Underserved Families Research Articles

A Nationwide Multidimensional Examination of Early Care and Education Access: Links Between Access Profiles, Equitable Enrollment, and Public Funding Policies

ABSTRACT Research Findings: As a result of inequitable early care and education access, state and federal policies have prioritized improving access and better serving diverse and traditionally underserved families. This study uses a multidimensional conceptualization of access, which includes reasonable effort, affordability, child development, and family needs, to classify early education centers that serve 4-year-olds into latent profiles. Using nationally representative data from the 2019 NSECE (n = 6066), latent profile analysis revealed four distinct early education center access profiles characterized by meeting a few (but not all) dimensions of access: (1) Most Features of Access; (2) Limited Features of Access; (3) Most Affordable; (4) Available for 4-Year Olds. Multinomial logistic regression analyses were then used to identify equitable enrollment trends and policies associated with access profile membership. Results identify disparities in access related to children’s ability, race, ethnicity, and socioeconomic status but suggest that enrollment priority policies in place for publicly funded early education programs may promote more equitable access. Practice or Policy: Findings suggest the need for enhanced policy attention to early care and education access and expanded financial investment in high-quality, affordable early care and education that supports child development and meets family needs in an effort to promote more equitable access.

Feasibility of a Home-Based Developmental Behavioral Intervention for Children With Autism Spectrum Disorder in Underserved Taiwanese Families

Purpose: This study aims to investigate the feasibility of the home-based parent- mediated intervention Naturalistic developmental behavioral intervention (HB-NDBI) in underserved Taiwanese families of children with Autism spectrum disorder (ASD) and explore its effects on children’s developmental skills and parents’ parenting stress. Method: 24 underserved Taiwanese families of children with ASD (mean age = 46.5 months) received 12-week HB-NDBI programs. Social Responsiveness Scale, Second Edition (SRS-2), Mullen Scales of Early Learning (MSEL), Child Behavior Checklist (CBCL/1.5-5), and Parenting Stress Index (PSI) were administered before and after the HB-NDBI programs. Results: Following the HB-NDBI programs, significant improvements in social cognition, social communication subscales, receptive language subscale, internalizing, externalizing, and total behavioral problems scales of children, and release of parenting stress were observed. Conclusion: This study demonstrated the feasibility of home-based parent-mediated intervention for underserved families in Taiwan. These promising results might facilitate the development of such interventions for underserved families.

Cultural Adaptation of RUBI Intervention with Korean Families(K-RUBI): A Mixed Method Study.

Challenging behaviors of young autistic children remain a major parenting challenge for many of their family members, including caregivers. Caregivers from underrepresented cultural or linguistic backgrounds may experience exacerbated difficulties related to challenging behaviors due to limited access to culturally sustaining and responsive interventions. Evidence-based behavior parent training programs, such as RUBI, are highly effective in increasing caregivers' capacity in preventing and responding to these behaviors in naturalistic settings using behavior analytic principles. Therefore, the purpose of this study was to examine the effectiveness, acceptability, and feasibility of the culturally adapted RUBI program with underserved families. We conduct a convergent mixed-methods study using a pilot randomized controlled trial with a waitlist control group and focus group interviews with 31 Korean families of young children with or suspected of autism. The Korean RUBI underwent rigorous cultural adaptation using the Cultural Adaptation Checklist, including the use of multiple community advisory boards to inform cultural adaptation. Both quantitative and qualitative findings revealed significant improvements in parents' confidence and knowledge in behavioral principles and decrease in severity of challenging behaviors, which suggest clinical utility of RUBI in an underrepresented, low-resourced community. A culturally adapted intervention for a different population can be perceived as a newly constructed intervention. This study provides insight on the systematic process of cultural adaptation of an established autism intervention and effectiveness, feasibility, and acceptability of RUBI.

Strategies for Equitable Recruitment to Engage Underrepresented Youth and Their Families into Clinical Research: Findings from the BEAD-T1D Pilot Study

Plain Language SummaryPrevious studies have demonstrated a need for increased diverse representation in clinical trials. However, they have not considered the impact of equitable and culturally congruent recruitment practices on underrepresented and underserved families. This study presents recruitment/retention strategies to address disparities in clinical trial recruitment to increase representation and participation of underrepresented families. This study offers practical strategies to increase diverse representation in clinical trials to lay the foundation for equitable clinical research.

Changes in unhealthy food consumption among vulnerable elementary-aged children in the United States during the COVID-19 pandemic: a serial cross-sectional analysis.

Several studies suggest that during the early pandemic, amidst socioeconomic instability, children from underserved families were more likely to resort to consuming cheaper, lower-quality foods with longer shelf lives. This study investigated the change in unhealthy food consumption across different phases (pre, early, mid) of the COVID-19 pandemic, and whether the strength of association between unhealthy food consumption and household socioeconomic disadvantage (HSED) varied across phases of the pandemic. This study utilized serial cross-sectional data collected from low-income families enrolled in a school-based food co-op, Brighter Bites. Secondary data analysis included 5,384 surveys from families who had complete data: 3422 pre-pandemic, 944 from the early pandemic, and 1,018 mid-pandemic. Outcome measures included sugary food intake and convenience/fast food intake, each of which was operationalized as a scale using pre-validated items from the surveys. HSED was operationalized as a composite of parent employment, parent education, food insecurity, and participation in government programs; responses were categorized into low, medium, and high HSED groups for analysis. We examined the interaction between HSED and time period to explore how HSED and its association with dietary measures changed over the course of the pandemic. A significant linear negative trend, i.e., a decrease in consumption from pre-to-mid-pandemic period was seen in sugary food intake (p < 0.001), but not in convenience food intake. In data pooled across time-periods, both sugary food and convenience/fast food consumption were inversely associated with HSED, and low unhealthy food consumption was observed among high-disadvantage groups. No significant interaction between time period and HSED was observed on either scale. However, the post-regression estimates from the adjusted interaction model showed a significant association between convenience/fast food consumption and HSED in pre- and mid-pandemic periods. The study highlights the nuances of socioeconomic dynamics on the diet behaviors of children from low-income families during a natural disaster.

Iowa’s Integrated Data System for Decision-Making (I2D2): a collaborative approach for responsible and relevant use of population data

Integrated data systems (IDS) bring together people, processes, and priorities in a disciplined approach to generate evidence about child and family needs and service system gaps. In response to pressure for more efficiently coordinated early childhood services, Iowa built an IDS as a collaborative effort between university researchers and government leaders. Iowa’s Integrated Data System for Decision-Making (I2D2) includes an engaged governance approach that has received national attention as a model for ensuring federal and state priorities direct the work, rigorous scientific standards are used, and community engaged users have access to the information they need when they need it. This presentation will describe I2D2’s governance and technology solutions and provide examples of cyclical, community-engaged projects that have informed program improvement. Multi-stage integration protocols ensure individual records from disparate systems in health, education, child welfare, and workforce are accurately matched within a process that attends to equity. Dissemination processes within communities of practitioners, executive leaders, and researchers ensure findings are relevant and used to drive strategic planning. Public facing dashboards and interactive applications display prioritized indicators and support improved data literacy and common language across partner groups. Examples of use will be discussed including the evolution of a statewide strategic planning process using integrated data indicators, evidence-based expansion of home visiting programming to meet the needs of underserved families, and support for sustainable childcare businesses through the availability of real-time vacancy, supply, and demand data and easy to access applications for families to find available care when they need it.

Therapeutic Alliance and Group Cohesion Across Telehealth Delivery of Mentalizing-focused Parenting Groups

ABSTRACT This study assessed changes in therapeutic alliance and group cohesion among parents/primary caregivers enrolled in Connecting and Reflecting Experience (CARE), a short-term, group-based, mentalizing-focused parenting program designed to support a diverse community facing socioeconomic and health disparities. Caregivers (N = 44) experiencing parenting stress or parent-child relational challenges were recruited from their children’s outpatient psychiatry clinic to participate in one of nine 12-session telehealth CARE groups. Caregivers completed the Working Alliance Inventory-Short Revised and the Therapeutic Factors Inventory Cohesiveness subscale after CARE Sessions 1 and 12. Ratings of group cohesion and therapeutic bond with facilitators increased significantly across treatment. Findings indicate that caregivers from underserved families with high levels of parenting stress experienced an increase in group cohesion and therapeutic alliance throughout a telehealth adaptation of CARE.

Sozialpädiatrische Versorgungssituation und -bedarfe in Zeiten der COVID-19-Pandemie 2020 bis 2022. Was wird jetzt gebraucht?

ZusammenfassungHintergrundKinder und Jugendliche mit sozialpädiatrischen Versorgungsbedarfen stellen eine Gruppe mit besonderen Herausforderungen dar. Ziel der qualitativen Studie war, die sozialpädiatrische Versorgung in der Pandemie aus Expert*innensicht zu beschreiben. Hieraus sollten Rückschlüsse für möglicherweise entstandene sozialpädiatrische Versorgungsbedarfe abgeleitet werden.MethodenEs wurden 25 Expert*innen aus dem sozialpädiatrischen Bereich von Mai bis November 2022 mit leitfadengestützten Interviews zu folgenden Themen befragt: Abweichungen der Versorgung, Inanspruchnahmeverhalten von Familien, individuelle Belastungen und Ressourcen sowie nachhaltige Bedarfe. Die Interviews wurden von 2 wissenschaftlichen Mitarbeitenden inhaltsanalytisch ausgewertet.ErgebnisseTemporär zeigte sich ein deutlich eingeschränktes sozialpädiatrisches Versorgungsangebot. Während bereits vor der Pandemie gut eingebundene Familien ausreichend mithilfe von Telefon‑/Videokontakten betreut werden konnten, wurde eine Dunkelziffer von Risikogruppen z. B. mit geringer Handlungskompetenz beschrieben, welche Leistungen nicht oder verzögert in Anspruch nahmen. Beobachtet wurden Versorgungsbedarfe für neu entwickelte psychische Auffälligkeiten und Therapierückschritte aufgrund eingeschränkter Fördermöglichkeiten sowie ein Nachholbedarf verpasster Möglichkeiten der Frühförderung bei Entwicklungsstörungen.DiskussionUm entstandene Versorgungsbedarfe zu decken, sollten zielgerichtet unterversorgte Familien identifiziert und zeitnah unter Berücksichtigung individueller Merkmale versorgt werden. Hierzu könnten z. B. vermehrt aufsuchende Versorgungsangebote etabliert werden, die unbürokratisch bei betroffenen Familien ankommen.

Examining Factors Associated with the Use of Community Food Resources: An Application of the Andersen Model to Inform Future Interventions.

The role of the food environment in shaping nutrition and health has gained substantial attention from policymakers, public health researchers, and advocacy groups. To promote equities in food access and nutrition outcomes, understanding factors linked with the utilization of local community food resources is crucial. Using Andersen's service utilization model, we explained how adults use their neighborhood food resources. In a cross-sectional study design, an online survey was conducted in REDCap Version 13.4.0 via the Amazon Mechanical Turk (MTurk) involving 1830 adults with a mean age of 37.9 ± 12.1 years. Participants answered questions on predisposing, enabling, and need factors that influence their use of different community food resources. The predisposing factors that were statistically significant included age, family size, marital status, race, and ethnicity. The enabling factors included travel time, travel mode, income, and shopping decision motivators (such as being able to use Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) vouchers, delivery services, great sales, and coupons). Food security and community food resources need for lower food price were the significant need factors. However, these factors vary by the types of food resources. In conclusion, enhancing the utilization of community-based food access initiatives and programs among underserved families requires consideration of family composition, racial and ethnic diversity, and transportation access.

Screening, brief intervention, and referral to treatment (SBIRT) implementation in urban underserved family medicine practices.

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice that provides early integrated intervention and treatment to patients with Alcohol Use Disorder (AUD) and/or Substance Use Disorders (SUD). Three Primary Care Medical Homes (PCMHs) in North Texas were selected as pilot sites for a SAMHSA grant designed to integrate SBIRT into existing services. The goal of this program is to support the stabilization and community reintegration of individuals who present with SUD by providing them with a continuum of care from screening, to brief intervention, to brief treatment, to referral for more advanced services. Specific aims of the grant included: provide SBIRT services to eligible participants, decrease substance and alcohol use at 6-month follow-up, improve patient physical and behavioral health measured at 6months, and decrease in emergency department visits and costs for program participants. This brief report examines project design, outlines the implementation strategies, and provides preliminary results.

Efficacy and Implementation of Stress-Reduction Interventions for Underserved Families of Autistic Preschoolers Across In-Person and Virtual Modalities

Abstract Objectives Parents of autistic children experience elevated stress relative to parents of children with neurotypical development and children with other intellectual and developmental disabilities. Adverse effects of parenting stress on parent, child, and family functioning may be especially heightened for marginalized families. We conducted a randomized controlled trial that demonstrated the efficacy of Mindfulness-Based Stress Reduction (MBSR) relative to psychoeducational support (PE) for reducing stress in diverse and underserved parents of autistic preschoolers. This paper presents implementation data, and examines efficacy across in-person and virtual intervention modalities. Method Primary caregivers (n = 117; 91% female, 51% Latinx, 44% income &lt; US $50,000) of 3- to 5-year-old autistic children (80% male, 68% with intellectual disability) were randomly assigned to MBSR (n = 59, 46% virtual) or PE (n = 58, 41% virtual). Assessments were conducted at baseline, immediately post-intervention, and at 6 and 12 months post-intervention. Results Both MBSR and PE demonstrated strong feasibility, acceptability, and utility for our diverse families. Comparable efficacy was observed across modalities. However, attendance was significantly better for virtual groups than for in-person groups. Parents participating in virtual MBSR also reported less difficulty completing homework and utilizing learned skills in everyday life than did in-person MBSR participants. Conclusions MBSR and PE appear feasible, acceptable, and efficacious for diverse and underserved parents of young autistic children. Preliminary evidence of comparable efficacy across virtual and in-person modalities indicates the potential to expand access to vital stress-reduction interventions through use of telehealth technology. Preregistration ClinicalTrials.gov Identifier: NCT03459625.

The Need to Standardize the Reanalysis of Genomic Sequencing Results: Findings from Interviews with Underserved Families in Genomic Research.

The reanalysis of genomic sequencing results has the potential to provide results that are of considerable medical and personal importance to recipients. Employing interviews with forty-seven predominantly medically underserved families and ethnographic observations we argue that there is pressing need to standardize the approach taken to reanalysis. Our findings highlight that study participants were unclear as to the likelihood of reanalysis happening, the process of initiating reanalysis, and whether they would receive revised results. Their reflections mirror the lack a specific focus upon reanalysis within consent and results sessions as observed in clinical settings. Mechanisms need to be put into place that standardize the approach to reanalysis in research and in clinical contexts. This would enable clinicians and genetic counsellors to communicate clearly with research participants with respect to potential for reanalysis of results and the process of reanalysis. We argue that that the role of reanalysis is too important to be referred to in an ad-hoc manner. Furthermore, the ad-hoc nature of the current process may increase health inequities given the likelihood that only those families who have the means to press for reanalysis are likely to receive it.

Benefits and Challenges of a Telehealth Eating and Mealtime Intervention for Autistic Children: Occupational Therapy Practitioners' Perspectives.

Eating and mealtime challenges are common in autistic children, yet intervention access is limited. Telehealth may provide opportunities to address this gap and increase access for underserved families. This study examined the occupational therapy practitioner's perceptions of transitioning from a caregiver-mediated, in-home eating, and mealtime intervention for autistic children to telehealth owing to COVID-19 while considering the impact on accessibility, challenges, and benefits. Family characteristics were compared between groups. Thematic analysis of semi-structured interviews explored practitioners' experiences of telehealth. Statistical findings and themes were directly compared and contrasted. The following three themes emerged: Intervention Adaptations, Challenges for Interventionists, and Benefits of Telehealth. The differences in the families' geographic location were identified. Themes and family characteristic differences supported increased intervention accessibility for the telehealth group. This study provides preliminary evidence that telehealth can increase access to specialized services. There are benefits and challenges to implementing telehealth with families and autistic children.

Understanding the Role of Race in Doula Communities: Florida Doulas’ Perceptions of Maternal Health Disparities [ID: 1377606

INTRODUCTION: This study, part of a larger qualitative project, spurred significant participant feedback related to BIPOC (Black, Indigenous, people of color) clients’ needs for support from racially similar doulas. As such, this study analyzed the data to investigate how doulas navigate client perceptions of race. METHODS: Seven in-depth interviews and six focus groups were conducted with doulas serving in Florida (n=31). Transcripts were coded post-inter-coder agreement using an inductive approach to thematic analysis. Participant consent and IRB approval were obtained. RESULTS: 1) White doulas reported Black doulas advising them to refrain from taking on Black, Brown, non-English speaking clients and instead to refer when possible. Some participants explained tendency for implicit bias and discrimination when White doulas try to step into the perspective of clients of color, specifically Black women, despite good intent in trying to support a community facing health disparities. 2) A few doulas referred to White doulas reaching out to non-White clients as a savior/virtue signaling act, while others countered that White doulas can use their racial status for advocacy in medical settings. CONCLUSION: Doulas shared a desire to work with underserved families and discussed that issues surrounding race must first be acknowledged in order to create safer spaces for open communication surrounding maternal health, thereby mitigating disparities. It is important to note that our study relied on convenience sampling, utilizing predominantly White doulas, limiting our data on Black doula experiences and their perceptions on the role of race in the doula–client relationship. Future directions must include diversification of participants and speaking directly with Black doulas.

Financial reimbursement and productivity metrics for pharmacist-led chronic care management services in rural practice settings.

The implementation of chronic care management (CCM) services has often been hindered by issues with reimbursement, raising concerns about sustainability. To date, little if any literature has examined the financial feasibility and sustainability of CCM services in rural practice settings. Assess financial reimbursement and productivity metrics for pharmacist-led CCM services at a rural, medically underserved family medicine clinic. This study retrospectively examined data from the clinic's CCM program from October 2020 through May 2021 and included total clinical encounters, minutes of pharmacist time spent on calls, CCM claims, work relative value units (wRVU), financial reimbursement, and overall personnel costs. Over an 8-month period, 46 patients were enrolled in CCM services. Of the 49 CCM calls placed during this time, 31 (63.3%) were billable, though only 20 (64.5% of billable calls) were ultimately reimbursed. Approximately 37% of pharmacist "time-on-task" was not billable. Compared to the $643 required to cover pharmacist time on CCM calls, $822 of reimbursement was collected. This $179 profit, or 27.8% return-on-investment, is similar to results from more urbanized practices. Furthermore, services were "net productive" in wRVU generation, which may appeal to physician stakeholders interested in such targets. Concerns about profitability and sustainability have prevented more widespread CCM implementation. In the present study, pharmacist-led CCM services achieved a 27.8% return-on-investment. Though rural-based CCM services may never attain significant profit margins, this data suggests they can still be financially self-sustaining and "net productive," all while providing high-quality patient care.

Racial Disparities in Autism Diagnosis, Assessment, and Intervention among Minoritized Youth: Sociocultural Issues, Factors, and Context.

Despite the increasing prevalence of autism spectrum disorder (ASD) among youth, disparities exist when it comes to access to diagnostic assessment and intervention of ASD in clinical and school settings. A review of the literature on sociocultural issues that contribute to these disparities would allow psychiatrists, clinicians, and researchers to better understand these challenges and aid in the development of culturally responsive approaches to support racially, ethnically, and linguistically diverse families of youth with ASD. Disparities in ASD services are primarily due to system-level factors, including access to information or healthcare, stigma, and discrimination. Similarly, interactional factors, such as language/communication barriers, a lack of trust in professionals, and limited training in cultural responsiveness, can hinder support for diverse families of youth with ASD. This review focuses on several areas: (1) structural inequities that contribute to disparities in ASD services, (2) sociocultural issues in assessment and diagnosis, (3) sociocultural issues in interventions and service use, and (4) neurodiversity. This review underscores the importance of including diverse samples in ASD research to improve understanding of the strengths, challenges, perspectives, and preferences of underrepresented and underserved families of youth with ASD. These efforts can lead to culturally responsive service delivery.

An Exploratory Social Justice Framework to Develop Public Library Services with Underserved Families

ABSTRACT An issue in the 21st century is how public libraries can be strategic and impactful to achieve greater equity. Based on a qualitative meta-analysis of chapters from the authors’ book A Librarian’s Guide to Engaging Families published in 2021, this article presents a framework of social justice to strengthen library services to engage underserved families in student learning. Three themes include: 1) Public libraries welcome underserved families using targeted universalism and active inclusion strategies. 2) They take bold leadership to rectify historically imbalanced inequities by removing barriers and reallocating resources. 3) They respect family roles/agency and uphold community economic development.

On the cross-city growth drivers of the most vulnerable region of Brazil

PurposeThe purpose of this paper is discussing on cross-city empirical economic growth, by estimating an unbalanced dynamic panel for the most vulnerable region of Brazil.Design/methodology/approachThe authors propose including additional and specific sources of cross-city variation, enabling them to capture the essence and reality of this region. The sample selection is given by the solution of a trade-off on the number of cities and the available explanatory variables. Considering the final choice, the analysis is based on 6,452 observations extracted from a sample of 925 cities between 2009 and 2015. Reconciling the regional growth literature and this availability of observable data, the authors decide to explain cross-city real gross domestic product per capita in log, controlling for its lagged value besides 15 explanatory variables on human capital, financial system, business environment and social infrastructure.FindingsThis study uses growth drivers on human capital, financial system, business environment and social infrastructure. Considering 6,452 observations for the period from 2009 to 2015, this study finds a significant role played by the levels of education of formal workers, rural financing, real estate financing and FIRJAN indices (health and employment).Research limitations/implicationsA more comprehensive and complete understanding of cross-city variation, whether in the Northeast, in the North of the country or in other regions, involves the expansion of growth drivers in the model. Certainly, the impact of the industrial sector (not captured by the FIRJAN employment/income index), or programs and initiatives geared to technology, must be significant and positive. Despite the low market share, the insertion of microcredit data for informal, small business owners and more underserved families, can bring insights not measured in this article.Practical implicationsOn financial system and development: The results on the significant and positive coefficient of rural and real estate financing are fundamental in conducting public policies aimed at granting credit. On human capital: The expected and intuitive relevant role of education suggests that good policies that are implementable need to be looked for and replicated to other northeastern cities. The state of Ceará seems to be that benchmark to be followed by the other states.Social implicationsAnother public policy that needs to be strengthened so that the most vulnerable cities can grow is related to the partnership with the private sector in the expansion and maintenance of basic sanitation. In this context, the new Legal Framework for Basic Sanitation is an important step. Its main objective is to universalize and qualify the provision of services in the sector. Theoretically, it seems to be an important advance and this also unlocks the first big wave of investments.Originality/valueThe analysis aims to contribute to the recent studies on regional growth applied to Brazil. To the best of the authors’ knowledge, this is an innovative contribution, and the main differences between this paper and the others are the sample of cities, the period, the growth model and the estimation technique. For instance, Da Mata et al. (2005, 2007) explore population growth and its implications for economic dynamics and income generation among 123 urban agglomerations between 1970 and 2000. Alves (2021) studied slum growth in contemporary urbanization of households in 272 Brazilian cities from 1991 to 2010.

Preschoolers’ parent and teacher/director perceptions of returning to early childcare education during the COVID-19 pandemic

BackgroundEarly Care and Education (ECE) sites are critical hubs for social, emotional, and physical learning development of preschool children (ages 3–5). The COVID-19 pandemic has impacted ECE enrollment and participation; until June 2022, preschool children in the US were ineligible for COVID-19 vaccines. It is critical to identify perceptions of teachers/directors and parents to enhance safe return-to-school efforts.MethodsFocus groups (n = 7; 22 participants) were conducted with ECE teachers/directors throughout Arizona to examine perceptions of COVID-19 testing for families and staff at ECE sites, and current and possible COVID-19 mitigation strategies during Summer 2021. Preschool parents from underserved families in Phoenix (n = 41) completed a brief survey on their perceptions of benefits of ECE for themselves and their children, thoughts on COVID-19 mitigation strategies, and timing for safe return to school during Spring 2021. Focus groups were transcribed and analyzed for themes using constant comparison.ResultsThere were 4 focus group themes: 1) perceptions of saliva-based COVID-19 testing, 2) logistical strategies for COVID-19 testing at ECE sites; 3) successes and challenges with current COVID-19 mitigation strategies; 4) ideas to support improved COVID-19 mitigation, including outdoor gardening. Parents rated peace of mind about the child’s education as the most important benefit for themselves of in-person ECE (74.6%), and social development for children as the most important benefit for their children (54.4%). Over 40% of parents reported it would not be safe to send children back until 2022.ConclusionsCOVID-19 continues to impact attendance at ECE sites, despite parents reporting key benefits to attending ECE sites. Teachers/directors supported COVID-19 mitigation strategies including saliva-based testing and gardening education to improve safe return to schools.

The well-being of head start teachers: a scoping literature review

ABSTRACT Attention to students’ socio-emotional, behavioral, and academic outcomes raises important considerations for the psychological well-being of teachers, especially Head Start teachers who often work with underserved families. This scoping review summarizes current literature on Head Start teacher psychological well-being and identifies 1. how teacher well-being is conceptualized and measured, 2. Which interventions exist to promote Head Start teacher psychological well-being or help them manage stress and 3. directions for future research. The review resulted in 32 articles (29 peer-reviewed and three gray literature). Findings highlight that research is primarily descriptive using cross-sectional surveys and secondary data. Evidence suggests that although resilient and committed as educators, Head Start teachers struggle to cope with the stressors involved in supporting early childhood education. Interventions to decrease stress and promote the psychological well-being are few but teachers indicate interest in such interventions. Autonomy, feeling valued for their work, collegiality between staff, and a supportive supervisor help improve job satisfaction, retention, and psychological well-being. Future research should be guided by conceptual models that prioritize Head Start teachers’ input, use of validated measures of psychological well-being with consideration of cultural and structural factors that influence well-being.