Workplace Health Promotion for Early Childhood Educators: Strategies for Intervention and Measurement
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Background. Early Childhood Education (ECE) educators play a critical role in supporting child development, yet experience disproportionately poor health and high burnout and turnover. These challenges threaten workforce stability and the quality and accessibility of ECE. While workplace health promotion initiatives have improved employee health in other sectors, the ECE workforce remains understudied in this regard, and no context-specific measures exist to assess and monitor health promotion in ECE workplaces. Objective. To examine the health and wellbeing of ECE educators, evaluate associations amongst workplace conditions, health, burnout, and turnover intentions, identify ECE-prioritized workplace health promotion concepts, and develop and validate a context-specific measure of workplace health promotion in ECE. Design. Data were drawn from the StayWell ECE (Staff and Youth Wellness for Early Childhood Educators) project, a sequential explanatory mixed-methods study of licensed ECE educators in New York State, from which 4 Aims were delineated. Aim 1 characterized educator health behaviors, health outcomes, and burnout. Aim 2 examined multilevel pathways linking workplace conditions, health behaviors and wellbeing, and job turnover intentions. Aim 3 applied participatory importance-feasibility analyses to identify prioritized workplace health promotion concepts for the ECE setting. Aim 4 involved the iterative development and psychometric evaluation of the WHECE measure based on findings from Aims 1–3. Results. ECE educators reported poor health behaviors, elevated stress and burnout, and high turnover intentions; analyses determined meaningful associations between these challenges. Specifically, that burnout serves as a central mechanism to health behaviors, and between stress, social support, and turnover. Participatory analyses identified specific and prioritized workplace health promotion concepts across individual, interpersonal (social), and environmental levels. The resulting Workplace Health Promotion for Early Childhood Educators (WHECE) measure, developed to target these levels, demonstrated evidence of adequate psychometric properties. Conclusions. Workplace conditions are critical, modifiable determinants of ECE educator health and retention. Findings in this dissertation provide empirical evidence linking workplace environments to educator health and wellbeing and introduce a validated ECE-specific measure to support multilevel intervention and policy efforts to support the ECE workforce.