Methods: Staff (N = 1,469) from two cohorts of sites implementing HSTS were included in this study. HSTS training was delivered in two-hour segments once a month for ten months. The remaining intervention components were provided continuously across the school year. Pre-to-post changes in attitudes related to trauma-informed care were collected prior to and immediately following participation in a 10-module training sequence. Staff also completed learning checks after each module, which consisted of staff answering three multiple-choice questions. Lastly, staff self-reported overall satisfaction of HSTS on a five-point likert scale at the conclusion of each module.
Results: The percentage of participants who reported positive satisfaction with the overall training program was 96%. Staff tended to answer most learning checks correctly with percent correct for each module ranging from 73% to 94%. The average across all modules was 84%. Finally, staff reported significant attitude changes from pretest to posttest on the ARTIC scale following completion of the HSTS training program. Paired-samples t-tests showed a significant increase in positive attitudes related to trauma-informed care for the overall ARTIC scale and for all subscales. Effect sizes ranged from .20 to .43. Small to small-medium effects were found for all subscales, with a small effect for the overall ARTIC scale. (d = .30).
Conclusions: Findings suggest HSTS is an effective program for shifting staff attitudes related to trauma-informed care in Head Start preschool classrooms. HSTS also shows promise in training preschool staff to implement best practices in creating a trauma-informed culture, as well as to promote positive social-emotional development for preschool children with histories of trauma exposure.