Evaluation of Thrive By Three: A Model of Intervention and Implementation of Quality-Building and Quality-Control in Childcare Centers to Strengthen Mental Health and Development in 1-3 Year-Olds.

Introduction: High quality childcare protects and promotes the underpinnings of mental health, hence it may prevent the onset of deviant developmental trajectories in toddlers and compensate for insufficient resources at home. Because 80% of Norwegian one and two year-olds attend childcare, and stay there for long hours, interventions targeting caregiver-child interactions may prove an important avenue towards universal prevention of mental health problems. Since the requirements for high quality is not sufficiently met in many Norwegian childcare centers today, and childcare teachers report lack of competence in handling children under the age of three, a cost-efficient, sustainable model of intervention is called for to enhance and track the quality of childcare for 1-3 year-olds.

Methods:

Intervention: Thrive by Three is a newly developed intervention that addresses most aspects that are vital for young children’s mental health, including emotion regulation, social skills, attachment security, language development and early learning. It is culturally sensitive, and is universally preventive in the sense that it includes all 1-3 year-olds attending childcare. Thrive by Three is modelled after the “Thrive by Five”, “Seeds to Success”, and “Early Achievers” quality-building and quality control, broadly implemented in childcare centers in Washington state, USA. Moreover, the Thrive by Three includes an innovative system of peer-driven monitoring of quality among childcare staff in which they mutually collaborate within clusters of childcare centers in their municipality.

Sample and design: In a sample of 69 childcare centers and 1100 children, we will evaluate the effectiveness of Thrive by Three by comparing centers who are randomly allocated to the intervention with ‘wait-list’ control centers who will receive the intervention 12 months later. Because the effectiveness of any intervention rests on how well it is implemented and its sustainability, we will monitor and evaluate the implementation process in close collaboration with parents and caregivers.

Results: There are no results yet. Our primary aims are to investigate to what extent the Thrive by Three 1) improves the quality of caregiver child interactions and 2) strengthens children’s mental health, social- and cognitive development, after the intervention and at 12 months follow-up. Our secondary aims are to investigate whether the intervention effect is moderated by implementation outcomes (i.e. fidelity and acceptability) as well as child-, and family characteristics (i.e. temperament, ethnicity, SES). We will also, in a subsample, qualitatively investigate parents’ and caregivers’ experience with the intervention.