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的发展成果，包括改善语言发展、认知功能、社交能力和情绪调整。这导致许多州尝试通过分级质量评级系统来提高高质量幼儿保育的可用性。在该系统下，各州定义了各个质量维度的阈值或截止点，并根据提供者对质量标准的遵守情况向其提供不同金额的补偿。文献几乎没有为国家政策制定者提供关于阈值设定的指导，因为很少有研究确定可以区分不同水平的儿童结局的具体分界点或阈值。因此，尚不清楚国家政策制定者设立的分界点是否真的区分了更好和更差的儿童结局。如果提供者因实施不同质量水平而获得不同金额的报销，但儿童的结果没有差异，这可能会引发公平问题。本研究的目的是通过使用先进的统计方法来确定必须超过的阈值，然后才能在满足既定质量标准的提供者之间观察到儿童结果的显着差异，从而为州政策制定者提供有关潜在最佳截止点的一些指导。不这样做的提供商。它还将确定优质投资回报递减的点。我们将使用成本、质量和结果研究以及早期儿童纵向研究出生队列至 2 岁、限制使用的数据来检查阈值效应。我们将检查各种质量指标，例如员工教育和培训、儿童员工比例、小组规模（即班级中的儿童数量）、ECERS/ITERS 以及家长参与。儿童的社交、认知和身体健康结果将作为结果衡量标准。研究结果将使政策制定者更好地了解哪些具体分界点区分了不同水平的儿童结局。这将有助于为差异化报销策略提供明智的方法。