Measures

Seven true or false statements assessed staff knowledge regarding trauma and resilience, for example, “Resilience is recovering from or adjusting to misfortune or change; the ability to ‘bounce back’ or overcome odds.” Responses were scored 0 or 1 based on an incorrect or correct response. To assess knowledge regarding signs and symptoms of trauma in young children, staff were asked to mark all that apply from a list of seven behaviors such as fearfulness, eating and sleeping problems, and aggressiveness. Finally, staff were asked three multiple choice questions about adverse childhood experiences (ACEs) and Trauma Informed Care: the definition of ACEs; components of ACEs training; and principles of trauma informed care. Each correct answer was scored as 1, and an incorrect answer as 0.

Three items assessed knowledge about trauma and resilience. Parents were asked to respond “yes” or “no” to, “Have you heard of adverse childhood experiences (ACEs)?” In addition, parents were asked to indicate “true” or “false” to the statements, “Nurturing and responsive care can help a child who has experienced trauma” and “It is important to talk to young children about things that happened and help them understand the experience.” Responses were scored 1 if a “yes” was marked about an awareness of ACEs or “true” to a correct statement about resiliency. To assess knowledge related to possible causes of trauma, parents were asked to mark all that apply from a list of life events such as, “Being neglected or not cared for.” To assess knowledge regarding signs and symptoms of trauma in young children, parents were asked to mark all that apply from a list of seven behaviors such as fearfulness, eating and sleeping problems, and aggressiveness.

Parental attitudes towards promoting resilience was measured using a three Likert response option to eight statements. For example, parents indicated whether they agree, somewhat agree, or disagree with the following statement, “I can support my child by being calm and patient.” Responses ranged from 1 to 3, with higher scores indicating stronger agreement. Parents were also asked to indicate how much they "believe there are things you can do to help your child if he or she has experienced trauma" with four response categories: “nothing”, “a little”, “a fair amount”, and “a lot.” This item was scored 1–4 with higher scores indicating a greater ability to support a child who has experienced trauma. Parents were asked whether their child had been exposed to adverse childhood experiences, with response options of “yes,” “no,” and “don’t know.” Finally, parents were asked, “In your child’s life, has she/he experienced any of the following?” with potential answers including: (1) violence, abuse or neglect; (2) death or separation from a primary caregiver; (3) parent substance abuse or untreated mental illness; and (4) homelessness and/or lack of food. Responses were coded as 0–4, corresponding to the number of items selected from the list.