Closing Gaps in Care: Effects of CARE Training on Early Childhood Provider Trauma-Informed Attitudes and Collaboration

Addressing the constellation of risks associated with early childhood adversity requires a range of professionals, including from health, early intervention, and education. Yet there exist gaps in knowledge or responses to early childhood trauma among professionals. The current study examines the influence of a trauma-informed training, Child Adult Relationship Enhancement (CARE) among a diverse sample of early childhood providers. Participants (n = 106) represented early education (34%), childcare (31%), early intervention (18%), mental health (9%), medical (2%), and other roles (8%). Trauma-informed attitudes and collaboration (giving advice, receiving advice, making referrals, and getting referrals) were surveyed at baseline, post-training, and a 2-month post-training. Linear and piecewise growth curve modeling was used to estimate changes in outcomes across time. Trauma-informed attitudes increased from baseline to post-training (Coefficient = 0.25, p < 0.001) and maintained from post-training to follow-up (Coefficient = -0.02, p = 0.243). A similar pattern emerged for four out of the five trauma-informed attitude subscales. Linear growth curve models showed significant increases in Giving Advice from baseline to 2-month follow-up (Coefficient = 0.13, p = 0.001) and no increases in the other three collaboration variables. The majority of random effects were statistically significant, indicating individual differences in baseline levels and rates of change across outcomes, which were tested. A brief (half-day) training can have lasting effects on aspects of early childhood providers' trauma-informed attitudes, however shifting collaboration across early childhood providers may require more time-intensive efforts.