Suspension and expulsion in Colorado early care and education settings: Child, program, and community-level predictors.

Expulsion presents a significant risk in Early Care and Education (ECE) settings due to its association with early disadvantage and frequency of use. A statewide survey was conducted to characterize ECE suspension and expulsion (S/E) in Colorado. Child, program, and community-level factors were examined as predictors of S/E, alongside preventative intervention supports capable of reducing S/E. Six hundred and sixty three licensed child care programs participated in the survey, providing information on 19,848 enrolled children, 312 suspensions, and 74 expulsions. A series of multilevel hierarchical regressions were conducted, examining predictors for S/E. Children with IEPs/IFSPs were disproportionately suspended; 2-3-year-olds were disproportionately expelled; and boys, 5-6-year-olds, and children with disabilities were disproportionately suspended and expelled. Center-based programs, lower quality ratings, and "zero tolerance" policies predicted greater use of suspension. In contrast, school-district affiliation and knowledge of how to access infant and early childhood mental health consultation (IECMHC) decreased suspension. Lower levels of regional child poverty predicted higher use of expulsion. Affiliation with a school-district, IECMH consultant-led training, and use of quality coaches predicted decreased expulsion. This study identifies the need for ongoing protection for children with IEPs/ IFSPs and the preventative interventions that mitigate risk for S/E.

Introducción. La expulsión presenta un riesgo significativo en el marco del Temprano Cuidado y Educación (ECE) debido a su asociación con tempranas desventajas y la frecuencia de uso. Una encuesta a nivel estatal se llevó a cabo para caracterizar la suspensión y expulsión de ECE (S/E) en Colorado. Asuntos relacionados con el niño, el programa y de nivel comunitario se examinaron como factores de predicción de (S/E), junto con apoyos de intervención para prevenir, capaces de reducir S/E. Métodos. Participaron en la encuesta 663 programas de cuidado infantil autorizados, lo cual aportó información sobre 19,848 niños matriculados, 312 suspensiones y 74 expulsiones. Se llevó a cabo una serie de regresiones jerárquicas de niveles múltiples, examinando así los factores de predicción de S/E. Resultados. A los niños con participación en programas o planes IEP/IFSP se les suspendió de manera desproporcionada; niños entre los dos y tres años fueron desproporcionalmente expulsados; y varones de cinco a seis años, y niños con discapacidades fueron desproporcionalmente suspendidos y expulsados. Los programas con base en un centro, los más bajos puntajes de evaluación de la calidad y las políticas de 'tolerancia cero' predijeron el mayor uso de la suspensión. En contraste, la afiliación a un distrito escolar y el conocimiento de cómo tener acceso a la consulta de salud mental infantil y la temprana niñez (IECMHC) redujo las suspensiones. Los más bajos niveles de pobreza regional de niños predijeron el más alto uso de la expulsión. La afiliación a un distrito escolar, el entrenamiento de consultores de IECMH, así como el uso de entrenadores calificados predijeron una reducción de las expulsiones. Conclusiones. Este estudio identifica la necesidad de una continuada protección para niños en programas o planes IEP/IFSP y las intervenciones de prevención que mitigan el riesgo de S/E.

INTRODUCTION: L'expulsion présente un risque important pour les contextes de Soins Précoces et Education (en anglais Early Care and Education, abrégé ici ECE) du fait de son lien à un désavantage précoce et la fréquence de l'utilisation. Un sondage au niveau de l'état a été fait afin de caractériser la suspension ECE et l'expulsion (S/E) dans l'état du Colorado aux Etats-Unis. L'enfant, le programme et les facteurs aux niveau de la communauté ont été examinés en tant que facteurs de prédiction de la (S/E), en parallèle avec des soutiens d'une intervention préventive capable de réduire la S/E. Méthodes. 663 programmes de crèches accréditées ont participé au questionnaire, offrant des renseignements sur 19848 enfants inscrits, 312 suspensions et 74 expulsions. Une série de régressions hiérarchiques à niveaux multiples a été faite, examinant les facteurs de prédiction pour la S/E. Résultats. Les enfants avec des plans IEP/IFSP (Plan d'Enseignement Individualisé/Plan Individualisé de Service à la Famille) ont été suspendus de manière disproportionnée ; les enfants de deux à trois ans ont été expulsés de manière disproportionnée, et les enfants avec des handicaps ont été suspendus et expulsée de manière disproportionnée. Les programmes centres (centrés sur une condition), les cotes de qualité inférieure et les politiques de « zéro tolérance ¼ ont prédit une plus grande utilisation de la suspension. Par contre, l'affiliation à un district académique et des connaissances sur la manière d'accéder à la consultation de santé mentale du nourrisson et de la petite enfance (IECMHC) ont fait décroître le taux de suspension. Des niveaux plus bas de pauvreté de l'enfant régionale ont prédit une utilisation plus élevée de la suspension. L'affiliation à un district académique, la formation faite par un consultant IECMH et l'utilisation de formateurs de qualité ont prédit une expulsion moins élevée. Cette étude identifie le besoin de protection continue des enfants avec des plans IEP/IFSP et d'interventions préventives qui mitigent le risque de S/E.

Evaluating a train-the-trainer approach for improving capacity for evidence-based decision making in public health.

BACKGROUND: Evidence-based public health gives public health practitioners the tools they need to make choices based on the best and most current evidence. An evidence-based public health training course developed in 1997 by the Prevention Research Center in St. Louis has been taught by a transdisciplinary team multiple times with positive results. In order to scale up evidence-based practices, a train-the-trainer initiative was launched in 2010. METHODS: This study examines the outcomes achieved among participants of courses led by trained state-level faculty. Participants from trainee-led courses in four states (Indiana, Colorado, Nebraska, and Kansas) over three years were asked to complete an online survey. Attempts were made to contact 317 past participants. One-hundred forty-four (50.9 %) reachable participants were included in analysis. Outcomes measured include frequency of use of materials, resources, and other skills or tools from the course; reasons for not using the materials and resources; and benefits from attending the course. Survey responses were tabulated and compared using Chi-square tests. RESULTS: Among the most commonly reported benefits, 88 % of respondents agreed that they acquired knowledge about a new subject, 85 % saw applications for the knowledge to their work, and 78 % agreed the course also improved abilities to make scientifically informed decisions at work. The most commonly reported reasons for not using course content as much as intended included not having enough time to implement evidence-based approaches (42 %); other staff/peers lack training (34 %); and not enough funding for continued training (34 %). The study findings suggest that utilization of course materials and teachings remains relatively high across practitioner groups, whether they were taught by the original trainers or by state-based trainers. CONCLUSIONS: The findings of this study suggest that train-the-trainer is an effective method for broadly disseminating evidence-based public health principles. Train-the-trainer is less costly than the traditional method and allows for courses to be tailored to local issues, thus making it a viable approach to dissemination and scale up of new public health practices.

A standardized reporting system for assessment of diverse public health programs.

State public health agencies face challenges when monitoring the efforts and effects of public health programs that use disparate strategies and address various diseases, locations, and populations. The external evaluators of a complex portfolio of grant funding sought a standardized reporting framework and tool that could be used for all grants in the portfolio, without having to redesign it for each disease or intervention approach. Evaluators iteratively reviewed grant-funded projects to identify common project delivery strategies, then developed and implemented a common reporting framework and spreadsheet-based data capture tool. Evaluators provided training, technical assistance, and ongoing data reviews. During 2 fiscal years, 103 public health programs throughout Colorado submitted quarterly reports; agencies funded to implement these programs ranged from small community-based organizations to university- and hospital-affiliated groups in urban and rural settings. Aggregated reports supported estimates of program reach by strategy and by disease area, and the system supported production of summary descriptions of program implementation. Standardized language and expectations for reporting helped to align grant applications and work plans with reporting tools. A common language and standardized reporting tool can be used for diverse projects in a comprehensive evaluation framework. Decentralized data collection using common spreadsheet software enabled the aggregation of common data elements across multiple programs and projects. Further refinements could enable wider dissemination of common reporting criteria and expectations.