Abstract
BACKGROUND/OBJECTIVES: Early care and education programs promote children's social-emotional development, predicting later school success. The COVID-19 pandemic worsened an existing youth mental health crisis and increased teacher stress. Therefore, we applied an infant and early childhood mental health consultation model, Jump Start Plus COVID Support (JS+CS), aiming to decrease behavioral problems in children post-pandemic. METHODS: A cluster randomized controlled trial compared JS+CS to an active control, Healthy Caregivers-Healthy Children (HC2), at 30 ECE centers in low-income areas in South Florida. Participants were not blinded to group assignment. Teachers reported on children's social-emotional development at baseline and post-intervention using the Devereux Early Childhood Assessment and Strengths and Difficulties Questionnaire. We assessed whether teacher stress, classroom practices, and self-efficacy mediated the relationship between JS+CS and child outcomes. We also explored whether baseline behavior problems moderated JS+CS effects on child protective factors, relative to HC2. RESULTS: Direct group-by-time differences between JS+CS and HC2 were limited. However, JS+CS demonstrated significant within-group improvements in teacher-reported child protective factors, behavior support practices, and classroom safety practices. Classroom safety practices consistently mediated positive changes in child behaviors, including the DECA total protective factor score and subdomains of initiative and self-regulation. Additionally, teacher perceptions of behavior support mediated gains in child attachment. CONCLUSIONS: JS+CS shows promise in building protective systems around children through intentional support for teachers, underscoring the value of whole-child, whole-environment approaches in early intervention.