We trust our children, indeed our world's future, to care givers in day-care settings for as much as 8 to 10 hours each day. Through hard work and good science, the US and other countries have established rigorous health standards for day care, but we must do more. We must give others—the institutions and the individuals who care for our children—the tools to foster a healthful environment and promote healthy behaviors. The vision of the Centers for Disease Control and Prevention (CDC) is "healthy people in a healthy world to achieve a quality life." We must work together to make that vision a reality for our children in day care.

Our paper addresses translating scientific knowledge into practice and making prevention a practical reality. We outline the concepts underlying the assessment of the effectiveness of prevention activities and illustrate its use in three case studies from child day care. We close with a description of the prevention effectiveness program recently initiated at CDC.


It is important to assess the effectiveness of prevention practices to ensure that public health programs are built on scientifically sound strategies for improving the quality of life and reducing unnecessary morbidity and premature mortality.1 There are three basic approaches to prevention: clinical, behavioral, and environmental. Clinical prevention strategies rely on the one-on-one, provider-to-patient interaction, which underlie immunization and screening programs. These interactions usually occur within our regular health-care delivery system.

Behavioral techniques use a broad array of strategies to encourage lifestyle changes, such as exercise and healthful diets.

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