An interventional study of Changes in pesticide exposure and IPM Practices in Children, Only, Risk Reduction and Environmental Exposure, sponsored by University of California, San Francisco. Completed at 1 site in United States. Open to participants aged 3 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-02-17.
Sponsored by University of California, San Francisco · Not applicable, Interventional, and Prevention
A randomized control study was conducted to reduce the exposure to pesticides in child care centers. A 7-month child care health consultant-led integrated pest management (IPM) intervention was conducted in 85 child care centers serving preschool-age children in five California counties. Changes in IPM knowledge, self-efficacy, policies, IPM practices, pests, and pesticide exposure were assessed in the IPM centers and the control centers.
The goal of the study was to reduce children's exposure to pesticides in child care centers to improve their long-term health. A randomized-control trial in five northern California counties compared changes in director's IPM knowledge and self-efficacy, written IPM policies, IPM practices, number of pests and concentration of pesticides between child care centers assigned to an IPM intervention versus an attention control intervention on physical activity. Eighty-five child care center directors working in centers serving preschool-age children were enrolled. The child care health consultant-led intervention included an educational workshop, materials and tools, and center-specific consultation over seven months. In addition, the study included novel methods of measuring pesticide concentrations in child care centers (dust) and individual children (silicone wristbands). The study aims were to determine if an IPM intervention (1) increases child care center's director's IPM knowledge and self-efficacy, (2) improves center's IPM practices and policies, (3) reduces the number of pests present, (5) reduces pesticide exposures in child care center environments in the intervention IPM child care centers compared to the control centers.
The centers must meet the following criteria:
The child care providers must meet the following criteria:
The families must have a preschool-age child enrolled in the participating child care center and meet the following criteria:
Exclusion Criteria:
The intervention consists of an integrated pest management (IPM) educational workshop, providing IPM materials, and monthly consultation. The child care health consultants (CCHCs) conduct the educational workshop for child care center directors and providers on IPM practices including the providers' practices and beliefs. The workshop includes a slide presentation on pesticides and IPM practices and the directors receive an IPM Toolkit and IPM toolbox. After the workshop and baseline measures are completed, the CCHCs meet with center directors to review the results of the baseline observational Checklists and the directors identify center-specific intervention goals. Monthly child care health consultation visits are conducted with the director to review the center's progress towards the goals, discuss problems, and share resources.
Behavioral: Changes in pesticide exposure · Behavioral: IPM Practices · Behavioral: Educational Workshops
The attention control group is given an intervention covering physical activity (PA) for preschool-age children in child care centers. The PA intervention includes the same intensity as the IPM intervention provided by a child care health consultant (CCHC). The CCHC conducts a workshop on physical activity that includes a slide presentation and the directors receive a Physical Activity Toolkit and toolbox. After the workshop and baseline measures are completed, the CCHCs meet with center directors to review the results of the baseline observational Checklists and the directors identify center-specific intervention goals. Monthly child care health consultation visits are conducted with the director to review the center's progress towards the goals, discuss problems, and share resources.
Behavioral: Changes in pesticide exposure · Behavioral: IPM Practices
In the IPM centers the child care health consultant reviews the IPM baseline assessments and provides 7 monthly consultation visits to decrease the centers exposure to pesticides. Pre- and post- carpet dust samples and children's individual silicone wristbands are collected to identify changes in pesticide detection limits and concentrations at the child care center-level in both the IPM and PA centers pre- and post-intervention.
Also known as: Child care health consultant assessment and intervention
In the IPM centers, a research assistant completed the IPM Checklist which identifies the IPM practices that the center meets and doesn't meet. The child care health consultant reviews the IPM Checklist findings with the child care center director after the baseline Checklist is completed. The IPM Checklist is completed pre- and post-intervention in the IPM and PA centers. The post-intervention IPM Checklist findings are compared to the baseline IPM Checklist findings to identify changes in IPM practices in both the IPM and PA centers.
The IPM center directors and providers attend an IPM workshop and complete a survey to assess their knowledge of IPM practices pre- and post-workshop. The level of knowledge change is assessed by comparing the number of correct responses on the post-workshop survey compared to the pre-workshop survey.
Decrease in Child Care Center Pesticides
Change in the levels of pesticide exposures collected in carpet dust samples in the child care centers from baseline to 9 months later. Pesticides are summarized as geometric mean concentration (ng/g) and then the log10 is applied to the data. Carpet dust samples were collected in each child care center at pre-intervention and post-intervention. A decrease in pesticide concentration from pre-intervention to post-intervention is represented as a negative value. A negative change score would be a positive finding with a decrease in pesticide concentration post-intervention.
Time frame: Pre-intervention, 9 months after the workshop
Decrease in Children's Exposure to Pesticides
Change in the levels of pesticide exposures collected in personal silicone wristbands worn by 3 to 5 of the preschool-age children in each child care center. They wore the wristbands for \~30 hours pre-intervention/baseline and 9 months later. Pesticides are summarized as geometric mean concentration (ng/mL) and then log10 is applied to the data. A decrease in pesticide concentration from pre-intervention to post-intervention is represented as a negative value. A negative change score would be a positive finding with a decrease in pesticide concentration post-intervention.
Time frame: Pre-intervention and 9 months later (post-intervention)
Increase in Integrated Pest Management (IPM) Practices
The IPM practices were measured objectively with a standardized IPM Checklist during a 2-hour observational assessment at baseline/pre-intervention and then 9 months later using a standardized measure (Alkon etal, JPHC, 2016). The IPM practices observed included having garbage cans with liners and lids, using bait stations if there are pests, having window screens with no holes, no water leaks, and outside garbage bins on cement surfaces. Each item on the Checklist is marked as 1 (yes) or O (no). The mean ranged from 0 (no practices observed) to 1 (all of the items were observed). An increase in IPM practices would be positive change in the mean score post-intervention compared to pre-intervention.
Time frame: Pre-Intervention and 9 months later
Decrease in the Presence of Pests
The # of pests were observed as part of the IPM Checklist assessment in different places in the child care center: kitchen, outside garbage area, playground, landscape outdoor area, and classroom at the pre-intervention period and 9 months later. Pre- and post-intervention, the # of pests observed is a number on a scale of 0 to infinity. A positive outcome would be a negative change score showing be a decrease in the # of pests observed post-intervention compared to pre-intervention.
Time frame: Pre-intervention and 9 months later
Director's Self-Efficacy
The director's sense of self-efficacy provides information about their sense of control of their work environment and impact on the families and children that they serve. The intervention is designed to help the director's feel empowered (e.g., increase in self-efficacy) to make changes in their work environment and provide a healthy environment for children and families served in their center. The Self-Efficacy survey was modified from a standardized measure by Bandura, A (1977) to fit the intervention and child care center's environments. There are 8 items with responses rated on a likert scale from 1 to 4 as strongly disagree (1) to strongly agree (4). Mean self-efficacy scores were calculated for each director. The minimum and maximum mean scores were 2.8 to 4.0. Higher mean score shows higher self-efficacy.
Time frame: The Self-Efficacy Survey is completed by the directors pre-intervention and after the intervention (7 to 9 months later).
Number of Child Care Centers With Written IPM Policies
The presence of IPM policies was reviewed as (1 for "Yes") and (0 for "No") no both pre- and post-intervention in the IPM centers. Licensed child care centers are required to have written policies, but a specific policy on IPM is not required. Policies provide best practices for the child care administrators, providers and parents to follow when working or spending time in the center.
Time frame: 9 months
Change in Knowledge
An 8-item multiple choice knowledge survey was completed by participants who attended the IPM workshop pre- and post-workshop. The survey was developed by the PI and contained key content covered in the IPM workshop. There were 70 child care providers who attended the workshops and completed the knowledge and demographic surveys. Correct answers were coded as 'correct' and given a score of '1'. The range of scores for each participant were from 0 to 8 (all correct answers). The scores for each participant were calculated and then aggregated by center. Positive changes in scores showed an increase in IPM knowledge post-workshop compared to baseline.
Time frame: pre- and immediately after the workshop is completed
The study was conducted in 85 child care center and consent form were obtained from 85 child care center directors, 134 child care providers, 393 children, and 375 parents. The intervention and outcome measures included the child care directors and children. The parents completed a demographic survey pre-intervention and the child care providers completed demographic surveys and pre- and post-workshop knowledge surveys.
| Milestone | Integrated Pest Management (IPM) | Physical Activity (PA) |
|---|---|---|
| Started | 493 | 494 |
| Completed | 402 | 403 |
| Not completed | 91 | 91 |
| Withdrew: No follow up due to covid19 restrictions or left center | 91 | 91 |
| Milestone | Integrated Pest Management (IPM) | Physical Activity (PA) |
|---|---|---|
| Started | 44 | 41 |
| Completed | 42 | 37 |
| Not completed | 2 | 4 |
| Withdrew: Lost to follow-up | 2 | 4 |
| Milestone | Integrated Pest Management (IPM) | Physical Activity (PA) |
|---|---|---|
| Started | 70 | 0 |
| Completed | 70 | 0 |
| Not completed | 0 | 0 |
Change in the levels of pesticide exposures collected in carpet dust samples in the child care centers from baseline to 9 months later. Pesticides are summarized as geometric mean concentration (ng/g) and then the log10 is applied to the data. Carpet dust samples were collected in each child care center at pre-intervention and post-intervention. A decrease in pesticide concentration from pre-intervention to post-intervention is represented as a negative value. A negative change score would be a positive finding with a decrease in pesticide concentration post-intervention.
| log10(ng/g) | Integrated Pest Management (IPM) | Physical Activity (PA) |
|---|---|---|
| Bifenthrin | 1.95 ± 1.06 | 1.87 ± 1.12 |
| Chlorpyrifos | 0.59 ± 0.37 | 0.53 ± 0.35 |
| Cis-Permethrin | 2.21 ± 0.43 | 2.30 ± 0.73 |
| Cypermethrin | 2.32 ± 0.86 | 1.97 ± 0.86 |
| Fipronil | 1.85 ± 0.77 | 1.58 ± 0.67 |
| L-Cyhalothrin | 1.36 ± 0.75 | 1.16 ± 0.45 |
| Piperonyl | 1.71 ± 0.59 | 1.71 ± 0.59 |
| Trans-Permethrin | 2.43 ± 0.46 | 2.43 ± 0.46 |
Change in the levels of pesticide exposures collected in personal silicone wristbands worn by 3 to 5 of the preschool-age children in each child care center. They wore the wristbands for \~30 hours pre-intervention/baseline and 9 months later. Pesticides are summarized as geometric mean concentration (ng/mL) and then log10 is applied to the data. A decrease in pesticide concentration from pre-intervention to post-intervention is represented as a negative value. A negative change score would be a positive finding with a decrease in pesticide concentration post-intervention.
| log10(ng/g) | Integrated Pest Management | Physical Activity |
|---|---|---|
| Bifenthrin | -0.04 ± 0.62 | 0.17 ± 0.78 |
| Chlorpyrifos | -0.31 ± 0.31 | -0.29 ± 0.27 |
| Cis-Permethrin | 0.35 ± 1.05 | 0.24 ± 1.30 |
| Cypermethrin | 0.83 ± 0.76 | 0.65 ± 0.69 |
| Fipronil | 0.24 ± 0.65 | 0.16 ± 0.50 |
| Trans-Permethrin | 0.51 ± 1.03 | 0.65 ± 1.22 |
The IPM practices were measured objectively with a standardized IPM Checklist during a 2-hour observational assessment at baseline/pre-intervention and then 9 months later using a standardized measure (Alkon etal, JPHC, 2016). The IPM practices observed included having garbage cans with liners and lids, using bait stations if there are pests, having window screens with no holes, no water leaks, and outside garbage bins on cement surfaces. Each item on the Checklist is marked as 1 (yes) or O (no). The mean ranged from 0 (no practices observed) to 1 (all of the items were observed). An increase in IPM practices would be positive change in the mean score post-intervention compared to pre-intervention.
| score on a scale | Integrated Pest Management | Physical Activity |
|---|---|---|
| Increase in Integrated Pest Management (IPM) Practices | 0.83 ± 0.07 | 0.78 ± 0.11 |
The # of pests were observed as part of the IPM Checklist assessment in different places in the child care center: kitchen, outside garbage area, playground, landscape outdoor area, and classroom at the pre-intervention period and 9 months later. Pre- and post-intervention, the # of pests observed is a number on a scale of 0 to infinity. A positive outcome would be a negative change score showing be a decrease in the # of pests observed post-intervention compared to pre-intervention.
| pests | Integrated Pest Management (IPM) | Physical Activity (PA) |
|---|---|---|
| Decrease in the Presence of Pests | 1.36 ± 1.55 | 2.68 ± 2.99 |
The director's sense of self-efficacy provides information about their sense of control of their work environment and impact on the families and children that they serve. The intervention is designed to help the director's feel empowered (e.g., increase in self-efficacy) to make changes in their work environment and provide a healthy environment for children and families served in their center. The Self-Efficacy survey was modified from a standardized measure by Bandura, A (1977) to fit the intervention and child care center's environments. There are 8 items with responses rated on a likert scale from 1 to 4 as strongly disagree (1) to strongly agree (4). Mean self-efficacy scores were calculated for each director. The minimum and maximum mean scores were 2.8 to 4.0. Higher mean score shows higher self-efficacy.
| score on a scale | Integrated Pest Management (IPM) | Physical Activity (PA) |
|---|---|---|
| Director's Self-Efficacy | 3.75 ± 0.31 | 3.68 ± 0.37 |
The presence of IPM policies was reviewed as (1 for "Yes") and (0 for "No") no both pre- and post-intervention in the IPM centers. Licensed child care centers are required to have written policies, but a specific policy on IPM is not required. Policies provide best practices for the child care administrators, providers and parents to follow when working or spending time in the center.
| Child care centers | Integrated Pest Management | Physical Activity |
|---|---|---|
| Pre-Intervention | 9 | — |
| 9 Months Post-Intervention | 20 | — |
An 8-item multiple choice knowledge survey was completed by participants who attended the IPM workshop pre- and post-workshop. The survey was developed by the PI and contained key content covered in the IPM workshop. There were 70 child care providers who attended the workshops and completed the knowledge and demographic surveys. Correct answers were coded as 'correct' and given a score of '1'. The range of scores for each participant were from 0 to 8 (all correct answers). The scores for each participant were calculated and then aggregated by center. Positive changes in scores showed an increase in IPM knowledge post-workshop compared to baseline.
| score on a scale | Integrated Pest Management | Physical Activity |
|---|---|---|
| Change in Knowledge | 0.94 ± 0.08 | — |
Collected over There were 6 cohorts of child care directors, child care providers, and children followed for 9 to 12 months.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Integrated Pest Management (IPM) | 0/309 (0%) | 0/309 (0%) | 0/309 (0%) |
| Physical Activity (PA) | 0/303 (0%) | 0/303 (0%) | 0/303 (0%) |
Integrated pest management (IPM) 44 directors, 70 providers, 195 children, and 184 parents. The control/Physical activity centers had 41 directors, 64 providers,198 children, and 191 parents.
| Age, Categorical(Participants) | Integrated Pest Management (IPM) | Physical Activity | Total |
|---|---|---|---|
| Child care center directors — <=18 years | 0 | 0 | 0 |
| Child care center directors — Between 18 and 65 years | 44 | 41 | 85 |
| Child care center directors — >=65 years | 0 | 0 | 0 |
| Child care providers — <=18 years | 0 | 0 | 0 |
| Child care providers — Between 18 and 65 years | 70 | 64 | 134 |
| Child care providers — >=65 years | 0 | 0 | 0 |
| Children — <=18 years | 195 | 198 | 393 |
| Children — Between 18 and 65 years | 0 | 0 | 0 |
| Children — >=65 years | 0 | 0 | 0 |
| Parent — <=18 years | 0 | 0 | 0 |
| Parent — Between 18 and 65 years | 184 | 191 | 375 |
| Parent — >=65 years | 0 | 0 | 0 |
| Sex: Female, Male(Participants) | Integrated Pest Management (IPM) | Physical Activity | Total |
|---|---|---|---|
| Child care center directors — Female | 44 | 41 | 85 |
| Child care center directors — Male | 0 | 0 | 0 |
| Child care providers — Female | 70 | 64 | 134 |
| Child care providers — Male | 0 | 0 | 0 |
| Children — Female | 69 | 59 | 128 |
| Children — Male | 65 | 60 | 125 |
| Parent — Female | 163 | 134 | 297 |
| Parent — Male | 12 | 19 | 31 |
| Ethnicity (NIH/OMB)(Participants) | Integrated Pest Management (IPM) | Physical Activity | Total |
|---|---|---|---|
| Child care center directors — Hispanic or Latino | 14 | 13 | 27 |
| Child care center directors — Not Hispanic or Latino | 30 | 28 | 58 |
| Child care center directors — Unknown or Not Reported | 0 | 0 | 0 |
| Child care providers — Hispanic or Latino | 24 | 16 | 40 |
| Child care providers — Not Hispanic or Latino | 46 | 48 | 94 |
| Child care providers — Unknown or Not Reported | 0 | 0 | 0 |
| Children — Hispanic or Latino | 80 | 75 | 155 |
| Children — Not Hispanic or Latino | 93 | 77 | 170 |
| Children — Unknown or Not Reported | 18 | 32 | 50 |
| Parent — Hispanic or Latino | 71 | 69 | 140 |
| Parent — Not Hispanic or Latino | 102 | 84 | 186 |
| Parent — Unknown or Not Reported | 11 | 38 | 49 |
| Race (NIH/OMB)(Participants) | Integrated Pest Management (IPM) | Physical Activity | Total |
|---|---|---|---|
| Child care center directors — American Indian or Alaska Native | 1 | 0 | 1 |
| Child care center directors — Asian | 2 | 1 | 3 |
| Child care center directors — Native Hawaiian or Other Pacific Islander | 0 | 2 | 2 |
| Child care center directors — Black or African American | 7 | 7 | 14 |
| Child care center directors — White | 19 | 23 | 42 |
| Child care center directors — More than one race | 1 | 0 | 1 |
| Child care center directors — Unknown or Not Reported | 14 | 8 | 22 |
| Child care providers — American Indian or Alaska Native | 1 | 0 | 1 |
| Child care providers — Asian | 4 | 1 | 5 |
| Child care providers — Native Hawaiian or Other Pacific Islander | 2 | 1 | 3 |
| Child care providers — Black or African American | 6 | 5 | 11 |
| Child care providers — White | 28 | 26 | 54 |
| Child care providers — More than one race | 2 | 4 | 6 |
| Child care providers — Unknown or Not Reported | 27 | 27 | 54 |
| Children — American Indian or Alaska Native | 4 | 4 | 8 |
| Children — Asian | 19 | 9 | 28 |
| Children — Native Hawaiian or Other Pacific Islander | 1 | 0 | 1 |
| Children — Black or African American | 17 | 11 | 28 |
| Children — White | 66 | 75 | 141 |
| Children — More than one race | 38 | 36 | 74 |
| Children — Unknown or Not Reported | 46 | 49 | 95 |
| Parent — American Indian or Alaska Native | 3 | 3 | 6 |
| Parent — Asian | 12 | 25 | 37 |
| Parent — Native Hawaiian or Other Pacific Islander | 0 | 2 | 2 |
| Parent — Black or African American | 9 | 21 | 30 |
| Parent — White | 70 | 61 | 131 |
| Parent — More than one race | 15 | 13 | 28 |
| Parent — Unknown or Not Reported | 75 | 66 | 141 |
| Region of Enrollment(Participants) | Integrated Pest Management (IPM) | Physical Activity | Total |
|---|---|---|---|
| United States — San Francisco East Bay Counties | 23 | 21 | 44 |
| United States — Central Valley Counties | 21 | 20 | 41 |
| Pesticides in Carpet Dust Samples(log 10 (ng/g)) | Integrated Pest Management (IPM) | Physical Activity | Total |
|---|---|---|---|
| Bifenthrin | 1.84 ± .99 | 1.82 ± .98 | 1.83 ± .98 |
| Chlorpyrifos | .53 ± .36 | .51 ± .34 | .52 ± .35 |
| Cis-Permethrin | 1.89 ± .56 | 1.85 ± .81 | 1.87 ± .69 |
| Cypermethrin | 2.30 ± .88 | 2.01 ± .80 | 2.16 ± .85 |
| Fipronil | 1.64 ± .70 | 1.59 ± .70 | 1.61 ± .69 |
| L-Cyhalothrin | 1.49 ± .82 | 1.41 ± .69 | 1.45 ± .76 |
| Piperonyl | 1.40 ± .77 | 1.33 ± .74 | 1.37 ± .75 |
| Trans-Permethrin | 2.02 ± .75 | 1.90 ± .96 | 1.96 ± .85 |
| Pesticide concentrations on wristbands worn by children(log 10 (ng/g)) | Integrated Pest Management (IPM) | Physical Activity | Total |
|---|---|---|---|
| Bifenthrin | .26 ± 1.01 | .50 ± 1.12 | .38 ± 1.06 |
| Chlorpyrifos | -.12 ± .32 | -.24 ± .28 | -.21 ± .30 |
| Cis-Permethrin | .22 ± 1.23 | .27 ± 1.17 | .25 ± 1.19 |
| Cypermethrin | 1.07 ± .83 | .99 ± .89 | 1.03 ± .86 |
| Fipronil | .15 ± .49 | .32 ± .61 | .23 ± .56 |
| Trans-Permethrin | .68 ± 1.26 | .98 ± 1.14 | .83 ± 1.20 |
| IPM Checklist(units on a scale) | Integrated Pest Management (IPM) | Physical Activity | Total |
|---|---|---|---|
| Mean | 0.75 ± 0.10 | 0.78 ± 0.10 | 0.76 ± 0.10 |
3 further baseline measures are reported on the registry.
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University of California, San Francisco