Testing the Effects of the Caregiver Interaction Profile Training on the Interactive Skills of Daycare Providers

Study Overview
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Brief Summary
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The goal of this clinical trial is to test the Caregiver Interaction Profile (CIP) training program (Helmerhorst et al., 2017) promoting the relational quality between professional caregivers and children in daycare. The main questions it aims to answer are: Does the CIP training program, compared to no training, improve the relational quality between daycare providers and children in daycare? Does the CIP training program, compared to no training, foster children's social, emotional, and language development? Daycare providers assigned to the training group will participate in the CIP training program, which uses video-recorded interactions between the daycare providers and children in daycare to give feedback on the relational quality as observed in the videos. Daycare providers assigned to the waiting list control group will initially not take part in the training program but will receive the training after the study is finished. All daycare providers' daily interactions with the children in daycare will be filmed before and after the training in order to see if there has been a change in relational quality for the daycare providers in the training group (compared to the control group). Daycare providers in the training and control groups will also fill out questionnaires about the social, emotional, and language development of the children in their care. Researchers will compare daycare providers (and the children in their care) in the training group to daycare providers (and the children in their care) in the control group to see if the relational quality in the training group improves more than that in the control group as a result of the CIP training, and how that impacts the social, emotional, and language development of children.

Official Title
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The Copenhagen Daycare Project: Enhancing the Role of Daycare Providers in Supporting Young Children's Social and Emotional Development

Conditions
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Healthy, Emotion Regulation, Language Development, Interactive Skills Daycare Providers

Intervention / Treatment
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* Behavioral: Caregiver Interaction Profile (CIP) training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: currently working as a professional daycare provider in a daycare center Exclusion Criteria: temporary staff in daycare on short-term contracts
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CIP training group<br>Participants assigned to the CIP training group will receive either an individual 5-week CIP training or a pairwise 6-week CIP training, both with weekly sessions. | Behavioral: Caregiver Interaction Profile (CIP) training<br>* The CIP training aims to boost six interactive skills in daycare providers: sensitive responsiveness, respect for children's autonomy, structuring and limit setting, verbal communication, developmental stimulation, and fostering positive peer interactions. The training takes place with 1 or 2 daycare providers at a time, and consists of 5 or 6 weekly sessions, respectively. In individual trainings, sessions 1-3 focus on two skills each, session 4 is a recap of two skills the daycare provider chooses, and the final session is shared with a colleague. In pairwise sessions, session 1 focuses on the first two skills, sessions 2-5 each focus on one skill, and the last session serves as a recap of two skills the daycare providers choose. The training uses a video-feedback method: daycare providers are filmed in interactions with children in daycare, the CIP trainer preselects relevant fragments of video recordings to discuss with the daycare provider(s) during the training sessions.<br>|
| No Intervention: Waiting-list control group<br>Participants assigned to the waiting-list control group will receive no intervention while data collection is ongoing; after data collection is finished they will also receive the CIP training. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Pre-training to Post-Training Scores on CIP Scale Sensitive Responsiveness | The degree to which daycare providers respond promptly and appropriately to children's signals, coded using the Caregiver Interaction Profile scales (Helmerhorst et al., 2014), rated from 1 (low) to 7 (high). | 9 weeks time frame between pre-training and post-training measurements for individual trainings; 10 weeks between pre-training and post-training measurements for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on CIP Scale Respect for Children's Autonomy | The degree to which daycare providers are not intrusive but validate and encourage children's ideas, initiatives and intentions, coded using the Caregiver Interaction Profile scales (Helmerhorst et al., 2014), rated from 1 (low) to 7 (high). | 9 weeks time frame between pre-training and post-training measurements for individual trainings; 10 weeks between pre-training and post-training measurements for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on CIP Scale Structuring and Limit Setting | The degree to which daycare providers structure activities in a way that children can benefit, and communicate clearly to children what is expected of them and ensure they comply with the expectations, coded using the Caregiver Interaction Profile scales (Helmerhorst et al., 2014), rated from 1 (low) to 7 (high). | 9 weeks time frame between pre-training and post-training measurements for individual trainings; 10 weeks between pre-training and post-training measurements for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on CIP Scale Verbal Communication | The degree to which daycare providers verbally interact with children, and the quality of their interactions (incl form, tone, content), coded using the Caregiver Interaction Profile scales (Helmerhorst et al., 2014), rated from 1 (low) to 7 (high). | 9 weeks time frame between pre-training and post-training measurements for individual trainings; 10 weeks between pre-training and post-training measurements for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on CIP Scale Developmental Stimulation | The degree to which daycare providers stimulate children's personal competencies (incl cognitive, creative, motor development), coded using the Caregiver Interaction Profile scales (Helmerhorst et al., 2014), rated from 1 (low) to 7 (high). | 9 weeks time frame between pre-training and post-training measurements for individual trainings; 10 weeks between pre-training and post-training measurements for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on CIP Scale Fostering Positive Peer Interactions | The degree to which daycare providers facilitate and stimulate children interacting with each other in positive ways, such as helping, comforting, sharing, collaborating, coded using the Caregiver Interaction Profile scales (Helmerhorst et al., 2014), rated from 1 (low) to 7 (high). | 9 weeks time frame between pre-training and post-training measurements for individual trainings; 10 weeks between pre-training and post-training measurements for pairwise trainings | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Pre-training to Post-Training Scores on Ages and Stages Questionnaire: Social-Emotional, Daycare Provider-Report | The Ages and Stages Questionnaire: Social-Emotional (ASQ:SE; Squires et al., 2001) measures signs of disturbances in children's socio-emotional development; higher scores reflect more indications of socio-emotional disturbances in development. The ASQ:SE is filled out by children's daycare providers. Items describe socio-emotional behaviours, and daycare providers indicate whether these apply most of the time, sometimes, or rarely or never. They can check the item if it presents a particular concern for them, which increases the overall score. | 21 weeks time frame between pre-training and post-training assessments for individual trainings; 22 weeks time frame between pre-training and post-training assessments for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on Ages and Stages Questionnaire: Social-Emotional, Parent-Report | The Ages and Stages Questionnaire: Social-Emotional (ASQ:SE; Squires et al., 2001) measures signs of disturbances in children's socio-emotional development; higher scores reflect more indications of socio-emotional disturbances in development. The questionnaires are filled out by one of the children's parents. Items describe socio-emotional behaviours, and parents indicate whether these apply most of the time, sometimes, or rarely or never. They can check the item if it presents a particular concern for them, which increases the overall score. | 21 weeks time frame between pre-training and post-training assessments for individual trainings; 22 weeks time frame between pre-training and post-training assessments for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on Strengths and Difficulties Questionnaire, Daycare Provider-Report | The Strengths and Difficulties Questionnaire (SDQ; Goodman, 2001) has 25 items about positive and negative attributes in children, such as how children behave in social relationships. Daycare providers indicate for each item on a 3-point scale to what degree it applies to the child in question. A total difficulties score is calculated, and a prosocial behavour (strength) score. | 21 weeks time frame between pre-training and post-training assessments for individual trainings; 22 weeks time frame between pre-training and post-training assessments for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on Strengths and Difficulties Questionnaire, Parent-Report | The Strengths and Difficulties Questionnaire (SDQ; Goodman, 2001) has 25 items about positive and negative attributes in children, such as how children behave in social relationships. Parents indicate for each item on a 3-point scale to what degree it applies to their child. A total difficulties score is calculated, and a prosocial behavour (strength) score. | 21 weeks time frame between pre-training and post-training assessments for individual trainings; 22 weeks time frame between pre-training and post-training assessments for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on Child Behavior Checklist 1.5-5, Daycare Provider-Report | The Child Behaviour Checklist 1.5-5 (CBCL 1.5-5; Achenbach & Rescorla, 2000) has 99 items measuring problem behavior in young children (such as afraid to try new things), with answer options not true, somewhat/sometimes true, and very/often true. This questionnaire is filled out by daycare providers. Higher scores indicate higher levels of problem behavior. | 21 weeks time frame between pre-training and post-training assessments for individual trainings; 22 weeks time frame between pre-training and post-training assessments for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on Child Behavior Checklist 1.5-5, Parent-Report | The Child Behavior Checklist 1.5-5 (CBCL 1.5-5; Achenbach & Rescorla, 2000) has 99 items measuring problem behavior in young children (such as afraid to try new things), with answer options not true, somewhat/sometimes true, and very/often true. This questionnaire is filled out by parents. Higher scores indicate higher levels of problem behavior. | 21 weeks time frame between pre-training and post-training assessments for individual trainings; 22 weeks time frame between pre-training and post-training assessments for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on MacArthur Communicative Development Inventory-Short Form, Daycare Provider-Report | The MacArthur Communicative Development Inventory-short, adapted for daycare (CDI-short; Bleses et al., 2018) has 70 vocabulary items, including animal sounds, body parts, and food and drink, which are checked by the daycare provider if they have heard the child produce the item, independent of pronunciation. More checks indicate more advanced communicative development. | 21 weeks time frame between pre-training and post-training assessments for individual trainings; 22 weeks time frame between pre-training and post-training assessments for pairwise trainings | 
| Change from Pre-training to Post-Training Scores on MacArthur Communicative Development Inventory-Short Form, Parent-Report | The MacArthur Communicative Development Inventory-short, adapted for daycare (CDI-short; Bleses et al., 2018) has 70 vocabulary items, including animal sounds, body parts, and food and drink, which are checked by parents if they have heard their child produce the item, independent of pronunciation. More checks indicate more advanced communicative development. | 21 weeks time frame between pre-training and post-training assessments for individual trainings; 22 weeks time frame between pre-training and post-training assessments for pairwise trainings |