Variation in surface decontamination practices among Michigan child care centers compared to state and national guidelines

Abstract Background Environmental decontamination is one of the most effective methods to prevent transmission of infectious pathogens in child care centers (CCCs). Alongside state recommendations, national organizations—including the American Academy of Pediatrics (AAP)—offer best-practice policies. In Michigan, these sets of guidelines differ, and the extent to which CCC practices agree with either set of protocols is unknown. Methods A survey of environmental decontamination practices was administered at a professional meeting of CCC directors (N = 24) in a single Michigan county. CCC practices (eg, products, locations, frequencies) were compared to state and AAP guidelines. Bivariate analyses investigated CCC characteristics as predictors of decontamination policy agreement. Results CCC agreement with established policy was slightly higher for national AAP guidelines (66%) than Michigan standards (59%). The use of an outside child care health consultant was strongly associated with a significantly higher level of agreement with state decontamination policy ( P  = .01). Conclusion We noted substantial disagreement between county CCC practices and state/national guidelines, regardless of CCC size or director experience. Results highlight opportunities to improve CCC director familiarity with current state and nationally advised protocols, to consolidate state licensing and AAP guidelines, and to promote the use of child care health consultants.