Promoting interactive skills and mind-mindedness among early childcare professionals: study protocol for a randomized wait-list controlled trial comparing the Circle of Security approach with care as usual in center-based childcare (the SECURE project)

Johanne Smith-Nielsen, Katrine Isabella Wendelboe, Julie Elisabeth Warberg Mohr, Mette Skovgaard Væver, Maiken Pontoppidan, Katrien Helmerhorst, Ida Egmose, Johanne Smith-Nielsen, Katrine Isabella Wendelboe, Julie Elisabeth Warberg Mohr, Mette Skovgaard Væver, Maiken Pontoppidan, Katrien Helmerhorst, Ida Egmose

Abstract

Background: In countries where the majority of young children are enrolled in professional childcare, the childcare setting constitutes an important part of children's caregiving environment. Research consistently shows that particularly the quality of the daily interactions and relationship between young children and their professional caregivers have long-term effects on a range of developmental child outcomes. Therefore, professional caregivers' capacity for establishing high quality interactions with the children in their care is an important target of intervention.

Methods: A prospective, parallel, cluster-randomized wait-list controlled trial is used to test the efficacy of the attachment- and mentalization theory informed Circle of Security (COS) approach adapted to the childcare setting (COS-Classroom) on caregiver interactive skills and mind-mindedness. Participants are professional caregivers of children aged 0-2.9 years working in center-based childcare in Denmark. Approximately 31 childcare centers, corresponding to an estimated 113 caregivers, are expected to participate. The primary outcome is caregiver Sensitive responsiveness measured with the Caregiver Interactive Profile Scales (CIP-scales). Secondary outcomes include caregiver Mind-mindedness, the five remaining CIP-scales (Respect for autonomy, Structure and limit setting, Verbal communication, Developmental stimulation, and Fostering positive peer interactions), and caregivers' resources to cope with work-related stress. Data on structural factors (e.g., staff stability, caregiver-child ratio, and level of pre-service education), caregiver attachment style, acceptability and feasibility of the COS-C together with qualitative data on how the participants experience the COS-C is additionally collected to investigate moderating and confounding effects.

Discussion: Examining the effectiveness of the COS-C in center-based childcare contributes to the knowledge of evidence-based intervention programs and can potentially improve the caregiver quality early childcare.

Trial registration: ClinicalTrials.gov: NCT04654533. Prospectively registered December 4, 2020, https://ichgcp.net/clinical-trials-registry/NCT04654533 .

Keywords: Attachment-based intervention; COSP-Classroom; Caregiver–child interaction quality; Center-based childcare; Circle of Security; Early childhood education; Interactive skills; Mentalization; Mind-mindedness; Process quality.

Conflict of interest statement

Dr. Smith-Nielsen at the University of Copenhagen, Center for early intervention and family studies (CIF), is Danish COSP-trainer and certified COSP fidelity coach. She provides COSP trainings for professionals in Denmark with fees paid by Circle of Security International. Since 2019, she has provided COSP fidelity coaching for COSP facilitators working at CIF on research projects and for clinicians outside the University of Copenhagen. Fees for fidelity coaching have been directed to the University of Copenhagen to provide salary support for the research team at CIF.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
The Circle of Security (from Circle of Security International™)
Fig. 2
Fig. 2
Circle of Security in group-based childcare (from Circle of Security International™)
Fig. 3
Fig. 3
Ilustration of the development of an avoidant strategy in the child (from Circle of Security International™)
Fig. 4
Fig. 4
Flow of participants

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