Train-the-Trainer Approach in the Eco-Healthy Child Care® Program

Objective: In this study, we evaluated the effectiveness of an environmental health training program for child care providers. Methods: We conducted a retrospective analysis to evaluate a 5-state training program using a 20-question pretest and posttest. We also examined the effects of state regulation on knowledge scores. Analyses included descriptive statistics, dependent samples t-tests, and linear mixed models. Results: Posttest scores significantly improved following the training program (overall pretest = 13.78 of 20, posttest = 17.92 of 20, p < .001). Pretest scores were not associated with the degree of regulatory oversight. Conclusions: The training program improved the knowledge of environmental exposures and pretest knowledge was not associated with state policy. More research is needed to determine if knowledge persists, is shared, and decreases children's exposures.