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

项目总结 在贫困中长大与情绪调节(ER)问题有关，这会增加患上 随着儿童年龄的增长，精神病理学和疾病。高质量的早期护理和教育(欧洲经委会)方案 旨在通过加强年轻人的能力来预防贫困及其相关压力的负面影响 儿童急诊室能力，通过响应和培养与教师的关系和循证 教学实践和课程设置。然而，现实世界的欧洲经委会方案缺乏维持最佳方案的内部支持。 与积极的儿童结果相联系的做法。教师通过外部培训来使用基于证据的技能 顾问或干预主义者，但一旦这些支持不再可用，就会偏离这些做法。 因此，在欧洲经委会方案内提高对教师的支助质量的公共卫生需要不能 夸大其词，特别是考虑到缺乏计划主管的支持与减少使用 循证实践随着时间的推移，以及教师压力、职业倦怠和离职，这会导致糟糕的 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、响应文化的监督模式， 他们的教师要提高教学质量，增加循证技能的使用，以促进适应性急诊室 孩子们。这项创新研究将分两个阶段进行：开放试验和全功率集群 随机对照试验(CRT)。目标1公开试验的目标是评估可行性、可接受性和 实施障碍和促进者。将使用定量和定性数据来提炼RP/S CRT。第二阶段将针对等待列表控制条件(即标准管理)测试RP/S 监督)。目标2将确定RP/S是否与教学质量和教师使用率的提高有关 从治疗前到治疗后，以及在3个月的随访中，对循证技能进行评估。目标3将决定RP/S是否 与儿童中适应性ER的增加有关，用多方法评估组合测量。 这将是对RP/S进行的第一次严格评价，作为对欧洲经委会方案编制的加强，结果将是 地方和国家利益攸关方对此高度关注。高度结构化的培训计划将确保实现 提出研究目标。具体地说，PI将接受以下方面的专门培训：(1)婴儿心理健康；(2) 在欧洲经委会系统内实施，(3)实用的CRT开发、交付和评估，(4)临床试验 和多层次建模方法，以及(5)指导和领导技能。培训将由一个 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，并 协作。拟议的研究和培训计划进一步得到了中国丰富的培训环境的支持 布朗医学院和布拉德利医院。通过这个K23，PI将开始她的独立职业生涯 临床科学家专注于开发和评估基于系统的社区预防干预措施 环境，以改善处于逆境中的幼儿的情绪调节。

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.