Head Start Educators’ Well-being: Impact Results from a Cluster Randomized Controlled Trial of a Holistic Wellness Intervention

• In Event: Innovative Intervention Approaches to Promote Holistic Well-Being, Competence, and Retention of Early Childhood Educators

Abstract

Early Care and Education (ECE) teachers are widely documented to be underpaid and under-supported (Authors, 2020; Chang, 2013). This lack of support leaves the workforce vulnerable to poor well-being outcomes also associated with lower classroom quality and high turnover (Authors, 2021; Jeon et al., 2014). In addition, while much attention has been paid to teachers (Authors, 2024b), leaders face significant stress managing demands, tight budgets, and center personnel, often leaving them overextended (Authors, 2024a, 2025; Doromal & Markowitz, 2024) and without proper support (Authors, 2024a; Authors, 2025). The stakes of poor well-being are particularly high for Early Head Start (EHS) and Head Start educators (HS) working with children and families experiencing economic, health, and social challenges (Authors, 2022; Whitaker et al., 2015; Wilson et al., 2023).

Despite calls for improved support for ECE teachers and leaders (Institute of Medicine and National Research Council, 2015), no clear approach has emerged to support HS educators. Our interdisciplinary team, building on years of prior ECE educator well-being research, developed, implemented, and evaluated over the course of 2 years with multiple cohorts, a holistic, multi-tiered wellness intervention designed to help HS educators improve their P3 well-being (physical, psychological, and professional) and working conditions. Our 10-week-long tiered intervention model consisted of four key elements added by tier:

T1: Fitbit, a wearable fitness tracker
T2: T1 and adding ten weekly, self-guided online modules
T3: All of T2 and adding individualized wellness coaching
T4: All of T3 and adding center-level supports (additional staff for breaks, a wellness room, and healthy snacks)

Method

The study was a prospective, multi-center cluster RCT with a parallel group design conducted in a Southwestern state in the U.S. Implementation was conducted from the spring of 2023 to the fall of 2024 (4 semesters) with four full cohorts of HS educators. A total of 319 HS teachers and 151 leaders were recruited from 63 centers which were randomly assigned to one of the four tiers or a control condition (T0). We used a design-based approach (i.e., single-level OLS regression techniques with clustered standard errors) to estimate the treatment effects on our P3 well-being outcomes, including adjustments for module and coaching dosage and cohort membership (urban, rural, tribal nation).

Results

Participant demographics by tier for the final analytic sample are provided in Table 1. Tables 2 through 4 present the impact results across the P3 domains of physical, psychological, and professional well-being, including classroom quality while controlling for cohort (rural, tribal nation, urban [holdout/reference group]. Overall, teachers benefitted comparatively across P3 domains and tiers, but particularly Tiers 3 and 4. While leaders saw declines in hope, teachers saw improvement in hope and depressive symptoms. Leaders improved in sleep hours and exercise. Both groups improved in stress management, and overall classroom quality was positively impacted.

Implications

This study demonstrates the importance of taking a holistic approach to well-being and providing educators with a sustained opportunity to improve upon and prioritize their well-being, not only for their benefit, but the benefit of teaching and learning.

Authors

• Timothy G. Ford, University of Oklahoma

• Kyong-Ah Kwon, University of Oklahoma

• Carolyn Cheema, University of Oklahoma Health Sciences Center

• Mia Kile, University of Oklahoma

• Hongwu Wang, University of Florida