THRIVE BY 3 Daycare to Promote Development/ Mental Health in 1&2 Year-olds
Condition: Childcare Quality; Child Development
Study type: Interventional

Summary: 
      This study evaluates a preventive, knowledge enhancement and tailored quality building
      intervention to promote development and mental health in 1 and 2 year-olds. Half of the
      participating childcare centers will get the intervention (intervention group) and half will
      get the intervention after 1 year (waitlist-control).
    

Detailed description: 
      Mental health problems manifest already in preschool age and continue into middle and late
      childhood. However, research strongly indicates that mental health problems appear even among
      1-2 year olds. Because 80% of Norwegian under 3 years attend childcare, and stay there for
      long hours, interventions targeting caregiver-child interactions may prove an important
      avenue towards universal prevention of mental health problems.

      Since requirements for high quality is not sufficiently met in many Norwegian childcare
      centers today, a cost-efficient, sustainable model of intervention is called for to enhance
      and track the quality of childcare for 1-3 year olds. The investigators in the study will
      break new grounds by, conducting a cluster randomized control trial of a newly developed
      comprehensive intervention for promoting mental health among toddlers in childcare, the
      Thrive by Three. Because, high quality childcare is in a unique position to prevent
      developmental trajectories leading to mental health problems and to early identify children
      in need of help, effective quality enhancing interventions will be of great value for the
      Norwegian society, both on individual, family, community and national level. The primary
      objective of the project is thus to investigate whether the intervention Thrive by Three will
      improve childcare quality, and strengthen children's mental health and development. It is
      hypothesized that the intervention will prove superior to the wait-list control after the 10
      month intervention period and at 12 months follow-up with respect to childcare quality and
      children's mental health, development and well-being. Our secondary objective is to
      investigate the cost-effectiveness of the intervention and whether effects are moderated by
      characteristics of the children, caregivers and/or implementation outcomes. In a subsample of
      approximately 300 children the investigators will sample cortisol at two time points (pre and
      post intervention) to investigate whether quality enhancement alters the cortisol level in
      children in childcare, compared to cortisol secretion at home. User perspectives and
      experience with Thrive by Three will be captured through qualitative interviews.
    

Intervention name(s): Thrive by Three; Treatment as usual (TAU)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The intervention consists of the following components:
Measurement of daycare quality with CLASS (Classroom Assessment Scoring System) 3 times during the intervention period
Feedback to group staff on 8 CLASS-quality dimensions
Monthly supervision of staff on two levels: supervision of daycare staff, and supervision of supervisors
Competence building with all staff: 3 full training days, plus 2 extra training days for pedagogical leaders/supervisors
Written material to parents, supervisors, and staff
Web page for staff and parents: tf3.no; The wait-list control group will continue with their daily activities and work in the childcare as usual. The wait list control group will have received general information about the study prior to consenting, however no materials or are provided by project. The child-care centers in the control conditions will receive a gift certificate of 3000 Norwegian Crones (NOK) by the end of the intervention period.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participating childcare centers are randomized to either a wait list control- group or an intervention group. The wait-list control group will receive the intervention after 1 year.
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: childcare; quality; universal prevention; mental health; well-being