0-4.
In a multiple regression analysis of the 2008 data, greater use of health consultants, directors’ years of experience and being a Head Start program were significantly associated with higher PIP, while greater perception of barriers was associated with lower PIP. In 2016, higher average attendance and directors’ years of experience both were linked with higher PIP.
After adjusting for covariates, the directors’ experience, perceived barriers and use of a child care health consultant proved to be the top predictors of PIP in both years, according to the study.
The authors recommended training child care center directors through webinars and health consultants. They also suggested policymakers consider requiring such training and that pediatricians direct families and directors to Centers for Disease Control and Prevention resources.
“In summary, pandemic influenza is a potentially devastating global health event, and young children in child care centers are a vulnerable group that can augment the spread of pandemic influenza into the community,” according to the study. “Therefore, it is important to have strategies in place for mitigating pandemic influenza in these settings.”
