Relationship between Chronic Health Conditions and Occupational Burnout in the Early Care and Education Workforce.

OBJECTIVE: The early care and education (ECE) workforce experiences high rates of poor mental and physical health outcomes which impact staff well-being and burnout. This study aimed to assess the relationship between chronic health conditions and occupational burnout in ECE Head Start staff working in low-resourced locations. METHODS: This study administered an 89-item cross-sectional survey to 332 ECE staff employed in 42 Head Start centers in the United States. Staff self-reported on 10 chronic health conditions: arthritis, asthma, cancer, depression, diabetes, heart disease, high blood pressure, insomnia, lung disease, and musculoskeletal disorders. RESULTS: We found that multimorbidity of chronic conditions significantly predicted overall burnout (B = 2.39, p < .01), particularly related to emotional exhaustion (B = 2.04, p < .01). CONCLUSIONS: Workplace interventions targeting emotional exhaustion related to chronic health conditions are recommended to effectively address occupational burnout among ECE staff.

My Baby, My Move+: feasibility of a community prenatal wellbeing intervention.

BACKGROUND: Excessive gestational weight gain (EGWG), insufficient prenatal physical activity and sleep, and poor psychological wellbeing independently increase risks for adverse maternal and infant outcomes. A novel approach to mitigate these risks is utilizing peer support in a community-based prenatal intervention. This study assessed the feasibility (acceptability, demand, implementation, and practicality) of a remotely delivered prenatal physical activity intervention called My Baby, My Move + (MBMM +) that aims to increase prenatal physical activity, enhance mood and sleep hygiene, and reduce EGWG. METHODS: Participants were recruited through community organizations, local clinics, and social media platforms in the Fall of 2020 and Spring of 2021. Eligible pregnant women were randomized to either the MBMM + intervention or the control group. Each group met over Zoom for 16 sessions (twice weekly for 60 min over 8 weeks) to learn either behavioral change and wellbeing knowledge and skills (MBMM +) or knowledge and skills related to parenting (control group). Multiple methods of evaluation to better understand the feasibility of the intervention were conducted. RESULTS: A total of 49 women (25 MBMM + intervention, 24 control) completed both pre- and post-survey assessments and were included in the analyses. A subsample of 19 (39%) intervention participants completed a combination of semi-structured interviews/surveys to assess acceptability, demand, implementation, and practicality. Participants expressed positive feedback regarding acceptability (satisfaction and intent to continue use) and were extremely likely or likely to recommend the program to a friend (demand). Implementation metrics were assessed by observation and feedback forms completed by peer leaders and demonstrated high-quality control. Findings suggest that the intervention was practical due to remote sessions and cost-effectiveness. CONCLUSION: The MBMM + intervention was deemed to be a feasible intervention with high acceptability, demand, implementation, and practicality. These findings can be used to inform the scalability of the intervention and implementation of a larger efficacy trial. TRIAL REGISTRATION: 19-1366, initial date is on January 23, 2020.

Investigation of key domains associated with worker well-being and burnout and turnover in the early care and education workforce.

PURPOSE: The early care and education (ECE) workforce provides care for children aged zero to five. This critical segment of the workforce experiences significant burnout and turnover rates resulting from extensive demands, including job stress and poor overall well-being. Factors associated with well-being in these settings and the resulting impacts on burnout and turnover are understudied. The purpose of this study was to investigate associations between five well-being domains and burnout and turnover outcomes among a large sample of Head Start ECE staff in the United States. METHODS: An 89-item survey based off the National Institutes of Occupational Safety and Health Worker Wellbeing Questionnaire (NIOSH WellBQ) was administered to ECE staff employed in five large urban and rural Head Start agencies. The WellBQ is made up of five domains intended to measure worker well-being as a holistic construct. We utilized linear mixed-effect modeling with random intercepts to investigate associations between sociodemographic characteristics, well-being domain sum scores and burnout and turnover. RESULTS: After controlling for sociodemographic variables, the well-being Domain 1 (Work Evaluation and Experience) (ß = - .73, p < .05) and Domain 4 (Health Status) (ß = - .30, p < .05) were significantly and negatively associated with burnout; the well-being Domain 1 (Work Evaluation and Experience) (ß = - .21, p < .01) was significantly and negatively associated with turnover intent. CONCLUSIONS: These findings suggest that multi-level well-being promotion programs could be critical to mitigate ECE teacher stress and address individual-, interpersonal-, and organizational-level predictors of overall ECE workforce well-being.

Application of an Implementation Framework Using Mixed Methods in Preschool Settings.

Research Findings. Application of mixed methods in a dissemination and implementation framework can give researchers a better understanding of the reach and delivery of early childhood obesity prevention programs in preschool settings, as well as potential facilitators and barriers related to implementation and sustainability. This study utilized a simultaneous, exploratory, mixed-methods design to investigate individual-, organizational-, and intervention-level factors that were related to the implementation and sustainability of policy, system, and environment (PSE) changes as part of a larger obesity prevention program in a randomly selected sample of preschool centers (n = 20). Individual-level factors, and specifically the attitudes and skills of preschool providers, were identified in both the qualitative and quantitative data as important factors related to the sustainability of PSE changes (r = .56, p < .01). Staff and leadership engagement and adaptability of the program were also identified as important factors related to the implementation and sustainability of PSE changes. Practice or Policy. These findings highlight the complexity of implementation success and suggest PSE obesity prevention interventions in preschool centers require the consideration of numerous, multilevel factors to ensure programming is impactful and sustained over time.

Changes in demands and resources faced by the early childhood education workforce due to COVID-19.

The primary purpose of this study was to investigate the impacts of the COVID-19 pandemic on demands, resources, and job satisfaction among a convenience sample of early childhood education (ECE) staff employed in Head Start preschools in a large metro area of Colorado. A survey was administered to a sample of Head Start staff at two timepoints: Time 1 (pre-COVID-19 pandemic) in October of 2019 (n = 137) and Time 2 (during the COVID-19 pandemic) in November of 2020 (n = 86). The survey consisted of a combination of validated measures to assess personal and external demands and resources and work satisfaction. Workload is a perceived external demand that significantly improved from pre- to mid-pandemic in this sample (z = -3.3, p < 0.01). Many personal and external resources changed pre- to mid-pandemic, though none were statistically significant. Overall job satisfaction in this sample increased, though it was not statistically significant (z = -1.04, p = 0.3). Mitigating demands, such as minimizing workload, and increasing job-related resources, such as bolstering management supports, may lead to improved job satisfaction of the ECE workforce employed in Head Start settings. Although the COVID-19 pandemic has amplified poor mental health and numerous job demands, some of the pandemic-related regulations may have also decreased the workload for some subgroups of the ECE workforce, potentially translating to improved job satisfaction. However, significant disparities remain with respect to personal and external demands among this sample of the ECE workforce compared to the national workforce suggesting multi-level resources and supports are critical to further buffer these stressors.

Fostering Resilience Among Mothers Early (FRAME): using growth mixture modeling to identify resources that mitigate perinatal depression.

The primary objective of this study was to delineate classes of individuals based on depression trajectories from the antenatal period through 54-month postpartum and internal and external resources that are associated with low depression risk. Participants came from the Growing Up in New Zealand (GUiNZ) study (n = 5664), which is a pregnancy cohort study and is nationally representative of the ethnic and socioeconomic diversity of contemporary New Zealand births. Growth curve mixture modeling was used to identify distinct subgroups based on depression scores from the antenatal period through 54-month postpartum. Logistic regression models were run to investigate socioeconomic factors and internal and external resources that were associated with depression class membership. A two-class model, "low risk" and "high risk," resulted in the best model fit. Most of the sample (n = 5110, 90%) fell into the "low-risk" class defined by no-to-mild depression symptoms during pregnancy and decreasing depressive symptoms over time (bintercept = - .05, bslope = - .05). Approximately 10% of the sample fell into the "high-risk" class (n = 554, 10%) defined by mild-to-moderate depressive symptoms during pregnancy and increasing depressive symptomology over time (bintercept = .39, bslope = .57). More positive parenting-related attitudes, better pre-pregnancy self-reported health, informal social supports, and community belonging were significantly associated with greater odds of being in the "low-risk" class, after controlling for socioeconomic factors. These findings suggest that targeting internal and external resources for individuals across the perinatal and early childhood periods is important to mitigating maternal depression.

Parents' Mental Health Experiences during the Perinatal Transition: A Qualitative Study.

Capturing the voices of both parents regarding perinatal mental health is imperative. This qualitative study employed a purposive sampling technique to interview 23 individuals, including mothers, partners, and perinatal practitioners/educators. Qualitative data analysis utilized an inductive, data-driven approach. Four themes emerged. First, mothers' perception of risk of postpartum depression (PPD) changed over time and with subsequent children. Theme two focused on identity loss. Third, the stay-at-home parent often feels unrecognized by their partner. Fourth, a PPD prevention class for parents should include certain key elements. These themes can aid practitioners in prioritizing the needs of parents during the perinatal period.

Job Demands and Resources Experienced by the Early Childhood Education Workforce Serving High-Need Populations.

The early childhood education (ECE) workforce plays a key role in promoting early childhood development by their interactions with young children during formative years. However, the inherent demands of the profession and the work conditions within ECE settings affect job satisfaction and overall health and well-being. This study applied the Job Demands-Resources Model (JD-R) and administered a cross-sectional survey (n = 137) to examine disparities in personal and external demands and resources that may impact job satisfaction and turnover rates among ECE staff who provide care for preschool children (3-5 years of age). ECE staff reported higher levels of personal demands, including depression and perceived stress, and external demands, including workload and staffing concerns, compared to the national workforce (all p < .01). The data also illustrated disparities related to resource access; ECE staff reported lower levels of personal resources, including mindfulness, and less access to external resources including safety climate, resource adequacy, role clarity, respect, and management relationships (all p < .01). Only 34% of ECE staff reported being very satisfied with their work compared to 49% of the national workforce (p < .01). External resources were significantly and positively associated with job satisfaction (B = .09, p < .01). These findings suggest that ECE staff experience significantly higher demands and have access to significantly fewer resources in the workplace, and that bolstering job-related resources may translate to increased job satisfaction.

Maternal depression trajectories and child BMI in a multi-ethnic sample: a latent growth modeling analysis.

BACKGROUND: Perinatal (antenatal and postpartum) depression impacts approximately 12% of mothers. Perinatal depression can impact everyday functioning for mothers, and the relationship with, and development of, their children. The purpose of this study was to investigate depression trajectories from the antenatal period through 54-months postpartum and associations with child body mass index at 54-months postpartum. METHODS: This study applied latent growth modeling to the Growing Up in New Zealand study, which is a longitudinal pregnancy cohort study that provides nationally representative-level data, to investigate associations between depression at three time points (antenatal, 9-months postpartum, 54-months postpartum) and child body mass index at 54-months (n=4897). RESULTS: The average slope of depression for this sample is low and decreases over time. When child BMI was added to the model as an outcome variable, both antenatal depression (B=.25, p<.01), and the rate of change of depression across the perinatal and postpartum periods (B=.09, p<.01) were associated with child BMI at 54-months postpartum. After controlling for sociodemographic characteristics, antenatal depression, but not the slope of depression, remained significantly associated with child BMI (B=.05, p<.05). When controlling for maternal pre-pregnancy BMI the effect of antenatal depression on child BMI at 54-months was entirely attenuated (χ2 (9) = 39.60, p < .05, SRMR = 0.01, CFI = .99, RMSEA = 0.03, BIC=53213). CONCLUSIONS: Our findings align with the Developmental Origins of Health and Disease theory and imply that both the physical and mental health of mothers during pregnancy may be important indicators of child growth and development outcomes. Early intervention directed towards women who have even mild depression scores during pregnancy may promote healthy child development outcomes. Additionally, given the heterogeneity of depressive symptoms over time seen in this study, multiple assessment periods across the postpartum period may be valuable to adequately address and support maternal mental health.

Exploring Predictors of Social Distancing Compliance in the United States during the COVID-19 Pandemic.

OBJECTIVE: Through the application of the Health Belief Model, this study sought to explore how relationships between perceived susceptibility, severity, and benefits of social distancing recommendations, as well as psychological factors, may impact compliance with COVID-19 social distancing recommendations in the United States. METHODS: Between October and November 2020, a convenience sample of English-speaking adults in the United States completed an online, cross-sectional survey which included items assessing beliefs around threats (e.g., perceived susceptibility and severity), response efficacy (e.g., perceived benefits), psychological factors (e.g., stress and COVID-specific anxiety), and compliance with social distancing measures (e.g., avoiding social gatherings). RESULTS: Social distancing compliance was positively associated with perceived susceptibility of COVID-19 (b = 0.42, P < 0.05) and perceived benefits of social distancing recommendations (b = 0.81, P < 0.01). No significant associations were found between perceived severity of COVID-19 (P = 0.38), general stress (P = 0.28), COVID-19-related anxiety (P = 0.12), and compliance. CONCLUSIONS: Findings suggest that perceived susceptibility to COVID-19 and perceived benefits of social distancing measures significantly increased compliance with social distancing recommendations in this convenience sample of U.S. adults.

Protective resources that promote wellbeing among New Zealand moms with young children facing socioeconomic disadvantage.

Poor maternal mental health and well-being during early stages of parenting impact child developmental outcomes. The primary objective of this study was to explore protective resources that may confer resilience among mothers living in low resourced neighborhoods in New Zealand. A purposive, non-probabilistic sampling method was used to recruit an ethnically representative sample of mothers with children under the age of five living in high deprivation neighborhoods in Auckland, New Zealand (n = 74). Data was collected via focus groups and interviews. Analyses consisted of both a deductive, theory-driven approach, and an inductive, data-driven approach. The most frequently mentioned resources that supported positive mental health and well-being included: 1) social support, and specifically family and instrumental support; 2) neighborhood cohesion, including collective efficacy and neighborhood permanence; and 3) alignment with social and cultural norms, though tensions surrounding cultural identity were also identified as sources of stress by some mothers. These findings highlight how the socioecological context impacts subjective perceptions of environmental demands and modifiable factors that may be promoted to improve maternal mental health and well-being and subsequent child health and development outcomes.

Maternal mental health and early childhood development: Exploring critical periods and unique sources of support.

BACKGROUND: The objective of this study was to explore associations between maternal depression and anxiety during early sensitive periods, child social-emotional and behavioral problems and the moderating roles of financial, instrumental, and partner emotional support. METHODS: Analyses was conducted using data from the Fragile Families and Child Wellbeing Study. Hierarchical linear regression modeling was used to explore associations between maternal depression and anxiety at 1- and 3-years postpartum, three unique types of social support, and childhood behavioral problems at 5-years of age (n = 2,827). RESULTS: Mothers who were depressed at one or both timepoints, compared to nondepressed mothers, reported higher externalizing behavioral problems scores of 1.96 and 2.90, and internalizing behavioral problems scores of 1.16 and 2.20, respectively, at 5-years of age (both p < .01), after controlling for covariates. Financial, instrumental, and partner emotional support were independently and inversely associated with behavioral problems (p < .05); however, none of these types of support moderated the relationship between maternal depression and behavioral problems, after controlling for covariates. IMPLICATIONS: Promoting maternal mental health as well as different sources of support throughout the first five years of life, instead of one critical period, may help to reduce the burden of chronic disease in the next generation.

Trasfondo: El objetivo de este estudio fue explorar las asociaciones entre la depresión y ansiedad maternas durante los tempranos períodos sensibles, los problemas socioemocionales y de conducta del niño y los papeles moderadores del apoyo económico, instrumental y emocional de su compañero. Métodos: Se llevaron a cabo análisis usando datos del Estudio del Bienestar de las Familias Frágiles y del Niño. Se usó un modelo de regresión lineal jerárquico para explorar las asociaciones entre la depresión y ansiedad maternas al año y a los tres años posteriores al parto, tres tipos exclusivos de apoyo social, así como también los problemas de conducta en la niñez a los 5 años de edad (n = 2,827). Resultados: Las madres que tenían depresión en uno o ambos momentos temporales, comparadas con las madres que no tenían depresión, reportaron más altos puntajes de problemas de externalización de conducta de 1.96 y 2.90, y puntajes de internalización de conducta de 1.16 y 2.20, respectivamente, a los 5 años de edad (ambos p<.01), después del control por covariables. El apoyo económico, instrumental y emocional del compañero se asociaron independiente e inversamente con problemas de conducta (p<.05); sin embargo, ninguno de estos tipos de apoyo sirvió de moderador de la relación entre la depresión materna y los problemas de conducta, luego del control por covariables. Implicaciones: El promover la salud mental materna, así como diferentes fuentes de apoyo a lo largo de los primeros cinco años de vida, en vez de un período crítico, pudiera ayudar a reducir la carga de enfermedad crónica en la siguiente generación.

Contexte: L'objectif de cette étude était d'explorer les liens entre les liens entre la dépression maternelle et l'anxiété maternelle durant des périodes sensibles, les problèmes socio-émotionnels et de comportement de l'enfant et les rôles modérateurs du soutien émotionnel, financier, et instrumental du partenaire. Méthodes: Des analyses ont été faites en utilisant des données de l'Étude Familles Fragiles et Bien-Être de l'enfant. Une modélisation de régression linéaire hiérarchique a été utilisée pour explorer les liens entre la dépression maternelle et l'anxiété à un an et à trois années postpartum, trois types uniques de soutien social, et les problèmes de comportement de l'enfance à l'âge de 5 ans (n = 2827). Résultats: Les mères qui ont été déprimées à un ou deux temps d'évaluation, comparées aux mères non-déprimées, ont fait preuve de scores de problèmes de comportement d'externalisation plus élevés de 1,96 et 2,90 et de scores de problèmes de comportement d'internalisation de 1,16 et 2,20, respectivement, à 5 ans (les deux p<,01), après le contrôle des covariables. Implications: La promotion de la santé mentale maternelle ainsi que de différentes sources de soutien au travers des cinq premières années de vie, au lieu d'une période critique, peut aider à réduire le poids de la maladie chronique chez la génération qui suit.

Anxiety among fathers during the prenatal and postpartum period: a meta-analysis.

INTRODUCTION: The purpose of this review was to determine the prevalence of anxiety among fathers during the perinatal (pre- and post-natal) period. METHODS: A systematic search was conducted to identify studies published between 1995-2020. One hundred and seventy-two of the records met inclusion criteria and full texts were screened for eligibility. The authors followed PRISMA guidelines to extract the data. RESULTS: A total of 23 studies, representing 40,124 participants, are included in this meta-analysis. The overall random effects estimate of paternal perinatal anxiety was 10.69% (95% confidence interval (CI): 8.14 - 13.91%). Rates of paternal perinatal anxiety demonstrated significant heterogeneity that was large in magnitude (Q = 304,494, p < .001, I2 = 99.93 and τ2 = .5381). Study quality rating did not appear to moderate rates of paternal perinatal anxiety (low: 10.74%; 95% CI: 6.56-17.11%; high: 10.65%; 95% CI: 6.02- 18.15%). DISCUSSION: Paternal perinatal anxiety rates in this meta-analysis are considerably higher than the global WHO regional prevalence rates for anxiety among men suggesting the transition into parenthood may place men at greater risk for anxiety.

Prenatal Stress and Early Childhood Body Mass Index: A Path Analysis Approach.

OBJECTIVES: Stress experienced by mothers during the prenatal period can have negative impacts on offspring development. Elevated BMI in childhood in response to early stress experience is a particularly critical outcome of interest since high BMI in childhood is associated with diabetes, heart disease and stroke in later life. The primary objective of this study was to analyze pathways between prenatal stress and early childhood BMI at 54-months of age and to begin to explore ethnic variations in these pathways. METHODS: This study used the Growing Up in New Zealand (GUiNZ) dataset, which is a longitudinal, representative birth cohort study that began with recruiting pregnant women in 2009 and 2010 in Auckland, New Zealand. Path analysis modeling was used to explore risk and protective pathways between prenatal maternal stress and early childhood body mass index (BMI) at 54-months of age and differences by ethnicity (n = 5510). RESULTS: Prenatal stress was positively associated with early childhood BMI at 54-months and maternal nutrition behaviors and length of exclusive breastfeeding mediated this direct relationship (χ2 (1) = 0.83, p = 0.36; AIC = 50,496). Mediation and moderation paths varied by ethnicity. CONCLUSIONS FOR PRACTICE: These findings contribute to the understanding of the intergenerational transmission of stress with respect to early childhood obesity. Reducing early stress exposure and/or addressing mediating and moderating factors linking stress experience with obesity development may prove to be more effective than attempting to alter health behaviors and trajectories in adulthood.

Mental Health During the COVID-19 Pandemic in the United States: Online Survey.

BACKGROUND: The COVID-19 pandemic has had numerous worldwide effects. In the United States, there have been 8.3 million cases and nearly 222,000 deaths as of October 21, 2020. Based on previous studies of mental health during outbreaks, the mental health of the population will be negatively affected in the aftermath of this pandemic. The long-term nature of this pandemic may lead to unforeseen mental health outcomes and/or unexpected relationships between demographic factors and mental health outcomes. OBJECTIVE: This research focused on assessing the mental health status of adults in the United States during the early weeks of an unfolding pandemic. METHODS: Data was collected from English-speaking adults from early April to early June 2020 using an online survey. The final convenience sample included 1083 US residents. The 71-item survey consisted of demographic questions, mental health and well-being measures, a coping mechanisms checklist, and questions about COVID-19-specific concerns. Hierarchical multivariable logistic regression was used to explore associations among demographic variables and mental health outcomes. Hierarchical linear regression was conducted to examine associations among demographic variables, COVID-19-specific concerns, and mental health and well-being outcomes. RESULTS: Approximately 50% (536/1076) of the US sample was aged ≥45 years. Most of the sample was White (1013/1054, 96%), non-Hispanic (985/1058, 93%), and female (884/1073, 82%). Participants reported high rates of depression (295/1034, 29%), anxiety (342/1007, 34%), and stress (773/1058, 73%). Older individuals were less likely to report depressive symptomology (OR 0.78, P<.001) and anxiety symptomology (OR 0.72, P<.001); in addition, they had lower stress scores (-0.15 points, SE 0.01, P<.001) and increased well-being scores (1.86 points, SE 0.22, P<.001). Individuals who were no longer working due to COVID-19 were 2.25 times more likely to report symptoms of depression (P=.02), had a 0.51-point increase in stress (SE 0.17, P=.02), and a 3.9-point decrease in well-being scores (SE 1.49, P=.009) compared to individuals who were working remotely before and after COVID-19. Individuals who had partial or no insurance coverage were 2-3 times more likely to report depressive symptomology compared to individuals with full coverage (P=.02 and P=.01, respectively). Individuals who were on Medicare/Medicaid and individuals with no coverage were 1.97 and 4.48 times more likely to report moderate or severe anxiety, respectively (P=.03 and P=.01, respectively). Financial and food access concerns were significantly and positively related to depression, anxiety, and stress (all P<.05), and significantly negatively related to well-being (both P<.001). Economy, illness, and death concerns were significantly positively related to overall stress scores (all P<.05). CONCLUSIONS: Our findings suggest that many US residents are experiencing high stress, depressive, and anxiety symptomatology, especially those who are underinsured, uninsured, or unemployed. Longitudinal investigation of these variables is recommended. Health practitioners may provide opportunities to allay concerns or offer coping techniques to individuals in need of mental health care. These messages should be shared in person and through practice websites and social media.

An exploration of constructs related to dissemination and implementation of an early childhood systems-level intervention.

Obesity and overweight in early childhood have detrimental impacts on children's health and development. Changing policy, system and environmental features focused on physical activity and healthy eating behaviors as part of health promotion interventions can play a key role in prevention strategies in early childhood education settings. These types of changes can have broad reach and are often sustained over time, which allows for impact on children who enter the early childhood education setting year after year. However, there is currently a gap between the generation of evidence for health promotion programs and their application into practice. This study used qualitative methods to evaluate intervention-, organizational- and individual-level factors within a dissemination and implementation framework that may be related to the implementation of a health-promoting intervention in early childhood education settings. Intervention-level factors, including feasibility and adaptability, organizational-level factors, including staff and leadership engagement, and individual-level factors, including attitudes, skills and knowledge, were identified as constructs that impacted the successful implementation of the intervention. These findings provide insight into core dissemination and implementation constructs that should be targeted by obesity prevention interventions in early childhood education settings to ensure maximum impact on sustainable behavior change.

A Mixed-Methods Pilot Study of Perinatal Risk and Resilience During COVID-19.

Introduction/Objectives: National guidelines underscore the need for improvement in the detection and treatment of mood disorders in the perinatal period. Exposure to disasters can amplify perinatal mood disorders and even have intergenerational impacts. The primary aim of this pilot study was to use mixed-methods to better understand the mental health and well-being effects of the coronavirus disease 2019 (COVID-19) pandemic, as well as sources of resilience, among women during the perinatal period. Methods: The study team used a simultaneous exploratory mixed-methods design to investigate the primary objective. Thirty-one pregnant and postpartum women participated in phone interviews and were invited to complete an online survey which included validated mental health and well-being measures. Results: Approximately 12% of the sample reported high depressive symptomatology and 60% reported moderate or severe anxiety. Forty percent of the sample reported being lonely. The primary themes related to stress were uncertainty surrounding perinatal care, exposure risk for both mother and baby, inconsistent messaging from information sources and lack of support networks. Participants identified various sources of resilience, including the use of virtual communication platforms, engaging in self-care behaviors (eg, adequate sleep, physical activity, and healthy eating), partner emotional support, being outdoors, gratitude, and adhering to structures and routines. Conclusions: Since the onset of COVID-19, many pregnant and postpartum women report struggling with stress, depression, and anxiety symptomatology. Findings from this pilot study begin to inform future intervention work to best support this highly vulnerable population.

Safety and Health Innovation in Preschools: A Total Worker Health Pilot Project.

OBJECTIVE: The primary objective of this study was to evaluate quality of work life in early childhood education (ECE) centers and implement a total worker health (TWH) pilot project with a small sample of ECE teachers. METHODS: An evidence-based strategic planning process to make policy, system, and environmental (PSE) changes related to TWH was implemented with six ECE centers. A pre-post design with mixed-methods was used to evaluate the impact. RESULTS: Baseline findings suggest that there are significant disparities related to quality of work life among ECE teachers compared with the national population. After implementation of the pilot project, ECE centers averaged 4.7 PSE changes. Qualitative data informed facilitators and barriers to implementation of TWH-related changes. CONCLUSIONS: This pilot project reflects an evidence-based participatory approach to assessing and improving the well-being of ECE teachers.

Training Child Care Inspectors to Deliver Health Messaging: A Quality Improvement Pilot Project.

Early childhood obesity is at epidemic proportions. Early child care providers have a unique opportunity to instill healthy eating and active living behaviors in children that can foster lifelong health. Academic-community partnerships that involve collaborations between child care centers, local public health departments, and universities provide one avenue to strengthening healthy eating and active living-related knowledge and skills among early child care providers. This quality improvement pilot intervention, titled Healthy Child Care Makes a Healthy Start, is one example of this type of collaboration. This quality improvement pilot project consisted of two complementary intervention components. Inspectors were trained to cofacilitate a strategic planning process with university researchers to help providers implement healthy eating and active living-related policy, system, and environment changes in their child care homes and centers. An average of five changes were implemented in participating child care locations. Inspectors also received training on health-related best practices and delivered 1-minute health messages to child care providers during routine inspection visits. This type of innovative partnership has the potential to leverage a currently existing relationship between child care providers and licensing and regulation inspectors and shift the relationship to include dissemination and implementation of health messaging in child care center and home settings.

The Impact of a Workplace Wellness Program on Provider Health in Early Childhood Education Settings.

Background: Early childhood education (ECE) working environments often contribute to poor health outcomes. The purpose of this study was to describe healthy eating-related and physical activity-related awareness and adoption of behavior change of ECE providers after participating in a workplace wellness (WW) program and to explore facilitators and barriers to ECE provider participation in WW program. Methods: The WW program offered healthy eating and physical activity challenges to promote ECE provider health and well-being. Approximately 1,000 ECE providers in Colorado from 35 ECE settings were invited to participate. After the intervention, ECE providers completed two surveys: (a) a provider postsurvey and (b) a WW challenge survey. Multivariable logistic regression modeling was used to examine factors associated with percent agreement that participation in the WW program increased awareness and adoption of health behaviors. Findings: A total of 250 (25%) ECE providers participated in WW program from 2015 to 2017. After participation, approximately 84% of respondents agreed they were more aware of the importance of eating fruits and vegetables and of being physically active, while 81% reported eating more fruits and vegetables, and 80% reported being more physically active in the workplace. Logistic regression models found that the length of time teaching in ECE settings was positively and significantly associated (odds ratio [OR] = 1.10, 95% confidence interval [CI] = [1.00, 1.21]) with the odds of providers agreeing that participation in the WW program increased their awareness of health behaviors. Conclusion/Application to Practice: The design and implementation of WW programs that emphasize facilitators, such as intrinsic and extrinsic motivation, as well as reduce barriers, such as time constraints and unachievable goal setting, may increase the awareness and adoptions of healthy eating-related and physical activity-related behaviors among ECE work settings.