Laurie Miller Brotman

Background: Children in low-and-middle-income countries (LMICs) are facing tremendous mental health challenges. Numerous evidence-based interventions (EBIs) have been adapted to LMICs and shown effectiveness in addressing the needs, but most EBIs have not been adopted widely using scalable and sustainable implementation models that leverage and strengthen existing structures. There is a need to apply implementation science methodology to study strategies to effectively scale-up EBIs and sustain the practices in LMICs. Through a cross-sector collaboration, we are carrying out a second-generation investigation of implementation and effectiveness of a school-based mental health EBI,ParentCorps Professional Development (PD),to scale-up and sustain the EBI in Uganda to promote early childhood students’ mental health. Our previous studies in Uganda supported that culturally adaptedPDresulted in short-term benefits for classrooms, children, and families. However, our previous implementation ofPDwas relied on mental health professionals (MHPs) to providePDto teachers. Because of the shortage of MHPs in Uganda, a new scalable implementation model is needed to providePDat scale.Objectives: This study tests a new scalable and sustainablePDimplementation model and simultaneously studies the effectiveness. This paper describes use of collaboration, task-shifting, and Train-the-Trainer strategies for scaling-upPD,and protocol for studying the effectiveness-implementation ofParentCorps-PDfor teachers in urban and rural Ugandan schools. We will examine whether the new scale-up implementation approach will yield anticipated impacts and investigate the underlying effectiveness-implementation mechanisms that contribute to success. In addition, considering the effects ofPDon teachers and students will influence by teacher wellness. This study also examines the added value (i.e. impact and costs) of a brief wellness intervention for teachers and students.Methods: Using a hybrid-type II effectiveness-implementation cluster randomized controlled trial (cRCT), we will randomize 36 schools (18 urban and 18 rural) with 540 teachers and nearly 2000 families to one of three conditions:PD + Teacher-Wellness (PDT), PDalone (PD), and Control. Primary effectiveness outcomes are teachers’ use of mental health promoting strategies, teacher stress management, and child mental health. The implementation fidelity/quality for the scale-up model will be monitored. Mixed methods will be employed to examine underlying mechanisms of implementation and impact as well as cost-effectiveness.Discussion: This research will generate important knowledge regarding the value of an EBI in urban and rural communities in a LMIC, and efforts toward supporting teachers to prevent and manage early signs of children’s mental health issues as a potentially cost-effective strategy to promote child population mental health in low resource settings.Trial Registration: This trial was registered with ClinicalTrials.gov (registration number: NCT04383327;https://clinicaltrials.gov/ct2/show/NCT04383327) on May13, 2020.

Emotion knowledge (EK) is a malleable set of skills that is central to social interactions and school success during early childhood. The current study describes an anti-racist approach to adapting an EK measure that assesses knowledge of facial expressions to be ecologically valid for young children of color attending pre-Kindergarten (pre-K) programs in a large urban school district. This approach involved (1) attending to race/ethnicity in selection of visual stimuli, (2) ensuring appropriate translation and language for administration, and (3) exploring the functioning of the measure within a racially, ethnically, and linguistically diverse group of children. A total of 235 children (67.4% Latinx, 14.1% non-Latinx Black, 7.1% non-Latinx White, 7.8% Asian, 3.6% another racial/ethnicity) were assessed in English (74%) or Spanish (26%) during the fall of pre-K (mean age = 4.4). Both English and Spanish versions appear to have similar reliability, although accuracy levels were lower when administered in Spanish. No differences in mean accuracy scores were found across racial/ethnic groups or for boys versus girls. This study contributes to the growing literature necessary to advance anti-racist research in affective science.

This study examined longitudinal relations between emotion knowledge (EK) in pre‐kindergarten (pre‐K; M_age = 4.8 years) and math and reading achievement 1 and 3 years later in a sample of 1,050 primarily Black children (over half from immigrant families) living in historically disinvested neighborhoods. Participants were part of a follow‐up study of a cluster randomized controlled trial. Controlling for pre‐academic skills, other social–emotional skills, sociodemographic characteristics, and school intervention status, higher EK at the end of pre‐K predicted higher math and reading achievement test scores in kindergarten and second grade. Moderation analyses suggest that relations were attenuated among children from immigrant families. Findings suggest the importance of enriching pre‐K programs for children of color with EK‐promotive interventions and strategies.

Developing students’ social and emotional skills positively affects their academic success. The Prosocial Classroom model (PCM) highlights the importance of teacher’s social-emotional competency (S...

Introduction Adequate sleep is essential for a child’s growth and development. However, a growing number of children are experiencing trouble falling asleep. Smartphone audio-based mobile applications with soothing melodies and calming nighttime stories may improve sleep onset. Our study examined the efficacy of Moshi Twilight, an app designed to improve sleep onset, among children ages 3-8 years old using a parent-child dyadic approach. Methods Our within-subjects pre-post study design focused on healthy children studied over 10 days, spanning 3 weeknights and 2 weekend nights. During the baseline (Days 1-5) and exposure (Days 6-10) conditions the Child Sleep Health Questionnaire was used to measure children’s sleep behavior. The PROMIS and Pittsburgh Sleep Quality Index were used to assess parents’ sleep quality. Parents exposed their child to 1 story per night (15-20 minutes) during the exposured condition. Statistical analysis was based on paired t-tests, independent t-tests, and correlations. Results On average, participating parents were 37 (SD +9.6) year-old mothers. The sample was: 60% Black; 20% White, 20% other race/ethnicity. On average, children were 4 (SD + 0.78) years old and 50% male. Paired t-tests showed significant differences in children’s sleep onset within 20 minutes (t=2.582, 95% CI 0.116, 2.634, p= 0.036). Significant correlations were noted for children’s bedtime consistency (r = -0.755, p = 0.030), falling asleep in own bed (r = 0.735, p=0.015) and sleep duration (r = -0.715, p=0.046,) Significant correlations and paired t-test in parents’ sleep onset were also found (r = 0.744, p = 0.014); (mean= -1.2, t= -3.674, 95% CI -1.939, -0.461, p=0.005) Conclusion Our results showed that the audio-based sleep app, Moshi Twilight, might be useful in improving sleep health among both children and parents. This could be included in enhance bedtime routine among preschool-aged children. Support Bezos Grant and Community Service Plan grant.

Introduction Insufficient sleep has been identified as an obesity risk factor due to mechanistic pathways contributing to higher carbohydrate intake, including in children. Dietary intake of macronutrients, such as fats and protein found in milk, may serve as a modifiable risk factor for adequate sleep. We hypothesize that milk intake among a sample of urban first-graders may be associated with sleep duration. Methods Cross-sectional analysis of parent reports of an adapted version of the Child Sleep Health Questionnaire (CSHQ) and Block Dietary Data Systems Food Frequency Questionnaire (FFQ) were analyzed among a sample of 837 Black children in Brooklyn, New York. Summary scores were created for milk type. Milk intake was classified by fat content: whole milk and 2% categorized as high-fat, and 1% and skim as low-fat. Independent t-test, correlations and regression analysis to identify associations between parent reports of child’s sleep duration and milk intake were conducted. Results On average, children were 7.3 + 0.6 years old and 52% female. Nearly 57% of parents were immigrants. Children’s mean BMI was 17.27, approximately at the 85th BMI percentile according to CDC index-for-age percentiles. On average, FFQ data reported children consumed high-fat milk 6 days a week. Linear variable regression analysis between high-fat milk intake and sufficient sleep were significant (β =, 0.090, p < 0.05). BMI was significantly associated with high-fat milk intake (β= 0.17, p<0.05). However, high-fat milk intake was not significantly associated with (in)sufficient sleep, after controlling for BMI, sex and age. No difference was reported between immigrant parents and U.S. born parents. Conclusion Plausibly, high-fat milk is contributing to satiety and longer sleep duration. Future studies should include more comprehensive measurement of milk consumption (i.e. time of day and volume) to consider possible effects on children’s sleep. Actigraphy measures and sleep diaries should also be considered. Support Bezos Grant and Community Service Plan grant.

Emotion knowledge, the ability to accurately perceive and label emotions, predicts higher quality peer relations, higher social competence, higher academic achievement, and fewer behaviour problems. Less is known, however, about predictors of early development of emotion knowledge. This study examines emotion knowledge development among children attending pre-Kindergarten and Kindergarten programmes in high-poverty urban schools. The study considers child pre-academic abilities, self-regulation, peer relations and parental education as predictors of emotion knowledge development over two years. The sample (n = 1034) of children living in historically disinvested neighbourhoods was primarily Black (85%) and low-income (∼61%). The sample was part of a longitudinal follow-up study of a cluster (school) randomised controlled trial in ten public elementary schools. Children’s emotion knowledge was assessed with a series of tasks three times over a two-year period. At baseline, parents and teachers reported on peer relations, children completed a test of pre-academic abilities, independent observers rated child self-regulation, and parents reported on their educational attainment. Results demonstrate that emotion knowledge increases over time, and pre-academic abilities, self-regulation, peer relations, and parent education independently predict children’s emotion knowledge. This study highlights multiple factors that predict emotion knowledge among primarily Black children living in historically disinvested neighbourhoods.