Participants
Educators within a public school district located in Southwestern Ontario, participated in the study. School district officials selected schools based on the presence or absence of ongoing research studies, administrator and staff’s willingness to implement an SEL program, and Social Risk Index (SRI) scores. This particular school district determines SRI scores based on socio-economic risk factors, including parental education, employment rate, and income; higher SRI scores are indicative of higher levels of risk. During the 2016–2017 pilot year, eight intervention schools were invited to participate in the study (see Crooks et al., 2020, for more information on school selection). A total of 26 educators (14 teachers and eight early childhood educators) from the pilot schools, received a half-day trauma-informed training, two full-days of MindUP training, and implemented MindUP in their classrooms. This cohort of educators implemented MindUP for two consecutive years, throughout the 2016–2017 and 2017–2018 school years; hence the group name, involved-twice. To scale up the evaluation following a successful pilot year, two additional intervention schools and seven comparison schools were invited to participate in the study at the beginning of the 2017–2018 school year. A total of 45 educators (37 teachers and eight early childhood educators) were recruited from the pilot and newly added intervention schools. These individuals attended both trauma-informed and MindUP training, and incorporated MindUP into their teaching practices for one year, during either the 2017–2018 or 2018–2019 school year; hence the group name, involved-once. Additionally, 41 educators (27 teachers and 14 early childhood educators) were recruited from the comparison schools and were assigned to the comparison group, either during the 2017–2018 or 2018–2019 school year. These individuals did not participate in either training and taught the regular curriculum. For equity of services, the comparison educators were offered the training and resources to implement MindUP the following school year. The entire sample consisted of 112 educators (involved-twice: n = 26; 23.2%, involved-once: n = 45; 40.2%, comparison: n = 41; 36.6%) over three consecutive school years (September 2016–June 2019).
Table 1 shows the descriptive statistics of the entire sample categorized into the three study groups. The majority of the participants were female (93.7%), with 92.7%, 91.1%, and 100% in the comparison, involved-once, and involved-twice groups, respectively. Likewise, participants who were White/Caucasian comprised a large proportion of the entire sample (92.7%), with 92.7%, 95.6%, and 87.0% in the three study groups, respectively. The highest attained education level was also not statistically different across the study groups, with approximately two-thirds (64.8%) of participants having completed a Bachelor's degree. More than half of the sample (57.6%) reported having an income level of more than $60K yearly, with no statistical difference across the study groups. For their current job role, 40.7%, 27.8%, and 31.5% of the participants reported being kindergarten teachers, kindergarten early childhood educators, and grade 1–3 teachers, respectively. The proportion of the current job role was statistically different across the study groups: more kindergarten teachers were in the comparison group (43.9%) and involved-twice group (63.6%), while more grade 1–3 teachers were in the involved-once group (55.5%).
Table 1 Descriptive statistics overall and by the three study groups at baseline (N = 112) The mean [SD] of the duration in the current job role was 7.9 [7.9] years, and working in the current organization was 10.9 [8.6] years in the whole sample, with no statistical differences in the distribution of these covariates across the study groups. The mean [SD] duration of working in the current field in the whole sample was 15.2 [9.1] years, with a longer duration in the involved-twice group (19.4 [7.1]) when compared with the comparison group (16.0 [8.3]) and involved-once group (12.4 [9.9]).
Procedure
Intervention
Intervention educators participated in a half-day in-person training on trauma-informed practice. In line with several core components of trauma-informed training highlighted by McIntyre et al. (2019), the training offered through this study addressed the following topics: prevalence and impact of trauma and adversity, the neurobiology of toxic stress, stress-related behaviors in the classroom, classroom management techniques, and school staff wellness to prevent vicarious traumatization.
In addition to the trauma-informed training, intervention educators participated in a full-day in-person MindUP training in the fall and a full-day extension training in the spring. The MindUP training was facilitated by a trainer affiliated with the Goldie Hawn Foundation, the developers of the MindUP program. Through demonstrations, discussions, interactive activities, and implementation planning for each MindUP lesson, the educators learned strategies to deliver MindUP in their classrooms.
Intervention educators had the opportunity to implement MindUP in their classrooms during the school year. MindUP is a manualized program for students in pre-kindergarten to grade 8 that integrates neuroscience, mindful awareness, positive psychology, and SEL. The four themes are addressed in four separate units: (1) Getting Focused (learn the functions of brain parts, the difference between mindful and unmindful behavior, and how to perform a breathing exercise), (2) Sharpening Your Senses (practice mindful listening, seeing, smelling, tasting, and movement), (3) It’s All About Attitude (consider others’ viewpoints, cultivate optimism, and appreciate happy experiences), (4) Taking Action Mindfully (express gratitude and perform acts of kindness). Within the units are 15 teacher-led lessons taught once a week for approximately 40 min each (Crooks et al., 2020). Beyond the lessons, teachers are encouraged to implement the core practice of MindUP (i.e., brain break), a mindful breathing exercise, three times per day. During the brain break, students focus their attention on their breathing while listening to a chime rung by the teacher.
Data Collection
At the beginning of the school year, educators in the selected schools were given a letter of information and consent form outlining their roles as research participants. Those who consented to participate completed pre-implementation measures in September and post-implementation measures in June of the same school year. The timeline was consistent throughout the three consecutive school years. Educators in the involved-twice group were recruited in September 2016 (T0a) and followed until June 2018 (T1b), with initial follow-up in June 2017 (T0b) and re-entering in September 2017 (T1a).Footnote 1 Nine educators were lost to follow-up at T1b, due to transferring to schools that are not part of the research study or switching to non-targeted grades.Footnote 2 Educators in the involved-once and comparison groups were either recruited in September 2017 (T1a) and followed until June 2018 (T1b), or recruited in September 2018 (T2a) and followed until June 2019 (T2b). T1a and T2a data were combined to create the baseline, pre-implementation time period for each involved-once and comparison group, and T1b and T2b data were combined to form the follow-up, post-implementation time period for each involved-once and comparison group. Figure 1 shows a flowchart depicting the timeline of the three groups in this study. Intervention educators were required to complete the pre-implementation measures prior to receiving trauma-informed and MindUP training in October. Post-implementation measures and focus groups were conducted with intervention educators after MindUP implementation was complete. Comparison educators completed the pre- and post-implementation measures at similar time points. Participants received compensation for completing the surveys and the focus groups. The study procedures were approved by the Western University Research Ethics Board and the school district research department.
Measures
Attitudes Related to Trauma-Informed Care (ARTIC) Scale
The 35-item education version of the Attitudes Related to Trauma-Informed Care (ARTIC) scale was used to assess educators’ trauma-informed attitudes (Baker et al., 2015). The ARTIC scale measures five core aspects of trauma-sensitive attitudes. Educators rated the items on a 7-point bipolar Likert scale with an attitude descriptor anchoring each end of the scale. Higher scores on the subscales represent a higher endorsement of trauma-informed attitudes. The scales include: (a) Underlying Causes of Problem Behavior and Symptoms (Underlying Causes; e.g., favorable attitude: “Students’ learning and behavior problems are rooted in their history of difficult life events,” unfavorable attitude: “Students’ learning and behavior problems are rooted in their behavioral or mental health condition”), (b) Responses to Problem Behavior and Symptoms (Responses; e.g., favorable attitude: “Focusing on developing healthy, healing relationships is the best approach when working with people with trauma histories,” unfavorable attitude: “Rules and consequences are the best approach when working with people with trauma histories”), (c) On-the-Job Behavior (Job Behavior; e.g., favorable attitude: “Being upset doesn’t mean that students will hurt others,” unfavorable attitude: “If I don’t control students’ behavior, other students will get hurt”), (d) Self-Efficacy at Work (Self-Efficacy; e.g., favorable attitude: “I have the skills to help my students,” unfavorable attitude: “I do not have the skills to help my students”), (e) Reactions to the Work (Reactions; e.g., favorable attitude: “I have to take care of myself personally in order to take care of my students,” unfavorable attitude: “How I am doing personally is unrelated to whether I can help my students”). Baker et al. (2015) established the internal consistency and validity of the ARTIC scale, and we also observed high internal consistency for the full scale in our sample (α = 0.88). The scale has been used in some other pilot studies to evaluate trauma-informed practice (e.g., Gubi et al., 2019), and there have been calls to use more standardized measures in the evaluation of trauma-informed approaches (Purtle, 2020); however, at this point, there are not many intervention studies that have used the ARTIC scale.
Maslach Burnout Inventory (MBI)
Educators’ perceived burnout levels were assessed using the Maslach Burnout Inventory (MBI; Maslach et al., 1996). The educator version of the MBI has been used extensively in research to measure burnout in professionals working in the education sector (García-Carmona, Marín, & Aguayo, 2019). Educators can also use the MBI as a self-assessment tool and compare their scores with colleagues to gauge their stress level. Two core aspects of burnout syndrome (i.e., emotional exhaustion and lack of personal accomplishment) were measured using nine items from the Emotional Exhaustion subscale (e.g., “I feel burned out from my work”) and eight items from the Personal Accomplishment subscale (e.g., “I deal very effectively with the problems of my students”). The educators reflected on the frequency of certain thoughts and behavior on a 7-point Likert scale with endpoints ranging from 0 = never to 6 = every day. Higher scores on the Emotional Exhaustion subscale and lower scores on the Personal Accomplishment subscale indicate higher degrees of burnout. The measure has strong psychometric properties with high internal reliability and satisfactory validity (Chang, 2013). The internal reliability in the current sample was 0.89 for the overall scale.
Focus Groups
A total of 17 semi-structured focus groups were conducted with 59 out of 71 intervention educators (83%) across three consecutive years. The purpose of the meetings was to collect educators’ perspectives on the trauma-informed training and experiences with MindUP implementation (e.g., “How have your views/ideas concerning young children changed as a result of the MindUP and trauma-informed training?” and “Have you noticed any changes in your teaching or classroom as a result of implementing the MindUP program?”). The focus groups were conducted upon completion of the MindUP program in June of each year. The meetings were held at the intervention educators’ schools, in groups ranging from two to six participants, for approximately 1 h during lunchtime or after school.
Analysis
Quantitative Analysis
Mean and standard deviations (SD) were reported for continuous variables, and absolute and relative frequencies were reported for categorical variables. To compare the baseline characteristics across the three study groups, Chi-square test for categorical variables and one-way ANOVA for continuous covariates were used. Because there were no significant baseline differences across groups, paired t-tests were used to examine within-group change of the study outcomes (i.e., ARTIC and MBI subscales) in each study group from before (baseline) to after (post-intervention). One-way ANOVA was also used to compare the study outcomes across the study groups for the change scores when needed (i.e., when there were significant pre-post changes in all groups). Adjusted models using multivariable generalized estimating equation were also applied; however, we did not report them, given that there were no substantial differences relative to the unadjusted estimates (results are available upon request). Statistical analyses were performed using Stata (version 15) and SPSS (version 25).
Qualitative Analysis
The focus group conversations were audio-recorded and subsequently transcribed using Trint, an automated transcription software. The de-identified transcripts were revised and then analyzed by employing coding methods adapted from Saldaña (2016) and using Dedoose. Protocol coding method was used to assign pre-established codes (i.e., ARTIC and MBI subscales) to translate the data. The first and second authors analyzed the transcripts, and any discrepancies in interpretation were resolved through consensus. The codebook and exemplar excerpts are shown in Table 2.
Table 2 Codebook and exemplar quotes for ARTIC and MBI subscales