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The Effects of a Relationship-Focused Professional Development Intervention on Infant and Toddler Teachers' Mindfulness-Based Strategies for Coping

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Title: The Effects of a Relationship-Focused Professional Development Intervention on Infant and Toddler Teachers' Mindfulness-Based Strategies for Coping
Language: English
Authors: Holly E. Brophy-Herb (ORCID 0000-0003-2186-6025), Ann M. Stacks, Cynthia Frosch (ORCID 0000-0002-8330-5437), Ahnalee M. Brincks (ORCID 0000-0002-5049-1229), Jody L. Cook (ORCID 0000-0003-2965-8546), Claire D. Vallotton (ORCID 0000-0001-7815-2993), Haiden A. Perkins (ORCID 0000-0003-2009-0202), Loria E. Kim (ORCID 0000-0003-1110-9514), Russell Carson, Maria Muzik (ORCID 0000-0001-9888-8519), Katherine Rosenblum (ORCID 0000-0001-6952-9672), Patricia A. Jennings (ORCID 0000-0003-1026-1362)
Source: Early Childhood Education Journal. 2024 52(2):243-257.
Availability: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
Peer Reviewed: Y
Page Count: 15
Publication Date: 2024
Sponsoring Agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (DHHS/NIH)
Administration for Children and Families (DHHS)
National Institute of Food and Agriculture (NIFA) (USDA)
Contract Number: R21HD090406
90YR00920400
MICL02393
MIC02700
Document Type: Journal Articles
Reports - Research
Education Level: Early Childhood Education
Descriptors: Early Childhood Teachers, Infants, Toddlers, Metacognition, Coping, Intervention, Faculty Development, Stress Management, Emotional Response, Fatigue (Biology), Low Income Students, Interpersonal Relationship
Laws, Policies and Program Identifiers: Head Start
DOI: 10.1007/s10643-022-01416-0
ISSN: 1082-3301
1573-1707
Abstract: Teaching is a demanding profession with teachers of very young children reporting high rates of stress and exhaustion. We tested the effects of a relationship-focused professional development intervention designed to enhance teachers' use of mindfulness-based strategies to support coping on trajectories of teachers' stress, exhaustion (emotional, physical, and mental), and coping. Infant and toddler teachers (N = 81) from Early Head Start (EHS) or EHS childcare partnerships (CCP) were randomized to the intervention or usual care control condition. Using ecological momentary assessment, teachers completed twice-weekly reports of stress, exhaustion, coping, and coping strategy effectiveness via smartphones for 40 weeks. Multilevel linear regression modeling, accounting for within-person repeated measures, showed no intervention effects on stress and exhaustion trajectories. Teachers in the intervention reported increased use of mindfulness-based strategies for coping over time as compared to the control group, although frequency of use peaked and then declined. While perceptions of stress and exhaustion did not change, teachers' increased use of mindfulness-based strategies suggests improvements in how teachers managed stress and exhaustion; however, the decline in use of coping suggests the need for ongoing support within the workplace.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1408716
Database: ERIC
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  Value: <anid>AN0174972880;5mx01feb.24;2024Jan25.04:47;v2.2.500</anid> <title id="AN0174972880-1">The Effects of a Relationship-Focused Professional Development Intervention on Infant and Toddler Teachers' Mindfulness-Based Strategies for Coping </title> <p>Teaching is a demanding profession with teachers of very young children reporting high rates of stress and exhaustion. We tested the effects of a relationship-focused professional development intervention designed to enhance teachers' use of mindfulness-based strategies to support coping on trajectories of teachers' stress, exhaustion (emotional, physical, and mental), and coping. Infant and toddler teachers (N = 81) from Early Head Start (EHS) or EHS childcare partnerships (CCP) were randomized to the intervention or usual care control condition. Using ecological momentary assessment, teachers completed twice-weekly reports of stress, exhaustion, coping, and coping strategy effectiveness via smartphones for 40 weeks. Multilevel linear regression modeling, accounting for within-person repeated measures, showed no intervention effects on stress and exhaustion trajectories. Teachers in the intervention reported increased use of mindfulness-based strategies for coping over time as compared to the control group, although frequency of use peaked and then declined. While perceptions of stress and exhaustion did not change, teachers' increased use of mindfulness-based strategies suggests improvements in how teachers managed stress and exhaustion; however, the decline in use of coping suggests the need for ongoing support within the workplace.</p> <p>Keywords: Professional development; Coping; Mindfulness; Stress; Teachers; Toddlers</p> <p>Copyright comment Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</p> <p>Teachers' well-being has taken center stage as an important consideration in promoting high quality early care and education (ECE) practices. For example, teachers' well-being is increasingly emphasized as part of a comprehensive model for transforming the early childhood workforce (Madill et al., [<reflink idref="bib44" id="ref1">44</reflink>]). Both preservice teacher preparation programs (Decker et al., [<reflink idref="bib16" id="ref2">16</reflink>]; Meiklejohn et al., [<reflink idref="bib47" id="ref3">47</reflink>]) and professional development efforts for teachers already in the field (Cumming, [<reflink idref="bib15" id="ref4">15</reflink>]) are focused increasingly on reducing stress and promoting well-being, underscoring its importance. Notably, emerging work with infant and toddler teachers characterizes this portion of the workforce as highly vulnerable to stress (Berlin et al., [<reflink idref="bib6" id="ref5">6</reflink>]), which is problematic given that stress and exhaustion can compromise teachers' sensitivity to children (Buettner et al., [<reflink idref="bib10" id="ref6">10</reflink>]; Kwon et al., [<reflink idref="bib42" id="ref7">42</reflink>]; Whitaker et al., [<reflink idref="bib68" id="ref8">68</reflink>]). However, teachers' self-care skills may buffer the impact of stress on classroom quality (Jennings, [<reflink idref="bib32" id="ref9">32</reflink>]). Mindfulness-based skills and coping strategies have emerged as promising options for promoting well-being among teachers of older children (e.g., Hwang et al., [<reflink idref="bib30" id="ref10">30</reflink>], [<reflink idref="bib31" id="ref11">31</reflink>]) and for early childhood teachers (Roeser et al., [<reflink idref="bib55" id="ref12">55</reflink>]). Yet little is known about the effects of promoting well-being via professional development programs delivered to infant and toddler teachers. Given the unique qualities of infant and toddler care and education, findings from samples of preschool and primary school teachers cannot necessarily be generalized to the infant and toddler teacher workforce. Hence, the goal of this study was to test the effects of a relationship-focused, mindfulness-informed, professional development intervention on teachers' long-term experiences of stress and emotional, physical, and mental exhaustion, three longstanding dimensions of exhaustion (Shirom, [<reflink idref="bib62" id="ref13">62</reflink>]).</p> <hd id="AN0174972880-2">Stress and Exhaustion in Early Childhood Educators</hd> <p>Early childcare and education is emotionally demanding labor (Roeser et al., [<reflink idref="bib55" id="ref14">55</reflink>]), particularly among infant and toddler teachers (Lee & Brotheridge, [<reflink idref="bib43" id="ref15">43</reflink>]; Vincent & Braun, [<reflink idref="bib66" id="ref16">66</reflink>]), requiring teachers to be mentally present and emotionally available throughout the workday. Unlike preschool aged children who have the skills to exert a large degree of autonomy in their day-to-day functioning in the classroom, infants and toddlers do not. As compared to preschool aged children, infants and toddlers rely more heavily on their teachers to help them self-regulate, engage with learning materials, and navigate the day. While teachers of older children also respond to children's needs, infant and toddler signals that may be less clear than those of older children who have greater language and motor skills to express their needs. This requires additional efforts from infant and toddler teachers. Moreover, as noted by Kwon et al. ([<reflink idref="bib42" id="ref17">42</reflink>]), infant and toddler teachers are uniquely subjected to a lack of respect for their work and a lack of understanding about the complexity of high-quality infant and toddler care and education, which may also contribute to their potentially unique experiences of stress. Infant and toddler caregiving requires continual, individualized planning and scaffolding of infants' and toddlers' unique needs and skills. Such ongoing emotional and mental demands may hamper teachers' capacities to fully engage in the many planning and decision-making processes that occur throughout the workday (Carson et al., [<reflink idref="bib13" id="ref18">13</reflink>]), and contribute to increased levels of stress and exhaustion. Infant and toddler caregiving also places physical stressors on teachers (Gratz et al., [<reflink idref="bib23" id="ref19">23</reflink>]; Kwon et al., [<reflink idref="bib42" id="ref20">42</reflink>]) given that the work involves holding, carrying, and lifting multiple children, moving often from sitting (including on the floor) to standing positions, and moving materials. In fact, Kwon's (e.g., [<reflink idref="bib42" id="ref21">42</reflink>]) research illustrates experiences of greater physical demands and exhaustion among teachers of very young children relative to teachers of older children. While it is clear that early childcare is a stressful and demanding profession, it is less clear how teachers' experiences of stress and exhaustion may change over time. Although research with infant and toddler teachers is limited in this area, findings from studies of elementary and secondary teachers suggest that teacher stress may increase, decrease, or stay the same across the year (e.g., Brenner et al., [<reflink idref="bib9" id="ref22">9</reflink>]; Harmsen et al., [<reflink idref="bib25" id="ref23">25</reflink>]; Katz et al., [<reflink idref="bib38" id="ref24">38</reflink>]; Mäkinen & Kinnunen, [<reflink idref="bib45" id="ref25">45</reflink>]; Voss et al., [<reflink idref="bib67" id="ref26">67</reflink>]). Discrepant findings regarding stability or variability in teachers' stress over time may reflect differences in the number of assessments conducted in each study. For example, some studies capturing two assessment points have reported little change in teacher stress (e.g., Brenner et al., [<reflink idref="bib9" id="ref27">9</reflink>]) while studies with additional assessments have captured the ebbs and flows of teacher stress during the school year (e.g., Mäkinen & Kinnunen, [<reflink idref="bib45" id="ref28">45</reflink>]).</p> <p>Differences in findings regarding stability or variability in teacher stress may also reflect the constructs studied in each investigation. For example, while Baumgartner et al. ([<reflink idref="bib3" id="ref29">3</reflink>]) examined stress and exhaustion in infant, toddler, and preschool teachers using ecological momentary assessment (EMA) methods over the course of the week, their study focused on stress and exhaustion related to evening professional activities rather than the stability of stress and exhaustion over time. In contrast, Carson et al. ([<reflink idref="bib13" id="ref30">13</reflink>]) assessed childcare teachers' emotional exhaustion and coping strategies throughout the day over a week's time. Teachers identified strategies rooted in mindfulness practices, such as muscle relaxation and meditation (Hunt et al., [<reflink idref="bib29" id="ref31">29</reflink>]), as most effective for immediate relief from exhaustion. Collectively, the extant literature demonstrates the need to better understand stress, exhaustion, and coping strategy use among teachers of very young children, particularly as it is experienced over time. Such information is critical in understanding how to support teachers' well-being, including how professional development efforts might increase teachers' repertoire of coping strategies to effectively managing stress and exhaustion.</p> <hd id="AN0174972880-3">Mindfulness-Based Strategies to Support Coping</hd> <p>Given the complex work of teaching young children, it is unlikely that stress and exhaustion can be eliminated. Hence, promoting teachers' use of effective coping strategies remains an important area of study in the professional development literature. In recent years, the use of mindfulness-based strategies to support coping has been identified as a potentially important resource for teachers (e.g., Abenavoli et al., [<reflink idref="bib1" id="ref32">1</reflink>]; Becker et al., [<reflink idref="bib4" id="ref33">4</reflink>]). Mindfulness is an awareness and acceptance of one's thoughts in the moment without judgment (Kabat-Zinn, [<reflink idref="bib37" id="ref34">37</reflink>]). Within the education field, there has been a surge in interest in teacher well-being (Cumming, [<reflink idref="bib15" id="ref35">15</reflink>]; Jennings et al., [<reflink idref="bib36" id="ref36">36</reflink>]; [<reflink idref="bib35" id="ref37">35</reflink>]), including an increased focus on mindfulness-based approaches to supporting well-being (Jennings & De Mauro, [<reflink idref="bib34" id="ref38">34</reflink>]; Roeser et al., [<reflink idref="bib55" id="ref39">55</reflink>], [<reflink idref="bib54" id="ref40">54</reflink>]). Teachers' instruction in, and application of, mindfulness is linked with reductions in teachers' job stress and increases in self-compassion (Gold et al., [<reflink idref="bib21" id="ref41">21</reflink>]; Roeser et al., [<reflink idref="bib54" id="ref42">54</reflink>]). Research with pre-K teachers has shown that increased mindfulness relates to positive shifts in teachers' emotional reactivity, resulting in more sensitive responsiveness to children and less stress for teachers (Jennings et al., [<reflink idref="bib33" id="ref43">33</reflink>]). Despite a robust literature linking mindfulness to well-being and to sensitive practices in pre-K and K-12 teachers (e.g., Gold et al., [<reflink idref="bib21" id="ref44">21</reflink>]; Jennings, [<reflink idref="bib32" id="ref45">32</reflink>]; Jennings & DeMauro, [<reflink idref="bib34" id="ref46">34</reflink>]; Jennings et al., [<reflink idref="bib33" id="ref47">33</reflink>]; Meiklejohn et al., [<reflink idref="bib47" id="ref48">47</reflink>]; Roeser et al., [<reflink idref="bib54" id="ref49">54</reflink>]; Woods, [<reflink idref="bib69" id="ref50">69</reflink>]) virtually no research has examined these associations among infant and toddler teachers.</p> <hd id="AN0174972880-4">Professional Development Support for Well-Being</hd> <p>Although promoting teacher well-being through the use of mindfulness-based strategies is increasingly prevalent in teachers' professional development (Braun et al., [<reflink idref="bib8" id="ref51">8</reflink>]; Herrmann & Gallo, [<reflink idref="bib27" id="ref52">27</reflink>]; Jennings, [<reflink idref="bib32" id="ref53">32</reflink>]; Jennings et al. [<reflink idref="bib36" id="ref54">36</reflink>]; Roeser et al., [<reflink idref="bib55" id="ref55">55</reflink>]), a recent review underscored the need for additional research (Hwang et al., [<reflink idref="bib30" id="ref56">30</reflink>]). Promising findings from Hwang et al.'s ([<reflink idref="bib30" id="ref57">30</reflink>]) systemic review, as well as from recent studies (e.g., Braun et al., [<reflink idref="bib8" id="ref58">8</reflink>]; Hwang et al., [<reflink idref="bib31" id="ref59">31</reflink>]; Roeser et al., [<reflink idref="bib53" id="ref60">53</reflink>]), illustrated consistent, positive benefits of mindfulness-based interventions for teachers, including favorable effects on stress and burnout, depression and anxiety, mindfulness, and self-compassion. Importantly, a handful of qualitative studies highlighted the processes through which mindfulness-based interventions may improve well-being (e.g., Bernay, [<reflink idref="bib7" id="ref61">7</reflink>]; Burrows, [<reflink idref="bib11" id="ref62">11</reflink>]; Napoli, [<reflink idref="bib51" id="ref63">51</reflink>]; Schussler et al., [<reflink idref="bib58" id="ref64">58</reflink>], [<reflink idref="bib59" id="ref65">59</reflink>]). Across these studies, teachers reported applying mindfulness-based strategies to support their coping such as bringing awareness to bodily sensations in order to recognize signals of stress (e.g., Schussler et al., [<reflink idref="bib58" id="ref66">58</reflink>]), building the capacity to reperceive stressors through emotional awareness and self-regulation (Schussler et al., [<reflink idref="bib59" id="ref67">59</reflink>]), and focusing on breathing to self-calm (e.g., Napoli, [<reflink idref="bib51" id="ref68">51</reflink>]).</p> <p>Despite the promising findings emerging in the teacher professional development literature, very few studies have included samples of infant and toddler teachers. Using a sample of early childhood preschool teachers, however, Jennings ([<reflink idref="bib32" id="ref69">32</reflink>]) reported associations between early childhood teachers' mindfulness and perspective taking, sensitivity in discipline and management, and emotional support of children. In addition, Hatton-Bowers et al. ([<reflink idref="bib26" id="ref70">26</reflink>]) evaluated early childhood teachers' responses to an online mindfulness-focused professional development training. Qualitative analyses illustrated teachers' positive perceptions of the training. Some teachers described familiarity with the concepts of mindfulness and appreciated the reminder to utilize mindfulness-based strategies to support their coping including breathing experiences and meditation. Moreover, DiCarlo et al. ([<reflink idref="bib17" id="ref71">17</reflink>]) found early childhood teachers' implementation of mindfulness-based practices in the classroom, including yoga poses, intentional breathing, and guided mediation, was related to perceived reductions in stress. Preservice early childhood teachers also perceived the benefits of mindfulness-based professional development experiences (Beers Dewhirst & Goldman, [<reflink idref="bib5" id="ref72">5</reflink>]). However, there have been no interventions designed specifically for infant and toddler teachers, particularly regarding intervention impacts on teachers' stress, exhaustion, and coping. In this study, we examine the effects of the Hearts and Minds on Babies professional development intervention on infant and toddler teachers' experiences of stress and exhaustion, including coping strategies.</p> <hd id="AN0174972880-5">Description of the Hearts and Minds on Babies Intervention</hd> <p>Hearts and Minds on Babies (HMB) is a comprehensive relationship-focused intervention designed to promote use of mindfulness-based stress reduction and coping techniques and improve reflective functioning and sensitive caregiving among infant and toddler teachers (Barron et al., [<reflink idref="bib2" id="ref73">2</reflink>]). HMB was adapted from Mom Power (Muzik et al., [<reflink idref="bib50" id="ref74">50</reflink>]; Rosenblum et al., [<reflink idref="bib56" id="ref75">56</reflink>]), an evidence-based, multifamily parenting and mental health intervention rooted in attachment theory, trauma-informed practice, self-compassion, and relational empathy. Mom Power aims to improve parental responsive caregiving by increasing parents' reflective capacity and stress coping (Ho et al., [<reflink idref="bib28" id="ref76">28</reflink>]; Swain et al., [<reflink idref="bib64" id="ref77">64</reflink>]). In contrast to Mom Power, which is a clinical intervention, HMB is a professional development (PD) program designed to support both teacher well-being and program quality via (a) increased use of mindfulness-based strategies for coping with stress; (b) improved reflective functioning by supporting participants capacity to anticipate, observe, and reflect on their own and others' emotions, thoughts, and behaviors; (c) increased responsiveness and sensitivity in relationships and interactions with children and families; and (d) enhanced social support through group experience. An overview of the HMB intervention is provided in Table 1. Teachers participated in 20 h of training which included two coaching sessions and one individual session over a 13-week span that was designed to fit into early childhood programs' professional development structures. Program facilitators were masters-level professionals with extensive training in infant mental health. Teachers learned how to use HMB concepts with children and how to share these concepts with parents. Concepts focused on recognizing and responding to children's attachment needs, understanding the meaning behind behaviors, self-awareness and self-regulation of emotion and attention, co-regulation of emotions, and the ways in which trauma can impact perceptions. During each of the training sessions, teachers learned about and practiced a variety of mindfulness-based strategies for coping including intentional breathing, container imagery meditation, progressive relaxation, and five senses exercises.</p> <p>Table 1 Overview of infant and toddler teachers' professional development intervention content and mindfulness-based self-care: Hearts and Minds on Babies (HMB)</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Session</p></th><th align="left"><p>Intervention concepts introduced</p></th><th align="left"><p>Overview of learning objectives</p></th><th align="left"><p>Mindfulness-based self-care concepts</p></th></tr></thead><tbody><tr><td align="left"><p>1</p></td><td align="left"><p>Social-emotional foundation of learning</p></td><td align="left"><p>Begin to describe the HMB perspective related to professional development and training</p><p>Offer a welcoming environment to support the development of group cohesiveness and relationships</p><p>Introduce the link between attachment and school readiness</p></td><td align="left"><p>Butterfly and seedlings</p></td></tr><tr><td align="left"><p>2</p></td><td align="left"><p>The tree</p></td><td align="left"><p>Introduce the Tree as a metaphor for children's behavior's being an expression of attachment needs</p><p>Identify activities to provide children with warmth within the early childhood education context (sunshine time)</p><p>Consider how race, culture, and values can impact understanding and acceptance of the Tree concept</p></td><td align="left"><p>Mindful breathing</p></td></tr><tr><td align="left"><p>3</p></td><td align="left"><p>The tree</p></td><td align="left"><p>Identify building roots/connection and branching out/exploration moments in videos of classroom interactions</p><p>Strengthen observation skills by practicing identifying behavior without interpretation</p><p>Identify and reflect upon one's own feelings in response to children's attachment needs</p></td><td align="left"><p>Progressive relaxation</p></td></tr><tr><td align="left" colspan="4"><p>Classroom Observation/Coaching (elicit motivation, gauge barriers to participation)</p></td></tr><tr><td align="left"><p> 4</p></td><td align="left"><p>Wondering & response wheel</p></td><td align="left"><p>Identify behavior as clues to a children's feelings and needs</p><p>Increase skills for responding to children's attachment needs, building on the Tree</p><p>Consider how race, culture, and values can impact understanding and acceptance of the "Wheel" concept</p></td><td align="left"><p>Safe place visualization</p></td></tr><tr><td align="left"><p> 5</p></td><td align="left"><p>Restore emotional balance</p></td><td align="left"><p>Increase vocabulary around feeling words</p><p>Understand ways to help children and oneself regulate emotional responses</p><p>Consider how race, culture, and values can impact understanding and acceptance of this concept</p></td><td align="left"><p>Coping thoughts</p></td></tr><tr><td align="left"><p> 6</p></td><td align="left"><p>Music in the background & co-regulation</p></td><td align="left"><p>Understand how adults' and children's past experiences can impact perceptions and behaviors</p><p>Understand very young children need help/a partner to regulate their emotional response</p><p>Consider how race, culture, and values can impact our understanding and acceptance of 'Co-Regulation'</p></td><td align="left"><p>Container visualization</p></td></tr><tr><td align="left" colspan="4"><p>Individual Coaching Session (deepen and process understanding of concepts)</p></td></tr><tr><td align="left"><p> 7</p></td><td align="left"><p>Balanced caregiving</p></td><td align="left"><p>Understand the need to be both "in charge & strong" <italic>and</italic> "warm & kind"</p><p>Develop ideas for balancing one's own needs with the needs of children</p><p>Consider how race, culture, and values can impact our understanding and acceptance of 'Balanced Caregiving'</p></td><td align="left"><p>Using senses to soothe</p></td></tr><tr><td align="left"><p> 8</p></td><td align="left"><p>Repair the disruption & circles of holding</p></td><td align="left"><p>Utilize the Tree and Wondering & Response Wheel to think about and respond to the feelings and needs of parents</p><p>Understand how to Repair a Disruption within a relationship (parent, child, colleague)</p><p>Consider how race, culture, and values impact our response to and our understanding and acceptance of parents</p></td><td align="left"><p>Bird's eye view</p></td></tr><tr><td align="left" colspan="4"><p>Classroom Observation/Coaching (application of concepts in the classroom)</p></td></tr><tr><td align="left"><p> 9</p></td><td align="left"><p>Bringing it all together</p></td><td align="left"><p>Practice applying HMB concepts to teachers' unique situations in the classroom with children</p><p>Practice applying HMB concepts to teachers' unique situations with parents</p><p>Discuss how HMB concepts fit or were challenging based upon their own beliefs, values, training, culture</p></td><td align="left"><p>Gratitude practice</p></td></tr><tr><td align="left"><p> 10</p></td><td align="left"><p>Celebration/ continued growth</p></td><td align="left"><p>Reflect upon the group learning experience</p><p>Celebrate progress</p><p>Strategize about ongoing support to utilize HMB concepts</p></td><td align="left"><p>Tree of Life Visualization</p></td></tr></tbody></table> </ephtml> </p> <p> <emph>Mindful breathing</emph>: employing various guided breathing exercises <emph>Progressive relaxation</emph>: gradual tensing and relaxing of muscles in the body from top to bottom <emph>Safe place visualization</emph>: visualizing and stepping into a recalled or imagined place in which the participant feels safe, secure, peaceful and tranquil <emph>Coping thoughts:</emph> developing and utilizing a positive internal voice through the use of a personal mantra <emph>Container visualization</emph><bold>:</bold> noticing and intentionally, lovingly putting upsetting memories or feelings into a container to revisit later when there is the support to process the memories/feelings <emph>Using the senses to soothe</emph>: bringing focus and attention to the senses to remain grounded in the present <emph>Bird's eye view-</emph> creating a mental space between an event and our response with the goal of noticing our thoughts, feelings, sensations with curiosity and without judgement to create space for intentional responses <emph>Gratitude practice</emph>: making a daily list of things for which you are grateful and directing attention to gratitude As strategies are introduced, they are used repeatedly during each session week and then revisited throughout the intervention. Participants are encouraged to practice and use the strategies outside of the intervention sessions</p> <hd id="AN0174972880-6">The Current Study</hd> <p>Three aims guided the present study. The first aim was to model trajectories of teachers' stress and emotional, physical, and mental exhaustion over time (40 weeks) and to test for HMB intervention effects on stress and exhaustion trajectories. We hypothesized that stress intensity and exhaustion, particularly emotional and mental exhaustion, would decline over time for teachers receiving the intervention as compared to trajectories for teachers in the control condition. The second aim was to examine intervention effects on teachers' reported use of mindfulness-based strategies to support coping over time. Because the HMB intervention focuses heavily on the use of mindfulness-based strategies, we expected teachers' self-reported use of mindfulness-based strategies would increase over time for teachers in the HMB group and remain unchanged for teachers in the control group. To preserve model parsimony and keeping in mind HMB's focus on mindfulness-based strategies, we focused on mindfulness-based strategies as the primary coping strategies of interest. The third aim was to test for changes in teachers' ratings of the effectiveness of mindfulness-based strategies over time. We expected that use of mindfulness-based strategies would be viewed as increasingly effective as teachers internalized intervention content, including the use of mindfulness-based strategies, and gained new skills and competencies to support their work and well-being.</p> <hd id="AN0174972880-7">Methods</hd> <p></p> <hd id="AN0174972880-8">Participants</hd> <p>Infant and toddler teachers (<emph>N</emph> = 134) were enrolled between 2018 and 2020 in the HMB intervention, following study recruitment via flyers and information sessions held at their workplaces. Of these teachers, 86 (84 female) consented to participate in this companion ecological momentary assessment (EMA) study of stress, exhaustion, and coping. Teachers came from eight Early Head Start programs (EHS), including EHS childcare partnerships (CCPs) sites, located in a midwestern city or other smaller urban cities in the state. Teachers were enrolled in either the fall or the spring of study years, depending on when their HMB intervention began. EHS and EHS CCPs operate year-round. Five teachers did not complete the pre-intervention and post-intervention assessments after consent. Thus, the final sample included 81 teachers. Teachers were randomly assigned to the HMB intervention (<emph>n</emph> = 41) or to a control group (n = 40). The study, and all protocols, were approved by the research ethics board at Michigan State University and were in accordance with ethical standards from the American Psychological Association and the World Medical Association (Helsinki Declaration). All teachers provided written, informed consent prior to any data collection activities.</p> <hd id="AN0174972880-9">Data Collection Procedures</hd> <p>Data on teachers' ongoing, real-time stress, exhaustion, and coping strategy use and effectiveness were collected via EMA methodology, a technique that has been employed in prior studies of stress in early childhood teachers (Baumgartner et al., [<reflink idref="bib3" id="ref78">3</reflink>]; Carson et al., [<reflink idref="bib13" id="ref79">13</reflink>]). EMA approaches are preferable to single reports of teachers' stress, exhaustion, and coping because they allow for a more nuanced understanding of change in these constructs over time (Stone & Shiffman, [<reflink idref="bib63" id="ref80">63</reflink>]), and they avoid limitations of single reports such as errors in memory and retrieval biases (Carson et al., [<reflink idref="bib13" id="ref81">13</reflink>], [<reflink idref="bib12" id="ref82">12</reflink>], [<reflink idref="bib14" id="ref83">14</reflink>]).</p> <p>Teachers used the RealLife Exp smartphone app (Runyan et al., [<reflink idref="bib57" id="ref84">57</reflink>]), an application platform programmed for this study to assess stress, exhaustion, and coping twice weekly for 40 weeks, beginning at study enrollment. Study staff installed or assisted teachers in installing the app on teachers' personal smartphones or on study-provided smartphones if teachers did not own a compatible smartphone or preferred to use a study smartphone (10 teachers). The twice weekly reports were automatically uploaded to a secure server with a wi-fi connection. At the time of enrollment in the study, teachers also completed an online questionnaire providing demographic characteristics and information on exposure to prior adverse childhood experiences. Teachers were compensated $20 for completing the initial set of questionnaires and $5 for each EMA report of stress/exhaustion/coping (maximum 80 reports per teacher; $400). Teachers received a $75 bonus if they completed at least 85% of the weekly reports over the 40 weeks of data collection. Thus, compensation totaled a maximum of $495 per participant.</p> <hd id="AN0174972880-10">Measures</hd> <p></p> <hd id="AN0174972880-11">EMA Measures</hd> <p>We used an interval-contingent sampling approach in which teachers were prompted at 6:00 PM at the beginning and end of week (early week = Monday or Tuesday, late week = Thursday or Friday) for 40 weeks, resulting in a maximum of 80 reports per teacher. Initial completion prompts were sent at 6:00 PM on the twice-weekly reporting days. Up to three reminder notifications were sent, arriving between 7:00 PM and 9:00 PM on those days. Responses were accepted until 11:59 PM on reporting days.</p> <p>Although multiple within-day responses are common in EMA methodology, we employed one end-of-day response with intention as EMA approaches are flexible and allow for single reports collected longitudinally (Carson et al., [<reflink idref="bib14" id="ref85">14</reflink>]). Most importantly, infant and toddler care and education is complex, relational work. Multiple EMA prompts during the workday would have compromised teachers' relational work with infants and toddlers, interrupted teachers' continual supervision and attentive guidance to infants and toddlers, and, therefore, contradictory to the goals of the HMB intervention. Similarly, given that many early childhood teachers report few scheduled breaks during the day (Kwon, [<reflink idref="bib41" id="ref86">41</reflink>]), asking teachers to respond to prompts during breaks away from children would have unfairly consumed the time likely needed for personal care. Moreover, our research questions were designed to address stress, exhaustion, and coping over 40 weeks and not to examine within-day variations in these.</p> <hd id="AN0174972880-12">Stress and Exhaustion</hd> <p>Consistent with EMA strategies using single items, accruing little time burden on respondents (Baumgartner et al., [<reflink idref="bib3" id="ref87">3</reflink>]; Carson et al., [<reflink idref="bib13" id="ref88">13</reflink>]), we assessed stress intensity with one item informed by other EMA studies (Metzenthin et al., [<reflink idref="bib48" id="ref89">48</reflink>]). Teachers reported their daily stress intensity (<emph>"What was the intensity of your stress today?"</emph>) using a sliding scale of 1 (extremely low) to 7 (extremely high).</p> <p>We measured the intensity of emotional ("<emph>How emotionally exhausted are you today?</emph>"), physical ("<emph>How physically exhausted are you today</emph>?"), and mental ("<emph>How mentally exhausted are you today?</emph>") exhaustion based on research from Carson et al. ([<reflink idref="bib13" id="ref90">13</reflink>]). Items were scored on a 1 (not at all exhausted) to 7 (extremely exhausted) sliding scale for each form of exhaustion.</p> <hd id="AN0174972880-13">Coping</hd> <p>The identification of coping strategies was driven by the existing literature (e.g., Griffith et al., [<reflink idref="bib24" id="ref91">24</reflink>]; Shernoff et al., [<reflink idref="bib61" id="ref92">61</reflink>]). Teachers selected coping strategies that they used on the reporting day from the following list: <emph>seeking support from a friend or family member</emph>, s<emph>eeking support from a colleague/someone from work</emph>, <emph>distraction</emph> (e.g., watching TV), <emph>using mindfulness-based coping</emph> (e.g., deep breathing), <emph>thinking about a problem in a new way</emph> (reframing), <emph>exercising</emph> (e.g., going for a walk, working out), and <emph>relying on spirituality or religion</emph>. Teachers were free to select none, one, or multiple strategies. For each reporting day, we calculated a sum total for each strategy from 0 (not selected) to (<reflink idref="bib1" id="ref93">1</reflink>) selected. Teachers were also asked, "Out of the coping strategies you selected, which one was most effective in managing your stress today." Each strategy was scored as either 0 (not selected) or 1 (selected) as the most effective strategy.</p> <hd id="AN0174972880-14">Contextual Characteristics as Covariates</hd> <p>Teachers characterized each reporting day as a sick/vacation day, professional training or meeting, classrooms/on-site day but without children, or a typical day with children in the classroom. The EMA app tracked the temporal characteristics including whether each report was completed at the beginning (Monday/Tuesday) or at the end (Thursday/Friday) of the week. Because teachers enrolled in the study and began their reports in the fall or the spring, depending on when the HMB intervention was implemented as part of each program's professional development programming, we covaried time of year.</p> <hd id="AN0174972880-15">Demographic Characteristics</hd> <p>Teachers provided demographic information including their age (in years), educational background, race, and ethnicity. Educational background categories included: less than an associate degree, associate degree, more than an associate degree (typically two years of college/university), or, not reported. Teachers self-selected ethnicity and race as: Hispanic or Latino or not Hispanic or Latino (ethnicity) and as American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, White, or Other (race).</p> <hd id="AN0174972880-16">Data Analyses</hd> <p>To begin, we analyzed descriptive statistics for teachers' demographic characteristics including their age, education, race/ethnicity, and reports of well-being (i.e., stress intensity, intensity of emotional exhaustion, physical exhaustion, mental exhaustion, use of coping strategies, and coping effectiveness).</p> <p>EMA data reflect repeated measures nested within individuals (i.e., teachers). Given the interdependency of the EMA data, we used multilevel regression modeling that allows for within-person variance (repeated measures) and between-person variance (Raudenbush & Bryk, [<reflink idref="bib52" id="ref94">52</reflink>]). The first aim of the study was to estimate trajectories of teachers' stress intensity, and mental, physical, and emotional exhaustion over time, and to determine if trajectories differed by intervention or control group status. First, we tested an unconditional multilevel regression model for each of the four measures (overall intensity of stress, and intensity of emotional exhaustion, physical exhaustion, and mental exhaustion) to estimate the intraclass correlation (i.e., the proportion of total variation due to differences between teachers), testing models between the intervention and control condition. Next, we estimated four, separate multilevel models that regressed each stress or exhaustion measure on within-person covariates and between-person covariates over the 40 reporting weeks, again comparing trajectories by intervention or control group status. Models utilized random intercepts. We included type of day as a within-person, time-varying covariate. We also included temporal covariates in the within-person model, including time of reporting (i.e., early in the week [Monday/Tuesday; reference] versus late [Thursday/Friday] in the week), as well as the dummy variables reflecting whether teachers began their EMA reports in the fall or spring (reference: fall). Between-person covariates included in the models were age, education level, program site location (urban, semi-urban), and race/ethnicity. All models used maximum likelihood estimation and analyses were completed in Mplus 8.0 (Muthén & Muthén, [<reflink idref="bib49" id="ref95">49</reflink>]–2017). The second aim of the study was to test for intervention effects on teachers' use of mindfulness-based strategies for coping. The third aim was to test for intervention effects on the perceived effectiveness of mindfulness-based strategies for coping over time. The analytic plan for aims 2 and 3 were similar to aim 1, adjusted to accommodate the categorical outcome variable.</p> <hd id="AN0174972880-17">Results</hd> <p>Baseline characteristics of the sample, including comparisons between the HMB and control conditions, are summarized in Table 2. Regarding ethnicity, 90% of teachers reported not identifying as Hispanic or Latino. Concerning race, 51% of teachers identified as Black or African American, and 33% identified as White. The mean age was 37.01 years, and most educators had an associate degree (22%) or higher (53%). Averaging over the first two weeks of EMA data to reflect the baseline measure, the average stress and exhaustion levels ranged between 3.7 and 4.1, with physical exhaustion having the highest baseline mean. Although Black and White teachers (the two largest racial groups) did not differ on baseline perceptions of stress intensity, emotion exhaustion, or mental exhaustion, teachers who were White reported greater physical exhaustion (b = 0.59, SE = 0.29, <emph>p</emph> = 0.046) than teachers who were Black. Teachers in the control group were older than teachers in the intervention group (<emph>t</emph>(<reflink idref="bib76" id="ref96">76</reflink>) = 2.19, p = 0.03), and the five teachers who endorsed Hispanic ethnicity were in the intervention group. There were no differences between the intervention and control group on any of the covariates in baseline perceptions of stress or exhaustion.</p> <p>Table 2 Descriptive Statistics for Demographics, Teachers' Characteristics and Reports of Stress and Exhaustion</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Characteristics</p></th><th align="left"><p>Full sample</p></th><th align="left"><p>HMB</p></th><th align="left"><p>Control</p></th><th align="left"><p>Difference test</p></th></tr><tr><th align="left"><p>Teacher characteristics</p></th><th align="left"><p>n(%)</p></th><th align="left" /><th align="left" /><th align="left" /></tr></thead><tbody><tr><td align="left" colspan="5"><p>Race</p></td></tr><tr><td align="left"><p> American Indian/Alaska Native</p></td><td char="." align="char"><p>2 (2%)</p></td><td char="." align="char"><p>2 (5%)</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char"><p><italic>p</italic> = <italic>.30</italic></p></td></tr><tr><td align="left"><p> Asian</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p> Black/African American</p></td><td char="." align="char"><p>41 (51%)</p></td><td char="." align="char"><p>18 (45%)</p></td><td char="." align="char"><p>23 (56%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p> Native Hawaiian/Other Pac Isl</p></td><td char="." align="char"><p>0 (1%)</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p> White</p></td><td char="." align="char"><p>27 (33%)</p></td><td char="." align="char"><p>15 (38%)</p></td><td char="." align="char"><p>12 (29%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p> Other</p></td><td char="." align="char"><p>1 (1%)</p></td><td char="." align="char"><p>1 (2%)</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p> Multiple categories selected</p></td><td char="." align="char"><p>9 (11%)</p></td><td char="." align="char"><p>3 (8%)</p></td><td char="." align="char"><p>6 (15%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p> Did not disclose</p></td><td char="." align="char"><p>1 (1%)</p></td><td char="." align="char"><p>1 (2%)</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p>Ethnicity</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p><italic>p</italic> = <italic>.01</italic></p></td></tr><tr><td align="left"><p> Hispanic or Latino</p></td><td char="." align="char"><p>5 (6%)</p></td><td char="." align="char"><p>5 (13%)</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p> Not Hispanic or Latino</p></td><td char="." align="char"><p>73 (90%)</p></td><td char="." align="char"><p>32 (80%)</p></td><td char="." align="char"><p>41(100%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p> Did not disclose</p></td><td char="." align="char"><p>3 (4%)</p></td><td char="." align="char"><p>3 (7%)</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char" /></tr><tr><td align="left" colspan="5"><p>Education</p></td></tr><tr><td align="left"><p> Less than Associate Degree</p></td><td char="." align="char"><p>19 (24%)</p></td><td char="." align="char"><p>12 (30%)</p></td><td char="." align="char"><p>7 (17%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p> Associate Degree</p></td><td char="." align="char"><p>18 (22%)</p></td><td char="." align="char"><p>10 (25%)</p></td><td char="." align="char"><p>8 (20%)</p></td><td char="." align="char"><p><italic>p</italic> =.19</p></td></tr><tr><td align="left"><p> More than Associate Degree</p></td><td char="." align="char"><p>43 (53%)</p></td><td char="." align="char"><p>17 (43%)</p></td><td char="." align="char"><p>26 (63%)</p></td><td char="." align="char" /></tr><tr><td align="left"><p> Did not disclose</p></td><td char="." align="char"><p>1 (1%)</p></td><td char="." align="char"><p>1 (2%)</p></td><td char="." align="char"><p>0 (0%)</p></td><td char="." align="char" /></tr></tbody></table> </ephtml> </p> <p>Table 2 Descriptive Statistics for Demographics, Teachers' Characteristics and Reports of Stress and Exhaustion</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" /><th align="left"><p><italic>M</italic> (SD)</p></th><th align="left" /><th align="left" /><th align="left" /></tr></thead><tbody><tr><td align="left"><p>Age</p></td><td char="." align="char"><p>37.03 (12.12)</p></td><td char="." align="char"><p>34.04 (10.22)</p></td><td char="." align="char"><p>39.86 (13.18)</p></td><td char="." align="char"><p><italic>p</italic> =.03</p></td></tr></tbody></table> </ephtml> </p> <p>Table 2 Descriptive Statistics for Demographics, Teachers' Characteristics and Reports of Stress and Exhaustion</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Stress and exhaustion (baseline*)</p></th><th align="left"><p><italic>M</italic></p></th><th align="left"><p><italic>M</italic></p></th><th align="left"><p><italic>M</italic></p></th><th align="left" /></tr></thead><tbody><tr><td align="left"><p>Stress intensity</p></td><td char="." align="char"><p>3.82</p></td><td char="." align="char"><p>3.77</p></td><td char="." align="char"><p>3.87</p></td><td char="." align="char"><p><italic>p</italic> = <italic>.68</italic></p></td></tr><tr><td align="left"><p>Emotional exhaustion</p></td><td char="." align="char"><p>3.78</p></td><td char="." align="char"><p>3.69</p></td><td char="." align="char"><p>3.86</p></td><td char="." align="char"><p><italic>p</italic> = <italic>.55</italic></p></td></tr><tr><td align="left"><p>Physical exhaustion</p></td><td char="." align="char"><p>3.99</p></td><td char="." align="char"><p>3.85</p></td><td char="." align="char"><p>4.12</p></td><td char="." align="char"><p><italic>p</italic> = <italic>.36</italic></p></td></tr><tr><td align="left"><p>Mental exhaustion</p></td><td char="." align="char"><p>3.81</p></td><td char="." align="char"><p>3.66</p></td><td char="." align="char"><p>3.94</p></td><td char="." align="char"><p><italic>p</italic> = <italic>.34</italic></p></td></tr></tbody></table> </ephtml> </p> <p>Participants could select more than one racial category. Averages over the first 2 weeks of data (up to four data points per person) were used for baseline as the intervention did not occur until after this time</p> <hd id="AN0174972880-18">Aim 1: Effect of HMB on Trajectories of Stress and Exhaustion</hd> <p>We first estimated longitudinal models of the stress and exhaustion measures including only time in the models (Table 3, Unadjusted Models). On average, the initial levels of stress and exhaustion were between 3.7 and 4.1, with a significant initial decrease (indicated by the negative linear slope terms), followed by a significant upward turn (indicated by the positive quadratic terms), then a significant downward turn (indicated by the negative cubic term). Though statistically different from zero, the changes in the trajectories were small and indicated teachers' levels of stress and exhaustion are relatively stable over time. We then estimated the average effect of the HMB intervention relative to the control condition on the random effects for initial level (intercept), linear, quadratic, and cubic terms adjusting the intercept for all covariates (Table 3, Fully Adjusted Models). There was no evidence of significant differences in the stress or exhaustion trajectories between participants in the HMB and control conditions.</p> <p>Table 3 Fixed and random effects from multilevel models testing the intervention effect on trajectories of stress intensity and exhaustion</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2" /><th align="left" /><th align="left"><p><italic>Stress</italic></p></th><th align="left"><p><italic>Emotional exhaustion</italic></p></th><th align="left"><p><italic>Physical exhaustion</italic></p></th><th align="left"><p><italic>Mental exhaustion</italic></p></th><th align="left"><p><italic>Mindful-based strategies for coping</italic></p></th><th align="left"><p><italic>Coping effectiveness</italic></p></th></tr><tr><th align="left"><p>Between-level</p></th><th align="left"><p><italic>Estimate (SE)</italic></p></th><th align="left"><p><italic>Estimate (SE)</italic></p></th><th align="left"><p><italic>Estimate (SE)</italic></p></th><th align="left"><p><italic>Estimate (SE)</italic></p></th><th align="left"><p><italic>Estimate (SE)</italic></p></th><th align="left"><p><italic>Estimate (SE)</italic></p></th></tr></thead><tbody><tr><td align="left" rowspan="4"><p>Unadjusted models</p></td><td align="left"><p>Intercept/threshold</p></td><td char="." align="char"><p>3.87*** (0.13)</p></td><td char="." align="char"><p>3.79*** (0.15)</p></td><td char="." align="char"><p>4.10*** (0.14)</p></td><td char="." align="char"><p>3.88*** (0.15)</p></td><td char="." align="char"><p>1.83*** (0.28)</p></td><td char="." align="char"><p>3.29*** (0.37)</p></td></tr><tr><td align="left"><p>Slope</p></td><td char="." align="char"><p>− 0.56*** (0.12)</p></td><td char="." align="char"><p>− 0.56*** (0.12)</p></td><td char="." align="char"><p>− 0.60*** (0.12)</p></td><td char="." align="char"><p>− 0.45*** (0.12)</p></td><td char="." align="char"><p>0.22 (0.13)</p></td><td char="." align="char"><p>0.43** (0.13)</p></td></tr><tr><td align="left"><p>Quadratic</p></td><td char="." align="char"><p>0.16*** (0.04)</p></td><td char="." align="char"><p>0.15*** (0.04)</p></td><td char="." align="char"><p>0.16*** (0.04)</p></td><td char="." align="char"><p>0.11** (0.04)</p></td><td char="." align="char"><p>− 0.04* (0.02)</p></td><td char="." align="char"><p>− 0.06*** (0.02)</p></td></tr><tr><td align="left"><p>Cubic</p></td><td char="." align="char"><p>− 0.01*** (0.003)</p></td><td char="." align="char"><p>− 0.01*** (0.003)</p></td><td char="." align="char"><p>− 0.01** (0.003)</p></td><td char="." align="char"><p>− 0.01** (0.003)</p></td><td char="." align="char"><p>N/A</p></td><td char="." align="char"><p>N/A</p></td></tr><tr><td align="left" rowspan="10"><p>Fully adjusted models</p></td><td align="left"><p>HMB→Intercept</p></td><td char="." align="char"><p>− 0.35 (0.24)</p></td><td char="." align="char"><p>− 0.28 (0.30)</p></td><td char="." align="char"><p>− 0.57* (0.26)</p></td><td char="." align="char"><p>− 0.58* (0.29)</p></td><td char="." align="char"><p>0.08 (0.50)</p></td><td char="." align="char"><p>0.31 (1.03)</p></td></tr><tr><td align="left"><p>HMB→Slope</p></td><td char="." align="char"><p>0.16 (0.20)</p></td><td char="." align="char"><p>0.08 (0.22)</p></td><td char="." align="char"><p>0.16 (0.20)</p></td><td char="." align="char"><p>0.24 (0.20)</p></td><td char="." align="char"><p>0.61** (0.23)</p></td><td char="." align="char"><p>0.18 (0.61)</p></td></tr><tr><td align="left"><p>HMB→Quadratic</p></td><td char="." align="char"><p>− 0.03 (0.06)</p></td><td char="." align="char"><p>− 0.02 (0.06)</p></td><td char="." align="char"><p>− 0.04 (0.06)</p></td><td char="." align="char"><p>− 0.07 (0.06)</p></td><td char="." align="char"><p>− 0.08** (0.03)</p></td><td char="." align="char"><p>− 0.01 (0.07)</p></td></tr><tr><td align="left"><p>HMB→Cubic</p></td><td char="." align="char"><p>.001 (0.005)</p></td><td char="." align="char"><p>0.001 (0.005)</p></td><td char="." align="char"><p>0.005 (0.005)</p></td><td char="." align="char"><p>0.005 (0.005)</p></td><td char="." align="char"><p>N/A</p></td><td char="." align="char"><p>N/A</p></td></tr><tr><td align="left" colspan="7"><p>Residual variances</p></td></tr><tr><td align="left"><p> Level-1</p></td><td char="." align="char"><p>1.99*** (0.11)</p></td><td char="." align="char"><p>1.83*** (0.14)</p></td><td char="." align="char"><p>1.84*** (0.14)</p></td><td char="." align="char"><p>1.79*** (0.14)</p></td><td char="." align="char"><p>N/A</p></td><td char="." align="char"><p>N/A</p></td></tr><tr><td align="left"><p> Level-2 Intercept</p></td><td char="." align="char"><p>0.69*** (0.16)</p></td><td char="." align="char"><p>1.14*** (0.23)</p></td><td char="." align="char"><p>0.88*** (0.17)</p></td><td char="." align="char"><p>1.06*** (0.19)</p></td><td char="." align="char"><p>2.64*** (0.70)</p></td><td char="." align="char"><p>3.27*** (2.20)</p></td></tr><tr><td align="left"><p> Level-2 Slope</p></td><td char="." align="char"><p>0.21* (0.09)</p></td><td char="." align="char"><p>0.35** (0.12)</p></td><td char="." align="char"><p>0.28** (0.10)</p></td><td char="." align="char"><p>0.29** (0.10)</p></td><td char="." align="char"><p>0.25** (0.10)</p></td><td char="." align="char"><p>0.35 (0.24)</p></td></tr><tr><td align="left"><p> Level-2 Quadratic</p></td><td char="." align="char"><p>0.02* (0.01)</p></td><td char="." align="char"><p>0.03** (0.01)</p></td><td char="." align="char"><p>0.03** (0.01)</p></td><td char="." align="char"><p>0.03* (0.01)</p></td><td char="." align="char"><p>0.004* (< 0.01)</p></td><td char="." align="char"><p>0.004 (0.008)</p></td></tr><tr><td align="left"><p> Level-2 Cubic</p></td><td char="." align="char"><p> <.001* (<.001)</p></td><td char="." align="char"><p> <.001* (<.001)</p></td><td char="." align="char"><p> <.001** (<.001)</p></td><td char="." align="char"><p> <.001* (<.001)</p></td><td char="." align="char"><p>N/A</p></td><td char="." align="char"><p>N/A</p></td></tr></tbody></table> </ephtml> </p> <p>All coefficients are unstandardized. Asterisks indicate statistically significant <emph>p</emph>-values (* <.05; ** <.01; *** <.001)</p> <hd id="AN0174972880-19">Aim 2: Effect of HMB on Trajectory for Use of Mindful-Based Strategies for Coping</hd> <p>The longitudinal model for the use of mindful-based strategies of coping indicated little change over time on the use of mindful-based strategies for coping in the unadjusted model but significant variance in the linear slope (var = 0.40, <emph>p</emph> = 0.01) and quadratic term (var = 0.01, <emph>p</emph> = 0.01). In the fully adjusted model, the average linear slope was significantly larger and the quadratic term significantly smaller for HMB participants compared to control participants. These results suggest an increase in the selection of mindfulness-based strategies for coping followed by a decrease for HMB participants compared to control participants (Table 3, Fully Adjusted Models, Column 5). As illustrated in Fig. 1, the decrease appears to begin about half-way through the 40-week reporting period. For many teachers, the HMB intervention ended near the 31st EMA reporting period (roughly week 17 of the 40 weeks of the study). Generally, the 20-h HMB intervention was administered between weeks 3 to 17 of the study.</p> <p>Graph: Fig. 1Estimated Trajectories Based on Quadratic Model by condition over 40 weeks.</p> <hd id="AN0174972880-20">Aim 3: Effect of HMB on Trajectory of Perceived Effectiveness of Mindfulness-Based Strategies...</hd> <p>The longitudinal model of selecting mindful-based strategies as the most effective coping strategy over time suggests a significant initial increase (linear slope = 0.43, <emph>p</emph> < 0.01) followed by a significant downward turn (quadratic = -0.06, <emph>p</emph> < 0.001). There were no significant differences in these trajectories between the HMB and control participants (Table 3, Column 6).</p> <hd id="AN0174972880-21">Discussion</hd> <p>Given the lack of literature addressing stress, exhaustion, and coping among infant and toddler teachers, the goals of this study were to: investigate teachers' longitudinal experiences of stress, exhaustion, and coping and test the effects of the HMB professional development intervention on the intensity of teachers' stress and exhaustion (aim 1); and test for HMB intervention effects on teachers' use (aim 2) and perceived effectiveness (aim 3) of mindfulness-based strategies for coping. Teachers' average stress and exhaustion trajectories were relatively stable over the 40 weeks of assessment, and no HMB intervention effects were detected. Teachers in the HMB intervention reported a significantly greater increase in the use of mindfulness-based strategies for coping over time compared to teachers in the control group, although reported use (selection) of mindfulness-based strategies for coping declined after the end of the intervention.</p> <hd id="AN0174972880-22">Teachers' Stress and Exhaustion Over Time</hd> <p>With stable trajectories of infant and toddler teachers' stress and exhaustion over time, we found no intervention effects on these aspects of teacher well-being. Two themes in our review of the literature may help to explain these null findings. While participation in professional development interventions has been linked to lower levels of perceived stress in teachers (e.g., Roeser et al., [<reflink idref="bib54" id="ref97">54</reflink>]), relatively few of these studies have (a) examined stress and exhaustion longitudinally (and none via EMA methodology or among infant and toddler teachers) or (b) focused on stress and exhaustion, as many studies have included a focus on other indicators of mental health, such as depression (e.g., Becker et al., [<reflink idref="bib4" id="ref98">4</reflink>]; Gouda et al., [<reflink idref="bib22" id="ref99">22</reflink>]) and anxiety (e.g., Jennings et al., [<reflink idref="bib33" id="ref100">33</reflink>]; Roeser et al., [<reflink idref="bib54" id="ref101">54</reflink>]). A handful of professional development intervention studies have included additional assessments following the immediate post-intervention period as a strategy for capturing longer-term teacher mental health, including somatization and phobic anxiety (e.g., Franco et al., [<reflink idref="bib20" id="ref102">20</reflink>]) and depression (e.g., Franco et al., [<reflink idref="bib20" id="ref103">20</reflink>]; Kemeny et al., [<reflink idref="bib40" id="ref104">40</reflink>]). However, these studies did not address stress and exhaustion, underscoring the need for research aimed at understanding whether professional development interventions effectively impact stress and exhaustion or only other aspects of mental health. Moreover, it is difficult to determine if mental health symptoms precede or exacerbate stress or exhaustion or if stress and exhaustion elicit other symptoms of anxiety or depression, another area for future research.</p> <p>Two studies reported mixed results for intervention effects on stress. Roeser et al. ([<reflink idref="bib54" id="ref105">54</reflink>]) tested the effects of mindfulness training on elementary and secondary teachers' stress and burnout. Improvements in self-reported stress and burnout were maintained three months post-intervention, although there were no intervention effects on physiological indicators of stress. Hence, while perceptions of stress may have changed, experienced stress perhaps did not. Similarly, Taylor et al ([<reflink idref="bib65" id="ref106">65</reflink>]) tested a mindfulness intervention on primary and secondary teachers' stress. Positive post-intervention effects were found for self-reported stress reduction, although the effect was no longer significant at the follow-up assessment, suggesting that intervention effects may wane over time. Both studies spanned about half of the 40 weeks addressed in the current study. However, we did not find intervention effects immediately post-intervention period or in the time that followed through the end of the 40 weeks. Few interventions are designed to address the multiple contributors to teachers' stress.</p> <p>Given the persistent stressors associated with teaching, it may simply be very difficult to alter teachers' experiences of stress in the absence of program-wide policies and procedures designed to reduce systemic stress on teachers. It may also be that interventions aimed at reducing stress must also tackle stressors occurring at multiple levels of the workplace. For example, recent calls for additional research emphasize the need to examine sources of stress at the level of the individual (teacher), the individual-organization juncture, and the organization (McIntyre et al., [<reflink idref="bib46" id="ref107">46</reflink>]). It is quite possible that level-specific coping strategies are most effective.</p> <p>Another explanation may be the measurement of stress and exhaustion. A recent examination (Eddy et al., [<reflink idref="bib18" id="ref108">18</reflink>]) of single-item measures of stress and coping confirmed solid concurrent and predictive validity, although single-item coping measures may be more sensitive to intervention effects as compared to stress measures. Moreover, another explanation for the effects on coping but not on stress or exhaustion may be that while increasing coping skills may help teachers manage stress, increased coping is not sufficient to reduce stress (Eddy et al., [<reflink idref="bib18" id="ref109">18</reflink>]).</p> <p>Finally, perceptions of stress over time vary by the sources of stress. For example, Mäkinen and Kinnunen ([<reflink idref="bib45" id="ref110">45</reflink>]) reported variations in associations between sources of stress and perceived stress among primary and secondary grade teachers depending on the source of stress.</p> <p>Commonly reported sources of stress among early childhood teachers include addressing children's ongoing needs and behaviors, workload relative to non-teaching tasks, personal life, and working with families (Kelly & Berthelsen, [<reflink idref="bib39" id="ref111">39</reflink>]), structural components of the work environment such as degree of control and support (e.g., Whitaker et al., [<reflink idref="bib68" id="ref112">68</reflink>]), and the low wages and lack of respect that often characterize infant and toddler and early childhood caregiving (Berlin et al., [<reflink idref="bib6" id="ref113">6</reflink>]). Examining how stress and exhaustion differentially relate to type of stressors may be helpful in designing supports to promote teachers' well-being.</p> <hd id="AN0174972880-23">Intervention Effects on Mindfulness-Based Strategies for Coping</hd> <p>The intervention effects on infant and toddler teachers' self-reported increased use of mindfulness-based strategies for coping are in line with the handful of studies addressing intervention effects on mindfulness-based strategies (e.g., Bernay, [<reflink idref="bib7" id="ref114">7</reflink>]; Burrows, [<reflink idref="bib11" id="ref115">11</reflink>]; Napoli, [<reflink idref="bib51" id="ref116">51</reflink>]; Schussler et al.., [<reflink idref="bib59" id="ref117">59</reflink>]). Specifically, these studies found that teachers reported using mindfulness-based strategies to manage stress. Teachers in the HMB intervention practice mindfulness-based strategies each week during intervention sessions. Practicing and using mindfulness-based strategies for coping on a regular basis increases the likelihood that the strategies help to manage stress (Zarate et al., [<reflink idref="bib70" id="ref118">70</reflink>]). A wealth of research underscores that mindfulness requires intentional practice (e.g., Eva & Thayer, [<reflink idref="bib19" id="ref119">19</reflink>]; Hatton-Bowers et al., [<reflink idref="bib26" id="ref120">26</reflink>]; Roeser et al., [<reflink idref="bib55" id="ref121">55</reflink>]; Sharp & Jennings, [<reflink idref="bib60" id="ref122">60</reflink>]). We found that gains in the use of mindfulness-based strategies for coping declined in the time after the intervention ended. Ongoing professional development that continually supports infant and toddler teachers' practice and use of mindfulness-based strategies may be most beneficial to the long-term management of stress and coping. A few studies (e.g., Taylor et al., [<reflink idref="bib65" id="ref123">65</reflink>]) found that while favorable intervention effects on stress were not maintained, teachers reported that they were coping more <emph>effectively</emph> with stress after the intervention. We did not find significant intervention effects on perceptions of the effectiveness of mindfulness-based strategies for coping. The decline in the use of mindfulness-based strategies for coping after the end of the intervention may suggest that these strategies were not internalized to an extent that they could be used as an ongoing regulatory mechanism. The potential lack of internalization of strategy use may also explain the lack of effects on perceived strategy effectiveness. It may be that longer-term use of mindfulness-based strategies is needed to fully internalize them as regularly used coping strategies. It may also be that "cross context" practice is needed such that mindfulness strategies are used consistently in home and work settings.</p> <hd id="AN0174972880-24">Strengths, Limitations, and Future Directions</hd> <p>Strengths of the study include a 40-week examination of infant and toddler teachers' stress, exhaustion, and coping and the use of EMA to investigate teachers' experiences over time in a way that recognized the need to focus on safety and relational experiences in the infant and toddler environment. Findings contribute to the literature on stress and coping among this population of teachers and suggest implications for the design and implementation of professional development experiences aimed at enhancing infant and toddler teachers' well-being.</p> <p>Still, limitations to consider include the use of a single item to address teachers' use of mindfulness-based strategies for coping. Exploring teachers' use of a variety of mindfulness-based strategies would provide helpful insight on teachers' preferred and most used mindfulness strategies. We wondered if the opportunity to report on stress and exhaustion over time might serve as an intervention of sorts, either serving cathartic purposes or perhaps increasing awareness of stress and exhaustion. Neither seemed to be the case. Examining trajectories of stress, exhaustion, and coping specific to particular types of stressors, rather than overall stress intensity and exhaustion, might yield important information to guide professional development supports. Similarly, identifying coping strategies unique to specific stressors might also be informative. Early childhood work, generally, is reported as stressful (Berlin et al., [<reflink idref="bib6" id="ref124">6</reflink>]), and may require teachers' use of multiple coping strategies, including mindfulness-based strategies for coping as well as other strategies, to effectively manage stress and exhaustion.</p> <p>Finally, given the complexity of early childhood systems (e.g., multiple levels of supervision, complex work with colleagues, children, and families, high rates of turnover, etc.), future research may benefit from examining interactions between stressors at the level of the teacher (e.g., personal characteristics such as mental health, demographic characteristics such as income), the classroom (e.g., characteristics of children, relationships with co-teachers), and the program (e.g., relationships with administrators, program policies and practices) as they relate to teachers' well-being. Our ongoing work will address how experiences of stress and exhaustion may be felt differently among diverse teachers. Although there were no apparent differences in teachers' perceptions of stress and most forms of exhaustion at study entry, it is possible that the ways in which stress and exhaustion were conceptualized and measured were not sensitive to the historical and contemporary effects of systemic racism on the mental health of teachers living and working in systems chronically characterized by structural inequalities.</p> <hd id="AN0174972880-25">Conclusions and Implications</hd> <p>The Hearts and Minds on Babies intervention did not impact infant and toddler teachers' self-reported stress or emotional, physical, or mental exhaustion. The intervention did, however, increase teachers' use of mindfulness-based strategies for coping as compared to teachers who did not receive the intervention, although use of these strategies declined after the intervention had ended. Hence, teachers may benefit from their administrators' and programs' continued support for use of mindfulness-based strategies for coping. Moreover, administrators or perhaps teacher coaches may also support teachers by seeking to understand and attend to the sources of teachers' stress and exhaustion. In short, sustained reductions in teachers' stress and exhaustion may be difficult to achieve, although efforts to reduce teachers' stress and exhaustion and increase use of mindfulness-based strategies for coping may still be beneficial to teachers' well-being.</p> <hd id="AN0174972880-26">Author Contributions</hd> <p>HEB-H: conceptualization, funding acquisition, investigation, project administration, supervision. Writing—original draft; AMS: conceptualization, funding acquisition, investigation, project administration, supervision, Writing—original draft; CF: roles/writing—original draft; AB: conceptualization, data curation, methodology, formal analysis, writing—original draft; JC: investigation, data curation, project administration; HAP- writing—review and editing; CDV: conceptualization, supervision, writing—review and editing; RC: methodology, writing-review and editing; PJ: conceptualization, Writing—review and editing.</p> <hd id="AN0174972880-27">Funding</hd> <p>This work was funded by a grant from the National Institutes of Health (NICHD) to the first author, R21HD090406, and a grant from the Administration for Children and Families to the second (PI) author, 90YR0092-04–00. Pilot work on use of the smartphone app was funded by the USDA National Institute of Food and Agriculture Hatch project MICL02393/MIC02700.</p> <hd id="AN0174972880-28">Data Availability</hd> <p>As analyses for the study are ongoing, data are not currently available. All protocols, measures, and syntax are available upon request from the first author. This study utilizes some data from Hearts and Minds on Babies (HMB) Study (A. Stacks, PI). The HMB Study was registered with the Registry of Efficacy and Effectiveness Studies Registry (REES; https://sreereg.icpsr.umich.edu/sreereg/), Registry ID 126.1v2.</p> <hd id="AN0174972880-29">Declarations</hd> <p></p> <hd id="AN0174972880-30">Conflict of interest</hd> <p>The authors have no competing interests to disclose that are relevant to the content of this article.</p> <hd id="AN0174972880-31">Ethical Approval</hd> <p>This research was approved by the Institutional Review Boards at Michigan State University and Wayne State University, and informed consent was obtained from all participants.</p> <hd id="AN0174972880-32">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0174972880-33"> <title> References </title> <blist> <bibl id="bib1" idref="ref32" type="bt">1</bibl> <bibtext> Abenavoli RM, Jennings PA, Greenberg MT, Harris AR, Katz DA. 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  Data: The Effects of a Relationship-Focused Professional Development Intervention on Infant and Toddler Teachers' Mindfulness-Based Strategies for Coping
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  Data: English
– Name: Author
  Label: Authors
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  Data: <searchLink fieldCode="AR" term="%22Holly+E%2E+Brophy-Herb%22">Holly E. Brophy-Herb</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-2186-6025">0000-0003-2186-6025</externalLink>)<br /><searchLink fieldCode="AR" term="%22Ann+M%2E+Stacks%22">Ann M. Stacks</searchLink><br /><searchLink fieldCode="AR" term="%22Cynthia+Frosch%22">Cynthia Frosch</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-8330-5437">0000-0002-8330-5437</externalLink>)<br /><searchLink fieldCode="AR" term="%22Ahnalee+M%2E+Brincks%22">Ahnalee M. Brincks</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-5049-1229">0000-0002-5049-1229</externalLink>)<br /><searchLink fieldCode="AR" term="%22Jody+L%2E+Cook%22">Jody L. Cook</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-2965-8546">0000-0003-2965-8546</externalLink>)<br /><searchLink fieldCode="AR" term="%22Claire+D%2E+Vallotton%22">Claire D. Vallotton</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-7815-2993">0000-0001-7815-2993</externalLink>)<br /><searchLink fieldCode="AR" term="%22Haiden+A%2E+Perkins%22">Haiden A. Perkins</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-2009-0202">0000-0003-2009-0202</externalLink>)<br /><searchLink fieldCode="AR" term="%22Loria+E%2E+Kim%22">Loria E. Kim</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-1110-9514">0000-0003-1110-9514</externalLink>)<br /><searchLink fieldCode="AR" term="%22Russell+Carson%22">Russell Carson</searchLink><br /><searchLink fieldCode="AR" term="%22Maria+Muzik%22">Maria Muzik</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-9888-8519">0000-0001-9888-8519</externalLink>)<br /><searchLink fieldCode="AR" term="%22Katherine+Rosenblum%22">Katherine Rosenblum</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-6952-9672">0000-0001-6952-9672</externalLink>)<br /><searchLink fieldCode="AR" term="%22Patricia+A%2E+Jennings%22">Patricia A. Jennings</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-1026-1362">0000-0003-1026-1362</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22Early+Childhood+Education+Journal%22"><i>Early Childhood Education Journal</i></searchLink>. 2024 52(2):243-257.
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  Data: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
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  Data: 15
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  Data: 2024
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  Label: Sponsoring Agency
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  Data: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (DHHS/NIH)<br />Administration for Children and Families (DHHS)<br />National Institute of Food and Agriculture (NIFA) (USDA)
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  Data: R21HD090406<br />90YR00920400<br />MICL02393<br />MIC02700
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  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
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  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Early+Childhood+Education%22">Early Childhood Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Early+Childhood+Teachers%22">Early Childhood Teachers</searchLink><br /><searchLink fieldCode="DE" term="%22Infants%22">Infants</searchLink><br /><searchLink fieldCode="DE" term="%22Toddlers%22">Toddlers</searchLink><br /><searchLink fieldCode="DE" term="%22Metacognition%22">Metacognition</searchLink><br /><searchLink fieldCode="DE" term="%22Coping%22">Coping</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Faculty+Development%22">Faculty Development</searchLink><br /><searchLink fieldCode="DE" term="%22Stress+Management%22">Stress Management</searchLink><br /><searchLink fieldCode="DE" term="%22Emotional+Response%22">Emotional Response</searchLink><br /><searchLink fieldCode="DE" term="%22Fatigue+%28Biology%29%22">Fatigue (Biology)</searchLink><br /><searchLink fieldCode="DE" term="%22Low+Income+Students%22">Low Income Students</searchLink><br /><searchLink fieldCode="DE" term="%22Interpersonal+Relationship%22">Interpersonal Relationship</searchLink>
– Name: SubjectThesaurus
  Label: Laws, Policies and Program Identifiers
  Group: Su
  Data: <searchLink fieldCode="SU" term="%22Head+Start%22">Head Start</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1007/s10643-022-01416-0
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1082-3301<br />1573-1707
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Teaching is a demanding profession with teachers of very young children reporting high rates of stress and exhaustion. We tested the effects of a relationship-focused professional development intervention designed to enhance teachers' use of mindfulness-based strategies to support coping on trajectories of teachers' stress, exhaustion (emotional, physical, and mental), and coping. Infant and toddler teachers (N = 81) from Early Head Start (EHS) or EHS childcare partnerships (CCP) were randomized to the intervention or usual care control condition. Using ecological momentary assessment, teachers completed twice-weekly reports of stress, exhaustion, coping, and coping strategy effectiveness via smartphones for 40 weeks. Multilevel linear regression modeling, accounting for within-person repeated measures, showed no intervention effects on stress and exhaustion trajectories. Teachers in the intervention reported increased use of mindfulness-based strategies for coping over time as compared to the control group, although frequency of use peaked and then declined. While perceptions of stress and exhaustion did not change, teachers' increased use of mindfulness-based strategies suggests improvements in how teachers managed stress and exhaustion; however, the decline in use of coping suggests the need for ongoing support within the workplace.
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  Data: 2024
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  Data: EJ1408716
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    PhysicalDescription:
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      – SubjectFull: Early Childhood Teachers
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      – SubjectFull: Infants
        Type: general
      – SubjectFull: Toddlers
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      – SubjectFull: Head Start
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