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findings in the report in which large percentages of providers indicated screen time and breastfeeding policies and practices did not apply to their program. Because the policy does not apply to their program, a provider may not have received training or be aware of best practices for that area of care.
As indicated in Tables 8 and 9, there were significant differences by language between English- and Spanish-speaking providers on two items at follow-up:
 Spanish speaking providers were 1.62 times more likely to indicate feeling very or somewhat prepared to make changes in breast feeding practices at their child care site at follow-up than English-speaking providers.
 English-speaking providers were 2.24 times more likely to indicate feeling somewhat or very prepared to make changes in screen time practices at their child care site at follow- up.
The higher level of preparedness to make changes in breastfeeding practices Spanish-speaking participants reported may be due to providers’ own cultural norms and not necessarily training she may have received through the ECE field. A recent study published in Pediatrics examining racial and ethnic disparities in breastfeeding found that having a family history of breastfeeding mediated racial / ethnic gaps in breastfeeding outcomes, and that Latinas were more likely to have reported a familial history of breastfeedingxxxiv. As such, Spanish-speaking providers may also feel a greater sense of preparedness to apply that to their program. In terms of the disparity in level of preparedness between English- and Spanish-speaking participants regarding screen time practices, this may also be related to the providers’ own level of experience with technology. A county-wide study in Los Angeles of early childhood educators in a professional development coaching program demonstrated that Spanish-speaking participants show lower levels of computer and technology literacy than English-speaking participants.xxxv Lower levels of computer and technology literacy skills may contribute to providers’ feelings of preparedness in managing screen time practices.
Table 8. Self-Efficacy: Relationship at Follow-up between Survey Language and Response to Question 36a. “How prepared do you feel to make changes in the [breastfeeding practices] at your child care site?”
    How Prepared
        English Spanish
      Very/Somewhat Prepared 206 (50.6%) 96 (62.3%)
       Not Prepared/Not Sure 201 (49.4%) 58 (37.7%)
       Note. P = .014, FET (n=561). Numbers in parentheses indicate column percentages. OR=1.62
    Improving Health in Child Care Settings: 2016 32

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