BACKGROUND/OBJECTIVES:National data show that about 250 preschoolers are suspended or expelled daily in the United States. Jump Start is a multi-tiered infant and early childhood mental health consultation program that strengthens early care and education centers' capacity to support children's social-emotional development and prevent school suspension and expulsion. This retrospective study examined center-level exclusionary discipline practices, Jump Start participation, and related changes in discipline and expulsion policies. METHODS:Data from 270 early care and education centers across Miami-Dade County that received Jump Start services during one of three academic years (2022-2023, 2023-2024, or 2024-2025) were included. Analyses examined associations between baseline exclusionary discipline practices, program duration, discipline and expulsion policy changes, and post-Jump Start exclusionary discipline practices. RESULTS:Statistically significant reductions were observed in the frequency of traditional suspensions/expulsions and soft expulsions following Jump Start participation. The association between the Jump Start duration and post-Jump Start soft expulsions was significantly moderated by changes in center discipline policies, such that Jump Start was effective at reducing soft expulsions only when discipline policies showed meaningful improvement. CONCLUSIONS:Infant and early childhood consultation models, such as Jump Start, show promise in reducing exclusionary discipline practices, especially when implementation improves discipline policies.

Background/Objectives: Early intervention is associated with improved outcomes for young children with developmental delays, yet many with mild delays are ineligible for services under the Individuals with Disabilities Education Act (IDEA). The Early Discovery (ED) Program addressed this gap by providing short-term, targeted intervention for children ages 0-5 who did not qualify for publicly funded services. This study evaluated program outcomes across intervention types. Methods: During 2024-2025, 342 families completed the ED Program, receiving one of the following: speech-language (68%), general developmental (12%), occupational (14%), or behavioral (6%) intervention across 8-20 sessions. Eligibility required Miami-Dade residency and ineligibility for IDEA-funded services. Standardized pre- and post-intervention assessments were analyzed using descriptive statistics, correlations, and group comparisons. Results: Most households reported incomes <$70,000 (71%), with many experiencing additional risk factors including prematurity (15%), public or no insurance (47%), limited English proficiency (21%), and single-caregiver households (30%). Overall, 85% of children met criteria for improvement. Improvement rates varied by child ethnicity. No statistically significant differences were observed by child age, race, gender, prematurity, insurance status, caregiver demographics, household characteristics, or intervention type. Sensitivity analyses largely confirmed the primary findings, with ethnicity no longer significant and younger age emerging as a significant predictor of improvement. Conclusions: Findings suggest short-term, targeted intervention may support developmental progress among young children with mild delays who would otherwise remain unserved. Community-based programs such as ED may play a critical role in advancing developmental equity by reaching children with developmental and socioeconomic risk factors prior to school entry.

High-quality early care and education (ECE) programs, characterized by safe environments, emotionally supportive communication, proactive behavior supports, and teacher self-care practices, play a pivotal role in healthy child development. Early Childhood Mental Health Consultation (ECMHC) is an evidence-based approach designed to strengthen these environments and support young children’s social–emotional outcomes. However, the long-term impacts of ECMHC models remain understudied. Grounded in ECMHC, the purpose of this study is to evaluate the effectiveness of Jump Start Plus COVID Support (JS+CS) in supporting child psychosocial outcomes (prosocial behaviors and reduced externalizing/internalizing behaviors) over two school years. In a cluster-randomized trial, 12 ECE centers received the 14-week JS+CS intervention, and 12 attention control centers received a 14-week obesity prevention program. Children were followed over two school years to determine long-term impacts on behavior, measured by the Devereux Early Childhood Assessment (DECA) and the Strengths and Difficulties Questionnaire (SDQ). Over two school years, significant time-by-group interactions emerged for primary child outcomes. The JS+CS group showed greater improvements in DECA Initiative and Self-Regulation (p = 0.01 and p = 0.02, respectively) compared to controls. JS+CS significantly enhanced child psychosocial functioning, supporting its potential as an effective model for a scalable mental health consultation in ECE settings.

This study examined teachers’ ( n = 19), and peer coaches’ ( n = 10) perceptions of a job-embedded peer coaching professional development intervention designed to support teachers’ assistive technology (AT) use in inclusive preschool classrooms. Under this professional development model, school-based personnel, trained as coaches, supported teachers' AT use. The six-month professional development intervention combined online learning modules, access to AT tools, and structured peer coaching cycles. Data from participant focus groups and teachers’ written reflections were analyzed using thematic analysis. Findings revealed teachers’ and coaches’ agreement that the job-embedded coaching intervention expanded teachers' understanding and use of a range of AT and enhanced student engagement, communication, and participation. At the same time, participants noted multiple barriers to optimal implementation of the model, including time constraints, classroom management challenges, and staffing shortages. Study findings support the promise of job-embedded peer coaching for AT implementation while underscoring the critical need for structural reforms that are essential for peer coaching to reach its full potential.

ObjectiveThe purpose of this study was to examine the longitudinal psychological impact of the COVID-19 pandemic on caregivers of young children in communities of color.BackgroundCOVID-19 has disproportionately affected people of color, with adverse impacts on family functioning and well-being. However, few studies have examined the longer-term psychological impacts of the COVID-19 pandemic on the mental health of caregivers of young children. As of the 2020 Census, Miami-Dade County was home to almost 130,000 young children ages 0-5, has a minority-majority population, and was an epicenter of the COVID-19 pandemic.MethodData from the COVID Risk and Resilience Survey collected over a 2-year period were used to conduct a path analysis predicting caregiver depression and anxiety in 2022 from caregiver stress and child behavioral problems in March 2020 and caregiver self-efficacy and use of coping skills in June 2020. The final model included 325 participants.ResultsThe results suggest that caregiver experiences of stress and behavioral concerns for their children in the early COVID-19 pandemic affected their mental health after 2 years, but caregiver use of effective coping strategies helped reduce their later anxiety and depression symptoms.ConclusionCOVID-19 had significant psychological impacts on caregivers of young children.ImplicationsUnderstanding the impact of the pandemic on families can help community organizations and schools develop policies to better meet the longer-term needs of families with young children during pandemics and other widespread stressful events.

BackgroundMany young children spend at least some time in early care and education programs, where they develop social-emotional skills that prepare them for future success. However, young children may exhibit behavioral challenges in these settings, negatively impacting their social-emotional development. It is critical that the early childhood workforce is prepared to support young children’s burgeoning social-emotional skills to address challenging behaviors in early care and education classrooms. Infant and early childhood mental health consultation is an evidence-informed approach for increasing teachers’ skills for managing young children’s emotions and behaviors. One mechanism to increase teachers’ access and use of the infant and early childhood mental health consultation programs is through on-demand mobile apps. ObjectiveThis study aims to investigate 2 primary objectives: to document the development of the Jump Start on the Go (JS Go) app through community-based participatory research (CBPR) methodologies, and to evaluate and refine the app based on early childhood education (ECE) teacher feedback using a mixed methods assessment approach. MethodsThis study used a community-based participatory research approach to design and evaluate the effectiveness of the JS Go app across 3 phases. In phase 1, a description of how the JS Go app was developed using CBPR principles is provided. In phase 2, teachers (n=12) were interviewed after reviewing mockups of the JS Go app to gather feedback about the interface and usefulness of the app to current and new teachers. Rapid qualitative analysis generated themes to inform phase 3 (n=31) of the study. ResultsPhase 2 findings suggested that teachers viewed the app as aesthetically pleasing with concise information, but there were design and content features that needed to be refined to improve ease of use for accessing content. Teachers also described the app as beneficial and useful to both current and new ECE teachers and identified it as a tool to support sustainability for the use of JS practices. In phase 3, teachers rated the JS Go app favorably across all mHealth (mobile health) App Usability Questionnaire dimensions, including interface satisfaction (mean 6.12 on a 7-point scale), ease of use (mean 5.56), and usefulness (mean 5.37). Despite positive usability ratings, teachers expressed less certain intentions to adopt the app, scoring near the midpoint on the Technology Acceptance Model Instrument-Fast Form’s predicted future use scale (mean 1.60, –4 to +4-point scale). Implications for how the findings were used to make adaptions to the app are discussed. The next steps for testing the efficacy of the app in a randomized control trial are described. ConclusionsECE teachers have overall positive perceptions about the value of the JS Go app. Future research will need to test the efficacy of the app for increasing and sustaining teacher’s use of JS practices.

Geographic disparities threaten equitable access for children to health-promoting safe green spaces, and quality early education in the communities in which they live and grow. To address gaps in the field, we integrated the fields of developmental psychology, public health, and environmental science to examine, at the population level, associations between the environmental burden, socioeconomic vulnerability, and kindergarten readiness in a diverse urban county. Three administrative datasets were integrated through an early childhood data sharing research partnership in Miami-Dade County. The Bruner Child Raising Vulnerability Index, the five domains of the Environmental Burden module from the Environmental Justice Index, and public school kindergarten readiness scores were aggregated at the census tract level. Analysis of variance and multiple regression analyses found associations between socioeconomic vulnerability and race/ethnicity. The socioeconomic vulnerability levels were highest in census tracts with a higher percentage of Black residents, compared to all other races/ethnicities. Areas of greater social vulnerability had lower kindergarten readiness and a higher environmental burden. A higher environmental burden predicted lower kindergarten readiness scores above and beyond race/ethnicity and socioeconomic vulnerability. The findings advance our understanding of global challenges to sustainable healthy child development, such as the persistence of a disproportionate environmental burden and inequitable access to resources such as green spaces and early education programs. The present study results can inform community health improvement plans to reduce risk exposures and promote greater access to positive environmental and educational resources for all children.

This study explored the experiences of Hispanic families accessing subsidized early care and education programs, and their access to other federal financial assistance programs, designed to increase family self-sufficiency and well-being. Federal programs include subsidized early care and education, Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), and Housing and Urban Development assistance programs. Understanding Hispanic families' perspective of barriers faced when accessing federal financial assistance programs is vital for policy changes to improve accessibility for these underserved families. The purpose of this study was to explore the voices of Hispanic mothers about their experiences accessing cross-sector federal financial assistance programs to gain an understanding about how these programs improve their self-sufficiency and family well-being. Qualitative methods were used by conducting 10 interviews with Hispanic mothers of young children under 5. Interviews were conducted in the preferred language of the mothers (English or Spanish) by trained staff. Interviews were transcribed and coded by four trained coders to achieve reliability. Data from the interviews were analyzed using grounded theory to code responses and develop meaning about mothers' experiences. The findings illustrate the interplay between different types of cross-sector federal financial assistance programs that support families and how they promote the education and health of young Hispanic children and their families. The findings can be used to guide policy decision-making and future research.

Prevention of behavioral and emotional problems in early childhood is essential to promote healthy development and reduce risky behaviors, academic failure, delinquency, and social difficulties. Evidence-based parenting interventions, such as the Incredible Years Toddler Basic program, are known to effectively address these challenges. However, access to such programs remains limited for many caregivers, especially those in ethnically diverse and at-risk families, due to structural, attitudinal, and interpersonal barriers. This study describes the implementation of the Incredible Years Toddler Basic parenting intervention, highlighting strategies to recruit, retain, and engage a predominantly Hispanic (68.3%), at-risk population while addressing participation barriers. Data from 301 families were collected using validated measures, including the Parental Stress Scale and the Adult and Adolescent Parenting Inventory, second edition. Of the participants, 262 (87%) met attendance requirements, significantly exceeding retention rates for comparable programs. Caregivers reported significant reductions in parental stress and improvements in parenting attitudes. Findings highlight the success of addressing structural, attitudinal, and interpersonal barriers to improve participation and outcomes in community-based parenting programs. This study serves as a model for leveraging community partnerships and tailoring programming to advance public health and support in ethnically diverse and at-risk families. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: Young children have experienced increased emotional difficulties, including anxiety, emotion dysregulation, and tantrums. Limited access to mental health services has created an urgent need for accessible interventions to equip professionals with effective strategies for managing children’s strong emotions. This study piloted an innovative virtual reality (VR) simulation designed to teach professionals emotion management techniques. Methods: Participants included 107 early childhood professionals (e.g., educational, healthcare, and allied health) working with children aged 3–6 years from the southeastern United States. The multilingual VR simulation taught professionals emotion management strategies. Participants self-selected whether to complete a temper tantrum management simulation (n = 71) or a separation anxiety simulation (n = 36). Participants’ responses to children’s strong emotions were assessed at baseline, post-intervention, and at one-month follow-up, along with a satisfaction survey. Results: Participants reported a significant increase in intent to use effective emotion regulation strategies immediately following VR completion. However, actual use of effective strategies showed no significant change at one-month follow-up. Being a Spanish-speaking professional was associated with significantly greater improvements in both intent and actual use of effective strategies at follow-up. Participants reported high satisfaction ratings with the VR simulations. Conclusions: VR simulations show promise as an innovative tool for teaching emotion management strategies, particularly benefiting Spanish-speaking early childhood professionals. While effective for immediate motivation, additional support mechanisms (e.g., repeated practice, workplace supports) may be needed to sustain long-term behavior change in professional practice.

Background/Objectives: Preschool children from low-income, ethnically diverse communities face disproportionate rates of behavioral challenges and early expulsion from early care and education (ECE) programs. This study evaluated the efficacy, feasibility, and utility of Jump Start on the Go (JS Go), a bilingual, AI-enabled mobile application. JS Go is designed to deliver a 14-week early childhood mental health consultation model in under-resourced ECE settings. Methods: This mixed-methods study compared JS Go to the standard in-person Jump Start (JS) program. Participants included 28 teachers and 114 children from six centers (three JS Go, three JS). Quantitative measures assessed teacher classroom practices and child psychosocial outcomes at baseline and post-intervention. App usability and acceptability were only evaluated post-intervention. Seven semi-structured interviews were conducted post-intervention with JS Go directors/teachers to assess the app’s feasibility for implementing the four program pillars: safety, behavior support, self-care, and communication. Results: JS Go was more effective than JS in promoting teacher classroom practices related to behavior support and resiliency. Both programs were similar in improving children’s protective factors and reducing internalizing behaviors, with consistent effects across English and Spanish-speaking children. Teachers rated the JS Go app with high acceptability, though predicted future usage showed greater variability. Rapid qualitative analysis showed that participants found the app easy to use, frequently accessed its resources, and considered it helpful for reinforcing key strategies across the four program pillars. Conclusions: JS Go is a novel approach to providing mental health consultation. It represents a promising mobile adaptation of the established JS consultation model, with important implications for future practice and research.

Background/Objectives: Early care and education programs promote children’s social–emotional development, predicting later school success. The COVID-19 pandemic worsened an existing youth mental health crisis and increased teacher stress. Therefore, we applied an infant and early childhood mental health consultation model, Jump Start Plus COVID Support (JS+CS), aiming to decrease behavioral problems in children post-pandemic. Methods: A cluster randomized controlled trial compared JS+CS to an active control, Healthy Caregivers–Healthy Children (HC2), at 30 ECE centers in low-income areas in South Florida. Participants were not blinded to group assignment. Teachers reported on children’s social–emotional development at baseline and post-intervention using the Devereux Early Childhood Assessment and Strengths and Difficulties Questionnaire. We assessed whether teacher stress, classroom practices, and self-efficacy mediated the relationship between JS+CS and child outcomes. We also explored whether baseline behavior problems moderated JS+CS effects on child protective factors, relative to HC2. Results: Direct group-by-time differences between JS+CS and HC2 were limited. However, JS+CS demonstrated significant within-group improvements in teacher-reported child protective factors, behavior support practices, and classroom safety practices. Classroom safety practices consistently mediated positive changes in child behaviors, including the DECA total protective factor score and subdomains of initiative and self-regulation. Additionally, teacher perceptions of behavior support mediated gains in child attachment. Conclusions: JS+CS shows promise in building protective systems around children through intentional support for teachers, underscoring the value of whole-child, whole-environment approaches in early intervention.

Background/Objectives: Excessive screen time and inadequate sleep are well-established developmental risk factors, yet limited research has examined the relationship between adherence to national sleep and screen time guidelines and language outcomes in children with mild language delays. This study examined sleep, screen time, and language outcomes in 765 children aged 1–5 with mild language delays enrolled in the Early Discovery Program. Methods: Sleep and screen time were categorized according to American Academy of Pediatrics and Caring for Our Children guidelines. Language outcomes were measured using standardized scores from the Preschool Language Scales–Fifth Edition. Results: Sociodemographic factors, including race, insurance status, and caregiver education, were significantly associated with sleep and screen behaviors. Excessive screen time was negatively associated with expressive language scores, while sleep duration showed no significant relationship. Conclusions: Findings highlight the need for early interventions that promote adherence to national health guidelines and address sociodemographic factors influencing language development in young children.

Early Childhood Mental Health Consultation (ECMHC) promotes children’s social–emotional development and reduces challenging behaviors in early care and education (ECE) centers, yet implementation barriers increase teacher stress and reduce confidence. Scalable, efficient, and accessible approaches are needed to meet ECE center demands. This quasi-experimental match-controlled study evaluated two ECMHC programs in promoting children’s social–emotional development and improving teachers’ skills/attitudes compared to an attention control condition in 22 ECE centers in lower-resourced areas of BLINDED. We compared Jump Start (JS; traditional human consultation model), Jump Start Go (JS Go; AI-enhanced consultation model), and Healthy Caregivers–Healthy Children (HC2; obesity-prevention consultation model). Child social–emotional development, teacher workplace stress/confidence, and classroom practices were assessed at pre-and post-intervention. Children in JS and JS Go interventions demonstrated significant social–emotional gains (F = 13.55, p < 0.001), with the largest reductions in internalizing problems observed in children who received JS Go (−2.91 points; F = 9.65, p < 0.001). JS Go classrooms also showed greater improvements in prosocial behavior (F = 5.05, p = 0.012) and resiliency (F = 8.95, p < 0.001) than HC2 classrooms. Findings suggest that both traditional and AI-enhanced ECMHC approaches can promote teachers’ capacity to support children’s social–emotional development.

IntroductionChildcare center closures during COVID-19 impacted education for approximately 40 million children nationwide. Unfortunately, COVID-19 restrictions significantly limited the extent that outside personnel could provide in-person support to educators, resulting in the need for innovative approaches to meet childcare centers’ needs. A virtual robotic telepresence approach was applied to early childhood consultation models to promote child resilience while mitigating COVID-19 risks. The goal of this study was to examine how training influenced consultants’ and childcare staff uptake of the virtual robotic telepresence consultation approach and their acceptance of this technology.MethodsTen early childhood consultants received multimedia/simulation training and weekly communities of practice related to virtual telepresence robotic consultation. Telepresence robotic consultation equipment was deployed to 16 childcare centers in a diverse multilingual metropolitan area as a part of a larger randomized controlled trial. Consultants trained childcare staff (14 center directors and 58 teachers) on how to receive virtual telepresence robotic consultation. Demographic information and measures of technology acceptability and uptake were collected from childcare staff and consultants. A mixed methods approach was used including multilevel modeling and focus groups to examine consultation uptake, acceptability, barriers, and facilitators of virtual telepresence robotic consultation implementation.ResultsConsultants and childcare staff generally perceived the virtual telepresence consultation approach to be useful and easy to use. Consultant perceptions of the acceptability of technology did not change over time. Childcare staff, center, and consultant factors impacted the uptake of the virtual robotic telepresence consultation approach and childcare staff acceptance of the technology. Focus groups revealed that consultants believed that additional hands-on training with childcare staff would have benefited implementation and expressed a desire for a hybrid approach for consultation.DiscussionPerceptions of telepresence robotic consultation acceptability are discussed, including future recommendations for training.

Children with disabilities have higher prevalence estimates of obesity than typically developing children. The Healthy Caregivers–Healthy Children Phase 3 (HC3) project implemented an obesity prevention program adapted for children with special health care needs (CSHCN) that includes dietary intake and physical activity (PA) components. The primary outcome was a change in dietary intake, PA, and the body mass index (BMI) percentile. Ten childcare centers (CCCs) serving low-resource families with ≥30 2- to 5-year-olds attending were randomized to either the intervention (n = 5) or control (n = 5). The HC3 CCCs received (1) snack, beverage, PA, and screen time policies via weekly technical assistance; (2) adapted lesson plans for CSHCN; and (3) parent curricula. The control CCCs received a behavioral health attention curriculum. HC3 was delivered over three school years, with data collected at five different timepoints. It was delivered weekly for six months in year one. To ensure capacity building, the HC3 tasks were scaled back, with quarterly intervention delivery in year 2 and annually in year 3. Adaptations were made to the curriculum to ensure appropriate access for CSHCN. Given that the program was being delivered during the COVID-19 pandemic, special modifications were made to follow CDC safety standards. The primary outcome measures included the Environment and Policy Assessment and Observation (EPAO) tool, standardized dietary intake and PA assessments, and the child BMI percentile. CCCs are an ideal setting for targeting CSHCN for obesity prevention efforts as they provide an opportunity to address modifiable risk factors.

Background: On 18 June 2022, Moderna and Pfizer-BioNTech COVID-19 vaccines were authorized under an Emergency Use Authorization by the United States Food and Drug Administration to prevent severe coronavirus disease in children six months to four years of age. Despite approval of the COVID-19 vaccinations for young children, there remain ongoing challenges reaching widespread coverage due to parental decision-making. Parental decision-making plays a pivotal, yet understudied, role governing vaccine adoption among this priority demographic. Methods: This cross-sectional analysis examined COVID-19 vaccine intentions for 320 predominately Hispanic parents of two to five-year-olds attending Miami-Dade County childcare programs in Florida USA, several months following the June 2022 emergency authorization. Parent’s self-reported survey data encompassed vaccine choices and rationales, social determinants of health, and parent immigrant status. Data analyses illustrate the associations between parent decision-making and these variables. Regression modeling and tests of independence identified predicting factors for parental vaccine decision-making. Results: Only 25% of parents intended to vaccinate their young child, while 34% resisted and 41% felt unsure, despite 70% personal vaccination rates. Household income under $25,000, identifying as a migrant, or testing COVID-19-positive significantly predicted unsure decision-making. The majority of hesitant groups expressed concerns around side effects (20%), safety (2.9%), and sufficiency of vaccine knowledge (3.3%). Conclusions: In this sample, the predominance of parents were unsure and resistant rather than accepting of having their child vaccinated despite emergency approval of the pediatric vaccine. Associations and predictive factors are examined.

Context: The childcare center (CCC) setting has the potential to be a strong foundation that supports the introduction of sustainable healthy lifestyle behaviors to prevent childhood obesity. It is important to assess barriers and facilitators to healthy weight development initiatives via program evaluation, including measuring CCC staff readiness to change. Objective: The overall goal of this study was to assess the readiness level over 1 school year among CCC staff who participated in “Healthy Caregivers-Healthy Children” (HC2), a cluster randomized controlled trial that evaluated the effectiveness of a childhood obesity prevention program from 2015 to 2018 in 24 low-income, racially/ethnically diverse centers. A secondary outcome was to assess how a CCC's stage of readiness to change was associated with CCC nutrition and physical activity environment, measured via the Environment and Policy Assessment and Observation (EPAO) tool. Design: Mixed-models analysis with the CCC as the random effect assessed the impact of readiness to change over time on EPAO outcomes. Participants: Eighty-eight CCC teachers and support staff completed the HC2 readiness to change survey in August 2015 and 68 in August 2016. Only teachers and staff randomized to the treatment arm of the trial were included. Main Outcome: Readiness to change and the EPAO. Results: Results showed the majority of CCC staff in advanced stages of readiness to change at both time points. For every increase in readiness to change stage over 1 year (eg, precontemplation to contemplation), there was a 0.28 increase in EPAO nutrition scores (95% confidence interval [CI], 0.04-0.53; P = .02) and a 0.52 increase in PA score (95% CI, 0.09-0.95; P = .02). Conclusions: This analysis highlights the importance between CCC staff readiness to change and the CCC environment to support healthy weight development. Future similar efforts can include consistent support for CCC staff who may not be ready for change to support successful outcomes.

Childcare centers (CCCs) can provide opportunities to implement physical activity (PA) via health promotion interventions to prevent obesity and associated chronic disease risk factors in young children. This study evaluated the impact of the Healthy Caregivers-Healthy Children (HC2) intervention on body mass index percentile (PBMI) and the PA environment in CCCs serving children with disabilities (CWD) over one school year. Ten CCCs were cluster-randomized to either (1) an intervention arm that received the HC2 curriculum adapted for CWD or (2) an attention control arm. Mixed-effect linear regression models analyzed the relationship between change in child PBMI and CCC childcare center PA environment by experimental condition and child disability status over one school year. Findings showed a significant decrease in PBMI among children in the HC2 centers (−6.74, p = 0.007) versus those in control centers (−1.35, p = 0.74) over one school year. Increased PA staff behaviors (mean change 3.66, p < 0.001) and PA policies (mean change 6.12, p < 0.001) were shown in intervention centers during the same period. Conversely, there was a significant increase in sedentary opportunities (mean change 4.45, p < 0.001) and a decrease in the portable play environment (mean change −3.16, p = 0.03) and fixed play environment (mean change −2.59, p = 0.04) in control centers. No significant differences were found in PBMI changes between CWD and children without disabilities (beta = 1.62, 95% CI [−7.52, 10.76], p = 0.73), suggesting the intervention’s efficacy does not differ by disability status. These results underscore the importance of (1) including young CWD and (2) PA and the supporting environment in CCC health promotion and obesity prevention interventions.

Given disruptions to early care and education following the COVID-19 pandemic, it is important to mitigate long-term impacts of the pandemic on child development among ethnic and racial minority children. Our team is implementing an early childhood mental health consultation (ECMHC) model, or a multi-tiered intervention to support young children’s social-emotional development, that utilizes mental health consultants to deliver a virtual toolkit to ethnically and racially diverse early care and education centers. Understanding the perspectives and ongoing needs of center directors, teachers, and parents is critical to intervention delivery. Between February and April 2023, 18 participants (n = 6 center directors, n = 6 teachers, n = 6 parents) across 12 early childcare centers completed individual interviews in English or Spanish. We used a rapid qualitative analysis to generate four themes related to participants’ perceived impact of COVID-19, including how it (1) exacerbated existing financial and administrative challenges, (2) increased their need for adaptability, (3) highlighted the importance of support for staff facing educational challenges during a public health emergency, and (4) highlighted the value of partnerships between parents and centers. We generated five additional themes specific to participants’ ongoing needs and suggestions, including (1) increased financial support, (2) outside behavioral support, (3) enhanced center staff self-care, (4) balancing in-person interaction with planned virtual delivery, and (5) use of existing smartphone applications for communication with parents. In addition to informing adaptations to our model, including expanding upon program pillars (e.g., expanding our safety planning pillar to include financial safety via linkages to community resources), these data may be used to inform the delivery of other ECMHC programs for diverse populations.