Feasibility and recommendations for the use of silicone bands for environmental exposure monitoring in young children

Background Silicone bands offer a non-invasive method for measuring environmental chemicals; however, their feasibility with young children is uncertain. This mixed-methods study examines toddler compliance with silicone bands, identifies predictors of compliance, and offers recommendations for research. Methods Children wore silicone wrist and ankle bands for 1 week; parents completed daily diaries capturing wear time of each band (hours) to indicate compliance (focal outcome). Mothers completed questionnaires capturing family characteristics and child cognitive and behavioral characteristics. Compliance and its associations with family and child characteristics were examined using descriptive, comparative, and associative statistics, and predictive modeling. Comments provided by parents in diaries and research assistants’ feedback were summarized to inform recommendations for future studies. Results Children ( n = 115, 28–39 months) tended to be highly compliant with wearing both bands (56%) or the ankle band only (23%), as reflected by a median of 11–12 hours/day of wear time over the week. Compliance was higher for ankle than wrist bands ( p -value <0.001). Wear time was not associated with child age, sex, associated clothing when wearing the band, or socioeconomic status ( p -values >0.05). Child language and anxiety were positively associated with wristband compliance ( p -values ≤0.038), whereas higher behavioral inhibition and lower effortful control were associated with higher ankle band compliance ( p -values ≤0.016). Qualitative data suggest improving band appeal and resolving sizing issues could improve compliance. Conclusions Results support the feasibility of deploying silicone bands with toddler-aged children. Studies using child-worn bands should account for hourly wear time, as compliance may predict both chemical exposure levels and child characteristics.