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.

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.

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.

The child care center directors participated in a physical activity intervention that consisted of an educational workshop and 6 consultation visits. The child care health consultants (CCHCs) conduct the educational workshop on the physical activities center policies and best practices over 7 months. The workshop included a Physical Activity Toolkit and toolbox. The CCHCs met with the center directors to review the results of the Baseline observational Checklists and to identify center-specific intervention goals. The consultation visits included reviewing the center's progress towards the intervention goals, discussing problems, and sharing resources.

IPM educational workshop and consultation: The interventions include a baseline assessment conducted by a research assistant and objective measures of pesticide exposure (center dust samples, children's silicone wristbands), review of assessment by the nurse child care health consultant, goal setting with the director, educational workshop, 7 monthly consultation visits, and post-intervention review of goals and post-assessment findings (conducted by research assistant and objective measures of pesticide exposure).

Total of all reporting groups

Data are separate for each participant group. The children demographics on sex were completed in the parent survey by all participants, there is data on 253 children's sex out of 375 enrolled families. There is no parent data for 9 IPM and 38 parents in the IPM and PA groups respectively. Therefore, 328 out of the 375 enrolled parents have complete data on sex.

Data are separate for each participant group.

Data are separate for each participant group.

Child care center location reported.

There were 14 pesticides analyzed and 8 were identified in most of the child care centers. The concentration (geometric means as nanogram(ng)/gram(g)) of the pesticides identified in the carpet dust samples will be reported for the 85 centers at baseline. The concentrations were not normally distributed and are reported as log10(ng/g).

The children wore the silicone wristbands in the child care center over the course of about a week. The average total time that the wristbands were worn for each child was ~30 hours. There were ~3 children per center who wore the wristbands. The data were aggregated by center. The data were summarized using geometric means that were imputed and log10 was applied to the data for the final analyses.

Children participated in data collection by wearing wristbands and data are aggregated by center.

At baseline, there are 42 centers out of 44 IPM centers and 40 out of 41 PA centers with child-level data on individual exposure to pesticides.

The 69-item IPM Checklist is a standardized, objective assessment of IPM practices and pests. The ratings are yes (meets the item) or no (does not meet the item). Mean scores are the # of 'yes' items reported divided by the total items observed. The range of mean scores are 0 to 1 with a higher score indicating the center staff practice IPM. The items include observable environmental practices that lower the risk of having pests in a child care center, such as screens without holes, garbage liners and lids, no water leaks, etc.

Each childcare director receive the results of the IPM Checklist.

There is one child care center in the PA group that is missing IPM Checklist data.

Pests or evidence of pests were identified in different locations in the child care center (e.g. indoor classrooms, kitchen, bathroom, outdoor playground) and the type of pest was identified using the standardized IPM Checklist. The score is the mean # of pests observed or evidence of pests observed in the different locations across the centers in each group. The type of pests or evidence of pests included ants, spiders, spider webs, mosquitos, etc. The # of pests were averaged across IPM and PA centers separately. The # of pests ranged from 0 to 173 (spiders and webs across all centers).

Each childcare director receive the results of the IPM Checklist including the number of pests.

There is one child care center that did not have the IPM Checklist-Pest observation completed.

Before and after the IPM Workshop a knowledge survey was completed at each center. There were 8 items in the survey. The child care director scores were divided by the # of centers in each group. The range was 0 to 1 (100% correct responses).

Each childcare director completed an IPM knowledge survey.

Only the IPM Centers participated in the IPM survey so the PA centers have no data for this baseline survey. There were 36 IPM centers with both baseline and post-intervention surveys. Thus, 8 IPM centers were missing knowledge surveys.

An 8-item survey was completed by the child care center directors to assess their level of self-efficacy at baseline and post-intervention in both the IPM and PA centers. Each item was rated as 'strongly agree', 'disagree', 'agree' or 'strongly agree'. The higher the mean score across the 8 items, the stronger the sense of self-efficacy. The director responses were totaled and then divided by the # centers in each group. The range of mean scores were from 1to 4.

Center directors completed the self-efficacy survey.

There were self-efficacy surveys missing for one IPM center and four PA centers at baseline.

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.

The # participants are the # of children and # of units are the # of child care centers. There are 8 IPM centers and 6 PA centers with no post-intervention wristband data. Some of the centers were dropped from the study and didn't complete the intervention and other centers had too few children participating and didn't meet the criteria with a minimum of 3 children participating per center.

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.

The IPM Checklist was not completed in 6 IPM centers and 5 PA centers. The centers didn't complete the post-intervention data collection since they dropped out of the study or the research assistant was not able to complete the data collection.

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.

Five IPM centers and three PA centers were missing data on the IPM checklist on pests observed.

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.

In the IPM centers, 43 out of 44 directors completed the Self-Efficacy surveys. In the PA centers, 37 out of 41 directors completed the Self-Efficacy surveys.

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.

Two IPM child care centers did not have data available pre-intervention. Four IPM child care centers did not provide policies post-intervention. Data were not collected in the PA centers.

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.

The IPM knowledge survey was only completed by participants in the IPM intervention centers, since they received the IPM workshop. The PA center directors did not attend the IPM workshop at baseline. The scores are not compared to the control centers. The scores are within-center comparisons for center means pre-workshop compared to post-workshop.

The intervention consists of a physical activity educational workshop and consultation. The child care health consultants (CCHCs) conduct the educational workshop for the child care center directors and providers on physical activities center policies and best practices over 7 months. The workshop includes a Physical Activity (PA) presentation, PA Toolkit and PA toolbox. The CCHCs meet with center directors to review the results of the baseline observational Checklists and to identify center-specific intervention goals. The intervention also includes 7 monthly child care health consultation visits where the CCHC and director review the center's progress towards the intervention goals, discuss problems, and share resources.