Profiles of Well-Being Among Early Childhood Educators

Research Findings: This study used a person-centered data analytic approach to identify distinct subgroups of early childhood educators (n= 133) based on their responses to multiple indicators of well-being (psychological, financial, and health indicators). Various fit indices established a two-class solution. Specifically, one group was characterized by more positive well-being and the other by less positive well-being. Subgroup differences were the greatest for indicators of psychological well-being, including self-care and self-compassion. In addition, educators with less than a bachelor’s degree, working as assistant teachers, receiving less pay, with more adverse childhood experiences, were overrepresented in the less positive well-being group, demonstrating system inequities and opportunities for improvement. Practice or Policy: These findings have implications for supporting the early care and education workforce. Specifically, findings suggest psychological well-being, including self-care and self-compassion, may be relevant focus areas for organizational and systems change efforts or interventions. Furthermore, findings suggest that trauma-informed approaches and support for assistant teachers are particularly important to promote equity and well-being across the workforce

Early Childhood Teacher Turnover in Nebraska

Teacher turnover is a serious challenge across early childhood settings. Turnover can be expensive for early childhood programs, burdensome to staff, and harmful to children throughout the nation. Nebraska is no exception. This research brief describes teacher turnover in the state’s early care and education settings, including licensed child care, state-funded PreK, and Kindergarten through Grade 3. Research Questions The following research questions were asked across early childhood programs (licensed child care, state-funded PreK, and K-3): 1. What was the average rate of annual teacher turnover? 2. According to administrators, what was the most common reason teachers left their employment? 3. Which hiring challenges did administrators experience in filling positions? 4. On average

Workforce well-being: Personal and workplace contributions to early educators\u27 depression across settings

Building on research demonstrating the importance of teachers\u27 well-being, this study examined personal and contextual factors related to early childhood educators\u27 (n =1640) depressive symptoms across licensed child care homes, centers, and schools. Aspects of teachers\u27 beliefs, economic status, and work-related stress were explored, and components of each emerged as significant in an OLS regression. After controlling for demographics and setting, teachers with more adult-centered beliefs, lower wages, multiple jobs, no health insurance, more workplace demands, and fewer work-related resources, had more depressive symptoms. Adult-centered beliefs were more closely associated with depression for teachers working in home-based settings compared to center-based settings. These findings provide preliminary evidence about what relates to depression in the early childhood workforce, which has implications for supporting well-being across settings

Risk Factors for Depression Among Early Childhood Teachers

This study examined possible risk factors associated with teachers’ depression in a variety of early childhood settings. Teachers with lower pay, no health insurance, multiple jobs, greater job stress, and more adult-centered beliefs reported more symptoms of depression. To reduce these symptoms, efforts should be made to support teachers’ mental health at multiple levels, including individual, environmental, and policy. Researchers used data collected in 2015-16 from a large survey of early childhood educators in Nebraska. Four early childhood settings were sampled: licensed family child care homes (home-based), licensed child care centers (center-based), state-funded PreK programs, and elementary schools serving children in Kindergarten through Grade 3 (K-3). Across settings, a total of 1,640 teachers responded to the survey: 36% in K-3, 25% home-based, 23% center-based, and 17% PreK. The survey included various measures, including economic circumstances (health insurance status, pay, public assistance use, and working multiple jobs), work-related stress, beliefs about children’s development (the extent to which teachers held more adult-centered vs. child-centered beliefs), and symptoms of depression

Nebraska Child Care Market Rate Survey Report 2019

The Child Care and Development Block Grant (CCDBG) Act of 2014 was reauthorized with renewed emphasis placed on the Child Care and Development Fund (CCDF) program, which seeks to provide equal access to quality child care for families. The CCDF program is necessary to ensure children from low-income families have the opportunity to experience stable, high-quality early experiences while their parents experience a pathway to economic stability. A primary goal of the CCDF program is to ensure that low-income families receive CCDF funds to help them access quality child care in the same manner as families that pay the full rate for child care services (Davis et al., 2017). The CCDBG Act requires Lead Agencies to engage in a number of activities designed to inform families receiving CCDF assistance, the general public, and child care providers of various aspects of the new law. This includes a requirement for Lead Agencies to conduct a market rate survey or alternative methodology to establish provider payment rates. Various factors should be considered when provider payment rates are established to ensure children from low-income families have equal access to highquality child care. Federal regulations indicate that the 75th percentile payment rate is a benchmark for gauging equal access for families receiving subsidy. However, States/ Territories are given the freedom to determine their own rates and eligibility requirements for families and programs. The Nebraska Department of Health and Human Services (NDHHS) is the CCDF Lead Agency in Nebraska. While the reauthorized CCDBG allows states to conduct a market rate survey every three years, state legislation requires that NDHHS adjust the reimbursement rate for child care every odd numbered year. For 2019, NDHHS contracted with the Buffett Early Childhood Institute (referred to as Institute throughout the remainder of this manuscript) at the University of Nebraska to conduct a market rate survey (MRS) for child care in the state of Nebraska. The 2019 MRS was designed to meet the following federal benchmarks: (a) includes the priced child care market; (b) provides complete and current data; (c) represents geographic variations; (d) uses rigorous data collection procedures; and (e) analyzes data in a manner that captures market differences as a function of age group, provider type, and geographic location (45 CFR § 98.4)

We Want to Know: Eliciting Hospitalized Patients' Perspectives on Breakdowns in Care

BACKGROUND: There is increasing recognition that patients have critical insights into care experiences, including breakdowns in care. Harnessing patient perspectives for hospital improvement requires an in-depth understanding of the types of breakdowns patients identify and the impact of these events. METHODS: We interviewed a broad sample of patients during hospitalization and post discharge to elicit patient perspectives on breakdowns in care. Through an iterative process, we developed a categorization of patient-perceived breakdowns called the Patient Experience Coding Tool. RESULTS: Of 979 interviewees, 386 (39.4%) believed they had experienced at least one breakdown in care. The most common reported breakdowns involved information exchange (n = 158, 16.1%), medications (n = 120, 12.3%), delays in admission (n = 90, 9.2%), team communication (n = 65, 6.6%), providers’ manner (n = 62, 6.3%), and discharge (n = 56, 5.7%). Of the 386 interviewees who reported a breakdown, 140 (36.3%) perceived associated harm. Patient-perceived harms included physical (eg, pain), emotional (eg, distress, worry), damage to relationship with providers, need for additional care or prolonged hospital stay, and life disruption. We found higher rates of reporting breakdowns among younger (<60 years old) patients (45.4% vs 34.5%, P < 0.001), those with at least some college education (46.8% vs 32.7%, P < 0.001), and those with another person (family or friend) present during the interview or interviewed in lieu of the patient (53.4% vs 37.8%, P = 0.002). CONCLUSIONS: When asked directly, almost 4 out of 10 hospitalized patients reported a breakdown in their care. Patient-perceived breakdowns in care are frequently associated with perceived harm, illustrating the importance of detecting and addressing these events. Journal of Hospital Medicine 2017;12:603-609. © 2017 Society of Hospital Medicin

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy