Enhancing early care and education through reflective supervision to promote adaptive emotion regulation in young children - PROJECT SUMMARY Growing up in poverty is associated with emotion regulation (ER) problems, which increase risk for psychopathology and disease as children age. High quality early care and education (ECE) programs were designed to prevent the negative effects of poverty and its associated stressors by strengthening young children’s ER capacity, through responsive and nurturing relationships with teachers and evidence-based teaching practices and curriculum. However, real-world ECE programs lack the internal support to sustain best practices that are linked to positive child outcomes. Teachers are trained to use evidence-based skills by external consultants or interventionists, but then drift from these practices once those supports are no longer available. Thus, the public health need to increase quality of support for teachers within an ECE program cannot be overstated, especially given findings that lack of support from program directors is associated with reduced use of evidence-based practices over time, and teacher stress, burnout, and turnover, which leads to poor socioemotional environments for children. Therefore, the proposed study aims to train ECE directors to use Reflective Practice and Supervision (RP/S), a relationship-based, culturally responsive model of supervision, with their teachers to improve teaching quality and increase use of evidence-based skills to promote adaptive ER in children. This innovative research will be conducted in two phases: an open trial and a fully powered cluster randomized controlled trial (CRT). The goal of the Aim 1 open trial is to assess feasibility, acceptability, and implementation barriers and facilitators. Quantitative and qualitative data will be used to refine RP/S prior to the CRT. The second phase will test RP/S against a waitlist control condition (i.e., standard administrative supervision). Aim 2 will determine whether RP/S is associated with increases in teaching quality and teacher use of evidence-based skills from pre- to post, and at 3-month follow-up. Aim 3 will determine whether RP/S is associated with increases in adaptive ER among children, measured with a multi-method assessment battery. This will be the first rigorous evaluation of RP/S as an enhancement to ECE programming, and results will be of high interest to local and national stakeholders. A highly structured training plan will ensure achievement of the proposed research aims. Specifically, the PI will receive specialized training in (1) infant mental health, (2) implementation within ECE systems, (3) pragmatic CRT development, delivery, and evaluation, (4) clinical trial and multilevel modeling methods, and (5) mentoring and leadership skills. Training will be guided by an outstanding mentorship team with highly relevant expertise and outstanding track records of mentorship and collaboration. The proposed research and training plan is further supported by the rich training environment in the Brown Medical School and Bradley Hospital. Through this K23, the PI will launch her career as an independent clinical scientist focused on developing and evaluating systems-based preventive interventions in community settings to improve emotion regulation in young children exposed to adversity.
