Exploring Public Schools As a Primary Setting for Early Prevention in Rural Areas: Qualitative Approach to Finding an Optimal Working Model for Trauma-Informed Elementary Schools

Background and Purpose: Built on an evidence-based-practice framework, Trauma-Informed Elementary Schools (TIES) is a pilot program designed to bring trauma-informed services to early elementary schools in a rural state. The program was created based on a practice-based approach to respond to a rural state’s urgent challenges with a high rate of parental substance use and related child exposure to traumatic experiences. As the rural nature, limited resources, and geographic barriers limit availability of public services, public schools serve as a primary safety net for children who experience trauma. Although two sequential TIES pilot studies found significantly positive outcomes in cultivating a trauma-sensitive school climate and culture, the program is limited to a few schools and has not yet been assessed for broader impact on primary stakeholder groups including service providers and classroom teachers. The current study explored stakeholders’ input to create a comprehensive intervention plan by identifying the benefits and challenges of implementing the program and adding their perspectives on strengthening the program. The study also explored the challenges of running the TIES program during the COVID-19 pandemic in order to optimize the program for its unique rural environment.

Methods: Sixteen semi-structured interviews were conducted with four TIES service providers and twelve TIES classroom teachers in pre-K, Kindergarten, and first grade either via zoom or in-person. Participants were recruited via posted fliers and an email sent through the program listserv. The average length of the interview was 1 hour. The interviews were transcribed, producing 225 single-spaced pages. Two authors primarily used thematic analysis to categorize findings from transcribed interviews with NVivo.

Results: The TIES program providers as well as school teachers positively recognized its focus on children’s social emotional learning and support with special attention to children in need and the overall improvement of general educational tasks for all children as a whole classroom. They highlighted the program’s benefit for all children as a classroom-level intervention, not only for those who experience trauma directly. However, the participants identified challenges including the lack of time to be more effective and consideration of “the fit” between service providers and classroom characteristics and needs. Also, the lack of formal training sessions and standardized resources both for TIES classroom teachers and the service providers created task-related confusions and tensions in classroom. Especially, the challenges of organizing the TIES program during the pandemic emerged in a relation to service modality. It was more difficult for TIES program providers to deliver any services through online modules, particularly for these young age groups. Stakeholders noticed more needs and behavioral issues from students this year compared with before the pandemic and expressed the need for expanding the program. To make an online TIES program effective, encouraging parent involvement and training was suggested.

Conclusions and Implications: Trauma-informed early intervention services are a critical prevention strategy for young children who experience trauma in rural areas. The results highlight the importance of the program as perceived by key stakeholders and provide specific suggestions for improvement.