Enhancing early care and education through reflective supervision to promote adaptive emotion regulation in young children

项目摘要 在贫困中长大与情绪调节（ER）问题有关，这增加了 精神病理学和疾病的变化。高质量的早期护理和教育方案， 旨在通过加强青年人的能力， 儿童的ER能力，通过与教师的反应和培养关系， 教学实践和课程。然而，现实世界的幼儿教育计划缺乏内部支持， 与积极的儿童成果有关的做法。教师接受外部培训，以使用循证技能， 咨询师或干预者，但一旦这些支持不再可用，就会偏离这些做法。 因此，在幼儿教育计划中提高教师支持质量的公共卫生需求不能被忽视。 言过其实，特别是考虑到缺乏项目主任的支持与减少使用 随着时间的推移，以证据为基础的做法，教师的压力，倦怠和营业额，这导致穷人 儿童的社会情感环境。因此，拟议的研究旨在培训欧洲经委会主任使用 反思性实践和监督（RP/S），一种基于关系的，文化上敏感的监督模式， 他们的教师，以提高教学质量和增加使用循证技能，以促进适应ER， 孩子这项创新研究将分两个阶段进行：开放试验和全动力集群 随机对照试验（CRT）。目标1开放试验的目标是评估可行性、可接受性和 执行障碍和促进因素。定量和定性数据将用于在 CRT。第二阶段将针对等待列表控制条件（即，标准行政 监督）。目标2将确定RP/S是否与教学质量和教师使用的增加有关 从术前到术后以及3个月随访时的循证技能。目标3将决定RP/S是否 与儿童适应性ER增加相关，用多方法评估电池测量。 这将是第一次严格评价作为欧洲经委会方案拟订工作的加强的区域方案/服务，其结果将是： 地方和国家利益攸关方的高度关注。高度结构化的培训计划将确保实现 提出研究目标。具体而言，PI将接受以下方面的专门培训：（1）婴儿心理健康，（2） ECE系统内的实施，（3）实用CRT开发、交付和评价，（4）临床试验 和多层次建模方法;（5）指导和领导技能。培训将由 优秀的导师团队，具有高度相关的专业知识和出色的导师记录， 协作拟议的研究和培训计划得到了丰富的培训环境的进一步支持， 布朗医学院和布拉德利医院。通过这个K23，PI将开始她的职业生涯作为一个独立的 临床科学家专注于开发和评估社区基于系统的预防干预措施 设置，以改善情绪调节的幼儿暴露在逆境中。

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.