Methods: A convenience sample of 43 preschool classrooms in rural Ohio were recruited and assigned to either intervention (n=10 teachers, n=123 children) or care as usual (n= 44 teachers, n=340 children). At baseline, teachers in the intervention group received 4 hours of CARE training, followed by 6 weekly and another 6 bi-weekly coaching sessions during 2018-2019 academic year. Teachers of usual care children received universal mental health consultation from a licensed mental health professional. Changes in preschool children’s social-emotional competence and behavior problems were measured by the standardized teacher rating scales: Devereux Early Childhood Assessment for Preschoolers, Second Edition (DECA-P2) and Sutter-Eyberg Student Behavior Inventory-Revised (SESBI), before and after the intervention.
Results: The Paired-samples t-test findings indicate that children in the intervention group experienced higher social-emotional competence (d =0.5, p <.0001) and self-regulation (d = 0.3, p<.05,) scores compared to children in the control group. A statistically significant regression model of social emotional competence was developed (F (6, 407) =60.85, p < .0001), with an R2 of 0.128. Generally, children in the intervention group had greater positive change in all measures of social emotional competence and behavior problems than the control but this was moderated by the level of behavioral problems at baseline.
Conclusions and Implications: CARE training is a brief, inexpensive intervention focused on equipping teachers with a set of skills that they can use to strengthen children’s social-emotional competence. This study indicates that CARE training holds promise in helping teachers address children’s behavioral health needs while requiring a limited investment in time and finances. Social workers in rural communities are few and need to be equipped with best practices that can expand the ability to meet needs in a sustainable fashion. Thus more research with randomized design is needed to build the rural setting evidence-based prevention programs for preschool behavior problems.