{"title":"加拿大quacmebec儿童保育专业人员提供的服务：当前服务提供模式的优势和局限性","authors":"Gabrielle Pratte, Mélanie Couture, Chantal Camden, Julie Poissant, Audrée Jeanne Beaudoin","doi":"10.1111/cch.70110","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Specialized professionals, including healthcare professionals and early childhood special educators (ECSEs), wish to offer more in-context interventions in childcare settings. Limited information is available about how these services are and should be organized. The aim of this study was to describe the different service delivery models currently used in a context of publicly funded healthcare and childcare systems (Québec, Canada) and to identify the strengths and limitations of these models.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>An interpretative descriptive research approach was used. Qualitative data from an online survey (<i>n</i> = 344) and semi-structured interviews (<i>n</i> = 18) were used. Questions focused on the description of services (e.g., type of specialized professionals involved, children served, funding) and strengths and limitations of those services. Data were coded using thematic analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Data were classified into 10 service delivery models and are presented using a four-quadrant paradigm based on the source of funding (either internal [childcare-led] or external to childcare) and the focus of service (either child-centred or childcare-centred). Services funded by childcare providers (Quadrants 1 and 3) offered flexibility in addressing priority needs identified by childcare providers and facilitated collaboration with early childhood educators. Childcare-centred models (Quadrants 3 and 4) addressed the needs of children not receiving individual healthcare services. Healthcare-funded services (Quadrants 2 and 4) provided free services for childcare providers.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Each service delivery model had its own strengths and limitations. To enhance support for childcare providers and the children they serve, stakeholders should consider using a variety of service delivery models covering all four quadrants. Three key actions should be considered to improve current services: (1) incorporate more childcare-centred services to reduce the number of underserved children; (2) offer more childcare-led services to align with priority needs identified by childcare providers; and (3) improve intersectoral collaboration by developing cross-institutional policies.</p>\n </section>\n \n <section>\n \n <h3> Key Messages</h3>\n \n <div>\n \n <ul>\n \n \n <li>A variety of service delivery models is needed to enhance support for childcare providers and the children they serve.</li>\n \n \n <li>Childcare-centred service delivery models could serve a greater number of children, particularly those underserved by child-centred service delivery models.</li>\n \n \n <li>Childcare-led service delivery models are needed to align services with the needs and priorities identified by childcare providers.</li>\n \n \n <li>Healthcare and childcare systems would benefit from formalized cross-institutional policies to facilitate intersectoral collaboration.</li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":55262,"journal":{"name":"Child Care Health and Development","volume":"51 4","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70110","citationCount":"0","resultStr":"{\"title\":\"Services Delivered by Specialized Professionals in Childcare Settings in Québec, Canada: Strengths and Limitations of Current Service Delivery Models\",\"authors\":\"Gabrielle Pratte, Mélanie Couture, Chantal Camden, Julie Poissant, Audrée Jeanne Beaudoin\",\"doi\":\"10.1111/cch.70110\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Specialized professionals, including healthcare professionals and early childhood special educators (ECSEs), wish to offer more in-context interventions in childcare settings. Limited information is available about how these services are and should be organized. The aim of this study was to describe the different service delivery models currently used in a context of publicly funded healthcare and childcare systems (Québec, Canada) and to identify the strengths and limitations of these models.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>An interpretative descriptive research approach was used. Qualitative data from an online survey (<i>n</i> = 344) and semi-structured interviews (<i>n</i> = 18) were used. Questions focused on the description of services (e.g., type of specialized professionals involved, children served, funding) and strengths and limitations of those services. Data were coded using thematic analysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Data were classified into 10 service delivery models and are presented using a four-quadrant paradigm based on the source of funding (either internal [childcare-led] or external to childcare) and the focus of service (either child-centred or childcare-centred). Services funded by childcare providers (Quadrants 1 and 3) offered flexibility in addressing priority needs identified by childcare providers and facilitated collaboration with early childhood educators. Childcare-centred models (Quadrants 3 and 4) addressed the needs of children not receiving individual healthcare services. Healthcare-funded services (Quadrants 2 and 4) provided free services for childcare providers.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Each service delivery model had its own strengths and limitations. To enhance support for childcare providers and the children they serve, stakeholders should consider using a variety of service delivery models covering all four quadrants. Three key actions should be considered to improve current services: (1) incorporate more childcare-centred services to reduce the number of underserved children; (2) offer more childcare-led services to align with priority needs identified by childcare providers; and (3) improve intersectoral collaboration by developing cross-institutional policies.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Key Messages</h3>\\n \\n <div>\\n \\n <ul>\\n \\n \\n <li>A variety of service delivery models is needed to enhance support for childcare providers and the children they serve.</li>\\n \\n \\n <li>Childcare-centred service delivery models could serve a greater number of children, particularly those underserved by child-centred service delivery models.</li>\\n \\n \\n <li>Childcare-led service delivery models are needed to align services with the needs and priorities identified by childcare providers.</li>\\n \\n \\n <li>Healthcare and childcare systems would benefit from formalized cross-institutional policies to facilitate intersectoral collaboration.</li>\\n </ul>\\n </div>\\n </section>\\n </div>\",\"PeriodicalId\":55262,\"journal\":{\"name\":\"Child Care Health and Development\",\"volume\":\"51 4\",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-06-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cch.70110\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Child Care Health and Development\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/cch.70110\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Child Care Health and Development","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cch.70110","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Services Delivered by Specialized Professionals in Childcare Settings in Québec, Canada: Strengths and Limitations of Current Service Delivery Models
Background
Specialized professionals, including healthcare professionals and early childhood special educators (ECSEs), wish to offer more in-context interventions in childcare settings. Limited information is available about how these services are and should be organized. The aim of this study was to describe the different service delivery models currently used in a context of publicly funded healthcare and childcare systems (Québec, Canada) and to identify the strengths and limitations of these models.
Methods
An interpretative descriptive research approach was used. Qualitative data from an online survey (n = 344) and semi-structured interviews (n = 18) were used. Questions focused on the description of services (e.g., type of specialized professionals involved, children served, funding) and strengths and limitations of those services. Data were coded using thematic analysis.
Results
Data were classified into 10 service delivery models and are presented using a four-quadrant paradigm based on the source of funding (either internal [childcare-led] or external to childcare) and the focus of service (either child-centred or childcare-centred). Services funded by childcare providers (Quadrants 1 and 3) offered flexibility in addressing priority needs identified by childcare providers and facilitated collaboration with early childhood educators. Childcare-centred models (Quadrants 3 and 4) addressed the needs of children not receiving individual healthcare services. Healthcare-funded services (Quadrants 2 and 4) provided free services for childcare providers.
Conclusions
Each service delivery model had its own strengths and limitations. To enhance support for childcare providers and the children they serve, stakeholders should consider using a variety of service delivery models covering all four quadrants. Three key actions should be considered to improve current services: (1) incorporate more childcare-centred services to reduce the number of underserved children; (2) offer more childcare-led services to align with priority needs identified by childcare providers; and (3) improve intersectoral collaboration by developing cross-institutional policies.
Key Messages
A variety of service delivery models is needed to enhance support for childcare providers and the children they serve.
Childcare-centred service delivery models could serve a greater number of children, particularly those underserved by child-centred service delivery models.
Childcare-led service delivery models are needed to align services with the needs and priorities identified by childcare providers.
Healthcare and childcare systems would benefit from formalized cross-institutional policies to facilitate intersectoral collaboration.
期刊介绍：
Child: care, health and development is an international, peer-reviewed journal which publishes papers dealing with all aspects of the health and development of children and young people. We aim to attract quantitative and qualitative research papers relevant to people from all disciplines working in child health. We welcome studies which examine the effects of social and environmental factors on health and development as well as those dealing with clinical issues, the organization of services and health policy. We particularly encourage the submission of studies related to those who are disadvantaged by physical, developmental, emotional and social problems. The journal also aims to collate important research findings and to provide a forum for discussion of global child health issues.
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