The COVID-19 pandemic increased the use of remote service delivery in early childhood intervention (EI), and this increased use is promising for young children with disabilities living in rural communities. However, the increase in remote service delivery requires a greater understanding of using evidence-based practices (EBP) delivered by EI providers via this mode. Remote service delivery adds a new context to EI services requiring study to identify (a) what works for whom and under what conditions, (b) how an evidence-based practice delivered remotely results in positive outcomes for young children and caregivers, and (c) the independent variables that influence those outcomes. This position paper explains the importance of remote service delivery for improving access to EBP for young children with disabilities and their families in rural communities using a conceptual framework. The conceptual framework includes three essential factors described in depth in this article. First, the conceptual framework can support researchers in designing rigorous studies to deliver evidence-based practices remotely. Second, the conceptual framework can support EI programs and providers in identifying EBP for service delivery for young children and families in rural communities.

Background: Many young children spend at least some time in early care and education programs, where they develop social-emotional skills that prepare them for future success. However, young children may exhibit behavioral challenges in these settings, negatively impacting their social-emotional development. It is critical that the early childhood workforce is prepared to support young children’s burgeoning social-emotional skills to address challenging behaviors in early care and education classrooms. Infant and early childhood mental health consultation is an evidence-informed approach for increasing teachers’ skills for managing young children’s emotions and behaviors. One mechanism to increase teachers’ access and use of the infant and early childhood mental health consultation programs is through on-demand mobile apps. Objective: This study aims to investigate 2 primary objectives: to document the development of the Jump Start on the Go (JS Go) app through community-based participatory research (CBPR) methodologies, and to evaluate and refine the app based on early childhood education (ECE) teacher feedback using a mixed methods assessment approach. Methods: This study used a community-based participatory research approach to design and evaluate the effectiveness of the JS Go app across 3 phases. In phase 1, a description of how the JS Go app was developed using CBPR principles is provided. In phase 2, teachers (n=12) were interviewed after reviewing mockups of the JS Go app to gather feedback about the interface and usefulness of the app to current and new teachers. Rapid qualitative analysis generated themes to inform phase 3 (n=31) of the study. Results: Phase 2 findings suggested that teachers viewed the app as aesthetically pleasing with concise information, but there were design and content features that needed to be refined to improve ease of use for accessing content. Teachers also described the app as beneficial and useful to both current and new ECE teachers and identified it as a tool to support sustainability for the use of JS practices. In phase 3, teachers rated the JS Go app favorably across all mHealth (mobile health) App Usability Questionnaire dimensions, including interface satisfaction (mean 6.12 on a 7-point scale), ease of use (mean 5.56), and usefulness (mean 5.37). Despite positive usability ratings, teachers expressed less certain intentions to adopt the app, scoring near the midpoint on the Technology Acceptance Model Instrument-Fast Form’s predicted future use scale (mean 1.60, –4 to +4-point scale). Implications for how the findings were used to make adaptions to the app are discussed. The next steps for testing the efficacy of the app in a randomized control trial are described. Conclusions: ECE teachers have overall positive perceptions about the value of the JS Go app. Future research will need to test the efficacy of the app for increasing and sustaining teacher’s use of JS practices.

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.

Background/Objectives: High-quality inclusive education is important for promoting the positive development of children with disabilities in early childhood care and education (ECCE) settings. However, ECCE teachers may not have the knowledge and skills to manage challenging behaviors in young children, especially those with disabilities. Infant and Early childhood mental health consultation (IECMHC) is one mechanism to support the professional development of teachers. This study explored the impact of an evidence-based IECMHC program, Jump Start Plus COVID Support (JS+CS), on outcomes for teachers in classrooms including children with disabilities. Methods: Utilizing a RE-AIM framework, we examined the extent that JS+CS impacted teacher outcomes related to classroom practice and teacher attitudes after the initial intervention period. In addition, we examined the extent that the classroom children with disability ratio moderated the impact of the intervention on teacher outcomes. Using a cluster randomized controlled trial in a sample of 138 racially and ethnically diverse teachers in 31 ECCE centers, we examined the reach, effectiveness, adoption, and implementation of JS+CS. Results: The results indicate that the JS+CS program shows promise as an intervention to support ECCE teachers working in classrooms with children with disabilities, particularly in improving teacher safety practices, behavior management skills, and resiliency coping. In addition, the program was adopted equally in classrooms that served children with and without disabilities. Conclusions: This is a unique contribution to the literature given that no previous IECMHC programs have examined adoption in classrooms serving children with disabilities. Further investigation is needed to determine the specific factors that impact program implementation considering that this study was conducted during various phases of the COVID-19 pandemic.

Background: On 18 June 2022, Moderna and Pfizer-BioNTech COVID-19 vaccines were authorized under an Emergency Use Authorization by the United States Food and Drug Administration to prevent severe coronavirus disease in children six months to four years of age. Despite approval of the COVID-19 vaccinations for young children, there remain ongoing challenges reaching widespread coverage due to parental decision-making. Parental decision-making plays a pivotal, yet understudied, role governing vaccine adoption among this priority demographic. Methods: This cross-sectional analysis examined COVID-19 vaccine intentions for 320 predominately Hispanic parents of two to five-year-olds attending Miami-Dade County childcare programs in Florida USA, several months following the June 2022 emergency authorization. Parent’s self-reported survey data encompassed vaccine choices and rationales, social determinants of health, and parent immigrant status. Data analyses illustrate the associations between parent decision-making and these variables. Regression modeling and tests of independence identified predicting factors for parental vaccine decision-making. Results: Only 25% of parents intended to vaccinate their young child, while 34% resisted and 41% felt unsure, despite 70% personal vaccination rates. Household income under $25,000, identifying as a migrant, or testing COVID-19-positive significantly predicted unsure decision-making. The majority of hesitant groups expressed concerns around side effects (20%), safety (2.9%), and sufficiency of vaccine knowledge (3.3%). Conclusions: In this sample, the predominance of parents were unsure and resistant rather than accepting of having their child vaccinated despite emergency approval of the pediatric vaccine. Associations and predictive factors are examined.

BACKGROUND Many young children spend at least some time in early care and education programs, where they develop social-emotional skills that prepare them for future success. However, young children may exhibit behavioral challenges in these settings, negatively impacting their social-emotional development. It is critical that the early childhood workforce is prepared to support young children’s burgeoning social-emotional skills to address challenging behaviors in early care and education classrooms. Infant and early childhood mental health consultation is an evidence-informed approach for increasing teachers’ skills for managing young children’s emotions and behaviors. One mechanism to increase teachers’ access and use of the infant and early childhood mental health consultation programs is through on-demand mobile apps. OBJECTIVE This study aims to investigate 2 primary objectives: to document the development of the Jump Start on the Go (JS Go) app through community-based participatory research (CBPR) methodologies, and to evaluate and refine the app based on early childhood education (ECE) teacher feedback using a mixed methods assessment approach. METHODS This study used a community-based participatory research approach to design and evaluate the effectiveness of the JS Go app across 3 phases. In phase 1, a description of how the JS Go app was developed using CBPR principles is provided. In phase 2, teachers (n=12) were interviewed after reviewing mockups of the JS Go app to gather feedback about the interface and usefulness of the app to current and new teachers. Rapid qualitative analysis generated themes to inform phase 3 (n=31) of the study. RESULTS Phase 2 findings suggested that teachers viewed the app as aesthetically pleasing with concise information, but there were design and content features that needed to be refined to improve ease of use for accessing content. Teachers also described the app as beneficial and useful to both current and new ECE teachers and identified it as a tool to support sustainability for the use of JS practices. In phase 3, teachers rated the JS Go app favorably across all mHealth (mobile health) App Usability Questionnaire dimensions, including interface satisfaction (mean 6.12 on a 7-point scale), ease of use (mean 5.56), and usefulness (mean 5.37). Despite positive usability ratings, teachers expressed less certain intentions to adopt the app, scoring near the midpoint on the Technology Acceptance Model Instrument-Fast Form’s predicted future use scale (mean 1.60, –4 to +4-point scale). Implications for how the findings were used to make adaptions to the app are discussed. The next steps for testing the efficacy of the app in a randomized control trial are described. CONCLUSIONS ECE teachers have overall positive perceptions about the value of the JS Go app. Future research will need to test the efficacy of the app for increasing and sustaining teacher’s use of JS practices. CLINICALTRIAL