Mindfulness Intervention for Early Childhood Educators

Study Overview
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Brief Summary
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This is a randomized trial of the 'Cultivating Healthy, intentional, Mindful Educators' (CHIME) intervention designed for early childhood educators. The intervention aims to enhance wellbeing, emotion regulation, and sensitive, responsive caregiving among educators by providing them with mindfulness, compassion-based techniques to alleviate stress and respond to emotional challenges in the classroom. The intervention ultimately aims to enhance children's self-regulation through sensitive, responsive caregiving. Measures of teachers' emotional regulation, wellbeing, and stress physiology will be collected pre- and post- the 8 week intervention and compared to a waitlist comparison group. Measures of child self-regulation also will be collected to assess the relation of teacher stress, wellbeing and emotion regulation to child self-regulation.

Detailed Description
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Across varied disciplines, the science is clear that early relationships and the quality of early care are central in achieving positive language, cognitive, and social development outcomes for young children and investments made in early childhood pay for themselves. Early childhood education is a critical context for fostering stimulating, responsive, and sensitive caregiving as a substantial number of children under the age of 5 years spend time in childcare settings, with 64% of children aged 3 to 5 years enrolled in non-relative care outside the home. While great efforts are made to improve the children's social emotional well-being in child care environments, less attention has been given to early childhood educators' (encompassing of early childhood teachers') own well-being. Research that has been conducted finds early childhood educators experience high levels of distress, including high levels of depression and burnout. Additionally, previous research finds school age teachers feeling overworked and overstressed show an altered hypothalamus-pituitary-adrenal (HPA) axis and higher levels of teacher burnout is related to elevated cortisol levels in elementary school students. The current study will test the efficacy of an 8-week compassion and mindfulness based stress reduction program for early childhood educators, as well as characterizing relations from early childhood educator wellbeing to child self-regulation. Teachers will be assigned at the center level to an intervention group or a wait-list comparison condition, with the wait-list group receiving the intervention after the 8-week study. Pre- intervention, teachers in both groups will complete survey measures of their wellbeing, mindfulness, and emotion regulation; emotion regulation tasks; and assessments of stress physiology in the classroom. Teacher-child interactions will be observed and children's self-regulation will be measured. Post-intervention, the same teacher measures will be collected.

Official Title
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Testing the Initial Efficacy of a Mindfulness Compassion-based Intervention to Support Wellbeing Amongst Early Childhood Professionals

Conditions
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Stress, Psychological, Stress, Physiological

Intervention / Treatment
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* Behavioral: CHIME


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Teachers/educators: Providing care to children aged birth through 6 years Participating in, or are signed up to eventually participate in, the 8-week Cultivating Healthy Intentional, Mindful Educators (CHIME) intervention English speakers 19 years of age or older. Children: Aged 3-6 years Enrolled in a preschool setting with a teachers enrolled/signed up to participate in the CHIME study. English or Spanish speakers Parents: Have a child aged 3-6 who is enrolled in a preschool classroom of a teacher participating in the study. Speak and read English or Spanish and Legal guardian 19 years of age or older. Exclusion Criteria: *Not participating/enrolled to participate in CHIME

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants are assigned, based on childcare center, to the intervention or waitlist control group.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CHIME Intervention<br>Participants will complete an 8-week compassion and mindfulness-based intervention with a group facilitator. The curriculum focuses on providing mindfulness-based stress reduction techniques for use in the early childhood education environment. | Behavioral: CHIME<br>* CHIME is a professional development program to provide knowledge and skills for nurturing early childhood educator mindfulness, compassion and socio-emotional learning. CHIME is a manualized curriculum delivered by a trained facilitator. The intervention consists of a 2-hour overview and seven weekly sessions, each lasting 90 minutes. Sessions can be delivered online or in-person.<br>|
| No Intervention: Waitlist control<br>Participants are placed on a wait-list to receive the intervention. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change on the Emotion Stroop | Computerized task administered online that measures the ability to override attentional interference from emotion. A greater difference in the reaction times for emotional vs. neutral trials indicates greater in difficulty in over-riding attentional interference from emotion. | Week 1, Week 9 | 
| Change on the Modified Emotional Exogenous Cuing Paradigm | Computerized task administered online that measures the ability to override attentional interference from emotion. Longer reaction times during incongruent emotional trials relative to neutral emotional trials indicate greater difficulty resisting attentional interference from emotion. | Week 1, Week 9 | 
| Change on the Short Warwick-Edinburgh Mental Wellbeing Measure | A Rasch-validated questionnaire that captures feelings of happiness, social wellbeing and quality of life. Scores range from 14-70, with higher scores indicating higher levels of wellbeing. | Week 1, Week 9 | 
| Change on the The Early Childhood Job Attitude Survey | A questionnaire that evaluates workplace satisfaction and supports and workload manageability. Scores range from 5-25, with higher scores indicating more negative workplace perceptions. | Week 1, week 9 | 
| Change on the Job Demands scale | Taken from the Child Care Worker Job Stress Inventory, this questionnaire will provide a more detailed assessment of stress related to parent interactions and challenging child behavior. The scale comprises 16 items rated on a scale from 1-5. Total scores range from 16-80, with higher scores indicative of greater stress. | Week 1, week 9 | 
| Change on the The Effort/Reward imbalance scale | This questionnaire measures the balance of effort relative to reward that people feel they are putting into their work. The effort-reward imbalance ratio is calculated as the effort score, which ranges from 5-25, divided by the reward score (ranging from 11-55) multiplied by a correction factor. The minimum score is 0 and values above 1 are less favorable and indicate a high level of effort relative to workplace reward. | Week 1, week 9 | 
| Change in Salivary Cortisol | Measure of the reactivity of the hypothalamic pituitary-adrenal axis. Saliva will be collected by passive drool in the morning and in the afternoon for two consecutive days. | Week 1, week 9 | 
| Change in the Heart rate variability | Teachers will wear an 'Actiheart' device to measure cardiac inter-beat intervals and motion for three consecutive days in the classroom. Root mean square of successive differences will be calculated as a measure of heart rate variability. | Week 1, Week 9 | 
| Change in Classroom Assessment Scoring System Emotional Support score | Teacher behavior will be observed and coded using the Emotional Support scale from the Classroom Assessment Scoring System. The primary outcome is the Emotional Support scale, which centers on the teachers' capacity to create a sensitive and positive emotional climate in the classroom. Scores range from 0 to 7, with scores of 7 indicating higher levels emotional support. | Week 1, week 9 | 
| Change on the Cognitive and Affective Mindfulness Scale Revised | Measures attention regulation, awareness, acceptance, and mindful focus on the present. The scale comprises 12 items rated on a 5-point scale. Scores on this scale range from 12-60, with higher scores indicating greater levels of mindfulness. | Week 1, week 9 | 
| Change on the Self Compassion Scale - Short Form | Measures the tendency to treat oneself with compassion, mindfulness and feelings of isolation. The scale comprises 12 items, with scores ranging from 12-60. Higher scores indicate greater levels of self-compassion. | Week 1, Week 9 | 
| Change on the Emotion Regulation Questionnaire | Measures the tendency to engage in cognitive reappraisal or suppression of negative emotions. The reappraisal scale comprises 6 items with scores ranging from 6-42. the suppression scale comprises 4 items with scores ranging from 4-28. Higher levels of reappraisal and lower levels of suppression are associated with better emotion regulation. | Week 1, Week 9 | 
| Change on the Difficulties in Emotion Regulation Scale | Measures emotional awareness, clarity and strategy use, and impulse control. The scale comprises 36 items rated on a 5-point scale, with total scores ranging from 36-180. Higher scores indicate higher levels of difficulty regulating emotions. | Week 1, Week 9 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Early childhood educator, Mindfulness, Intervention, Burnout