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Identifying Threshold Levels of Structural and Process Quality

确定结构和过程质量的阈值水平

基本信息

批准号：
7591056
负责人：
Vi-Nhuan Le
金额：
$ 9.14万
依托单位：
RAND CORPORATION
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-04-01 至 2011-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7591056
关键词：
2 year old Academy Address Adopted Age American American Public Health Association Birth Caring Characteristics Child Child Care Child Development Cognitive Consensus Data Data Set Development Dimensions Education Employment Enrollment Hand Health Home environment Institute of Medicine (U.S.)Investments Joints Language Development Learning Literature Longitudinal Studies Love Measures Monitor National Institute of Child Health and Human Development National Research Council Outcome Outcome Measure Outcome Study Pediatrics Policies Process Provider Quality Indicator Quality of Care Reporting Research Statistical Methods System Training and Education cognitive function cohort cost early childhood emotional adjustment experience improved meetings parental involvement physical conditioning programs social social skills statistics teacher

项目摘要

DESCRIPTION (provided by applicant): The cumulative evidence of research on early childhood care and children's development consistently finds that higher-quality care is predictive of a range of positive developmental outcomes for children, including improved language development, cognitive functioning, social competence, and emotional adjustment. This has led many states to attempt to improve the availability of high quality early childhood care through a tiered quality rating system. Under this system, states define thresholds or cut-off points across various dimensions of quality, and provide different amounts of reimbursement to providers depending on their compliance with the quality standards. The literature provides little guidance to state policymakers as to where the thresholds should be set, as few studies have identified the specific cut off points or thresholds that can distinguish among different levels of child outcomes. Thus, it is unknown whether the cut off points established by state policymakers actually discriminate among better and worse child outcomes. This can raise fairness questions if providers receive different amounts of reimbursement for implementing different levels of quality, yet there are no differences in child outcomes. The purpose of this study is to provide some guidance to state policymakers about potentially optimal cut off points by using advanced statistical methods to identify the thresholds that must be exceeded before significant differences in child outcomes can be observed between providers that meet the established quality standards and providers that do not. It will also identify the points at which there are diminishing returns in quality investments. We will use data from the Cost, Quality, and Outcomes Study and the Early Childhood Longitudinal Study Birth Cohort through 2 years old, Restricted Use to examine threshold effects. We will examine various quality indicators, such as staff education and training, childstaff ratios, group size (i.e., the number of children in the class), ECERS/ITERS, and parental involvement. Children's social, cognitive, and physical health outcomes will serve as the outcome measures. The results of the study will give policymakers a better indication of which specific cut off points discriminate among different levels of child outcomes. This will help inform sensible approaches to differential reimbursement strategies.

描述（由申请人提供）：关于幼儿保育和儿童发展的研究的累积证据一致发现，更高质量的保育可以预测儿童的一系列积极发展成果，包括改善语言发展，认知功能，社交能力和情绪调整。这导致许多州试图通过分级质量评级系统来改善高质量幼儿保育的可用性。根据这一制度，各州在质量的各个方面确定了门槛或分界点，并根据供应商对质量标准的遵守情况向其提供不同数额的报销。文献几乎没有为国家政策制定者提供关于阈值应设置在何处的指导，因为很少有研究确定了可以区分不同儿童结局水平的具体截止点或阈值。因此，目前还不清楚国家政策制定者建立的分界点是否真的区分了更好和更差的儿童结果。如果提供者因实施不同质量水平而获得不同金额的报销，但儿童结果没有差异，这可能会引起公平问题。本研究的目的是提供一些指导，以国家政策制定者潜在的最佳截止点，通过使用先进的统计方法，以确定必须超过的阈值之前，可以观察到显着差异的儿童结果之间的供应商，满足既定的质量标准和供应商，不。它还将确定优质投资回报递减的点。我们将使用来自成本、质量和结局研究以及儿童早期纵向研究出生队列至2岁的数据，限制使用，以检查阈值效应。我们将审查各种质量指标，如工作人员的教育和培训，儿童工作人员的比例，团体规模（即，班级中的儿童人数）、ECERS/ITERS和家长参与。儿童的社会，认知和身体健康结果将作为结果的措施。这项研究的结果将使决策者更好地了解哪些具体的分界点区分不同程度的儿童成果。这将有助于为差别补偿战略的合理做法提供信息。