high risk of bias in the individual studies. Although in this field often researchers have to balance scientific rigor and ecological validity, there is a need for large, well-designed and rigorously conducted trials grounded in contemporary theories.

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The reopening of child-care programs during COVID-19 demanded comprehensive preventive measures. Research to date has overlooked this reopening process as well as early childhood professionals’ (ECPs) implementation efforts and resulting changes in their work practices and well-being. As a result, this study sought insights into (1) the practical implementation of measures, (2) perceptions and evaluations of measures, (3) changes in work characteristics, and (4) its impact on well-being. Qualitative interviews were conducted with German child-care managers (N = 27) between June and August 2020. The semi-structured interviews were audio-recorded, transcribed, and content-analyzed using MAXQDA. ECPs, through a combination of high effort and engagement, ensured the feasibility of most preventive measures. This included practices which were perceived to be unreasonable or ones which were stricter than practices required for the public. This exacerbated the critical work characteristics (e.g., high workload, overtime, and multitasking) from pre-pandemic scenarios and led to new work demands (e.g., changes in work content and social interactions). ECPs maintained intensive work demands and consequently suffered from broad strain outcomes (e.g., worry, exhaustion, anger, fear of infection, and reduced psychological sense of community). This study highlights the adverse psychosocial work environment of ECPs despite the necessity of ensuring health and safety at work.

Background It can be suspected that work in child care facilities is associated with an elevated exposure risk towards SARS-CoV-2 infections. It is still unclear under which conditions employees in those facilities can safely pursue their work. Preventive workplace-related measures to reduce transmission dynamics in this work environment need to be developed. These measures need to build on a solid scientific foundation and be ready for practical use at the same time. Therefore, the aim of the study is to present a participatory approach to identify, minimize, and eliminate workplace-specific COVID-19 transmission within child care. The approach presented combines quantitative as well as qualitative elements and includes a screening of critical workplace conditions and the development of preventive measures to foster a safe workplace design. Methods First, 428 employees of different child care facilities in a large German city reported their subjective risk of infection, fear of infection, and support received by the employer. Second, the participants commented in detail about high risk conditions during work. Third, employees provided suggestions for preventive measures. We conducted a qualitative analysis of free text answers to evaluate which aspects are perceived as critical from an employee perspective. Results Participants provided valuable and practicable ideas on how to design and improve preventive measures to reduce COVID-19 transmission in child care dealing with structural conditions, the interaction with the parents, the implementation of preventive measures and recommendations for policy makers. Conclusions These new insights help to organize pandemic risk management in order to align theoretical based measures with the practical realization. We encourage researchers to adapt the approach presented to other work areas in order to foster participation of employees in work design to reduce COVID-19 transmission.