Stakeholder perspectives of adaptations of a burnout intervention for special education teachers

The high attrition and turnover rates of qualified special education teachers (SETs) is a significant concern exacerbated by COVID-19. Unfortunately, there are limited studies available on research-based interventions to decrease burnout. The purpose of this study was to describe our processes and results for adaptations and modifications of BREATHE, a burnout intervention originally developed for community mental health workers, into Burnout Reduction: Enhanced Awareness, Tools, Handouts, and Education: Evidence-based Activities for Stress for Educators (BREATHE-EASE) for special educators with guidance from the Framework for Reporting Adaptation and Modifications to Evidence-Based Interventions (FRAME). We applied the FRAME within a hybrid Type 1 trial for characterizing our approach. Four focus groups (N = 30; 83% female) were conducted separately according to job title (SETs; school administrators), with semi-structured questions tailored to each group. Emergent thematic analysis was used to identify core themes related to adaptations, and results were presented to a subset of focus group members. Modifications involved content, context, and implementation changes for the adapted intervention, with most changes identified for content. FRAME was helpful for providing a systematic approach to integrate stakeholder-informed adaptations of a burnout intervention, addressing significant concerns of SET stress, burnout, and attrition.