Effectiveness of out-of-home day care for disadvantaged families: randomised controlled trial

Toroyan, Tami, Roberts, Ian, Oakley, Ann, Laing, Gabrielle, Mugford, Miranda and Frost, Chris (2003) Effectiveness of out-of-home day care for disadvantaged families: randomised controlled trial. British Medical Journal, 327 (7420). ISSN 0959-8138

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Abstract

Objective: To assess the effects of providing day care facilities for young children on the health and welfare of disadvantaged families. Design: Randomised controlled trial. Eligible children from the application list to a day care facility were randomly allocated to receive a day care place or not. Setting: Early Years day care centre in Borough of Hackney, London. Participants: 120 mothers and 143 eligible children (aged between 6 months and 3.5 years). Intervention: A place at the centre, which provided high quality day care. Control families used other child care that they secured for themselves. Main outcome measures: Maternal paid employment, household income, child health and development. Results: At 18 months' follow up, 67% of intervention group mothers and 60% of control group mothers were in paid employment (adjusted risk ratio 1.23 (95% confidence interval 0.99 to 1.52)), but were no more likely to have a weekly household income of above £200 (risk ratio 0.88 (0.70 to 1.09)). Intervention group children had more otitis media with effusion (risk ratio 1.74 (1.02 to 2.96)) and used more health services (1.58 (1.05 to 2.38)), but both estimates were imprecise. Conclusion The provision of child day care may have increased maternal employment, but it did not seem to increase household income. The results suggest that providing day care may be insufficient as a strategy to reduce poverty. The study shows how random allocation can be used to ration and evaluate interventions where demand exceeds supply.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care Faculty of Medicine and Health Sciences > Research Groups > Health Economics Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Depositing User:	EPrints Services
Date Deposited:	25 Nov 2010 11:08
Last Modified:	18 Jun 2024 08:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/11946
DOI:	10.1136/bmj.327.7420.906

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