Dr. Courtney Baker and her team members are partnering with 13 New Orleans childcares, Head Starts, and pre-K/K classrooms within charter schools, which serve low-income children, in a program named Project DIRECT, a community-engaged approach, aimed to reduce disparities in mental health and academic achievement.

Baker and her team are reaching children who live in poverty, racial and ethnic minority children, and children who have experienced trauma. The efforts created by Dr. Baker and her team are designed to deliver high-quality evidence-based prevention and improve intervention programs for real-life applications, especially for children who are vulnerable to poor outcomes.

Dr. Baker, Project DIRECT Team Leader and Principal Investigator, is an Associate Professor in the Department of Psychology at Tulane University. She is a licensed clinical psychologist with a specialty in child clinical psychology and directs the APA-Accredited School Psychology doctoral program. She also co-directs the Tulane University Psychology Clinic for Children and Adolescents.

Dr. Baker notes that her career is committed to bridging the gap between research and practice, with a particular focus on understanding and facilitating the translation of evidence-based programs into school and community settings that serve children, youth, and families at risk for poor outcomes.

Following the best practices for working with marginalized communities, Baker and her group use a community-engaged research approach, to create high-quality, community-based mental health programs. They work to bridge the gap between research and practice and to ensure the results deliver effective prevention and interventions.

In order to achieve these essential and complex goals, Dr. Baker focuses on three interrelated objectives:

1) understanding developmental contexts that are central to disparities in the health and academic outcomes of vulnerable populations;

2) elucidating the barriers and facilitators of high-fidelity implementation; and

3) developing and testing system-level interventions that boost implementation quality, thus improving programs’ effectiveness.

Dr. Baker hopes to increase understanding and facilitate effective programs into community settings that serve children. One of the foundations of her work and scientific plan is the community-engaged research approach––to make sure all efforts are “relevant, culturally competent, and with a partnership focus and commitment to capacity building.”

She and her team use a community-based participatory research (CBPR) approach, where community partners are “equitably involved in identifying and evaluating relevant research questions.”

The programs activities are monitored by a Community Advisory Board, composed of individuals who are local educators, administrators, mental health professionals, and parents.

What are some of the most significant accomplishments so far in her community based projects?

“Community-based research strives to center the voices and needs of the community within projects,” Dr. Baker said, “that also use best practices in terms of research methods and study design. The rationale is that we can work as a team to create programs or tools that are effective, relevant, and useful. The process in and of itself is incredibly gratifying,” she said.

“However, a few accomplishments, in particular, come to mind when you ask this question,” she said. “First, we worked closely with pre-kindergarten teachers, administrators, and parents of preschoolers to create a flexible, easy-to-use classroom curriculum called PreK TIPS. The goal of PreK TIPS is to help children learn the social and emotional skills they need to be successful in school,” she said.

“Our randomized controlled trial of PreK TIPS happened to be ongoing when the tornado struck New Orleans East in 2017, including directly affecting one of our partner schools. One of the teachers we were working with at the time let us know afterward that the children were using our PreK TIPS coping and calming strategies to get through that extremely stressful and scary moment. I could not be more grateful that our teacher partner and his students had these tools and were able to use them to get through that crisis,” Dr. Baker said.

Project DIRECT involves a strong goal of information and skill transfer. The team “Trains the next generation.” The program provides advanced training and professional development in child development, mental health, and early education. Activities include hands-on training opportunities for Tulane students and development to community members.

“The consultation model we use in our clinical and research efforts builds teacher skills, contributes to the sustainability of evidence-based practices in preschools and schools, and increases site capacity.”

The Project DIRECT team provides training on a variety of topics, including:

Creating Safe and Supportive Schools

Expectations for Behavior through a Developmental Lens

Social-Emotional Learning in Preschool

Understanding Preschooler Development: Self-Awareness, Self-Control, and Delay of Gratification Creating Trauma-Informed Schools: Rationale and School Wide Approach

Working with Children who have Challenging Behavior Behavioral Assessment and Intervention in Schools

De-escalating Upset Children (and Angry Parents, too)

School-Related Anxiety

Understanding Normal (and Abnormal) Behavior in the Preschool Setting

 

The team also provides workshops for parents as a service to our community partners. Recent topics have included:

Discipline without Tears

Getting your Preschooler to Do What You Ask: Giving Effective Commands.”

Additionally, the team actively recruits partners for its ongoing research projects. These include: Project Pre-K TIPS, funded by the Louisiana Board of Regents; Safe Schools NOLA, funded by the National Institute of Justice; and Trauma-Informed Schools Demonstration Project, funded by the Department of Justice and United Way through the City of New Orleans Health Department.

Efforts to measure, evaluate, and study the implementation of trauma informed care, is conducted in partnership with Steve Brown and Pat Wilcox at the Traumatic Stress Institute. This includes developing the “Attitudes Related to Trauma Informed Care Scale.”

The team also provides clinical services in their efforts help each child get the healthiest start possible. To support this effort, additional services can be provided in Tulane’s Psychology Clinic for Children and Adolescents. This clinic is evidence[1]based practice, uses a sliding fee scale, and is co-directed by Drs. Baker and Sarah Gray.

Training Tulane students in community[1]based research includes engaging undergraduate, master’s, and doctoral students in developing competencies related to research and practice with children and their families. Undergraduates provide on-site classroom support to teachers, graduate students serve as clinicians-in-training, and both assist with ongoing research projects. Dr. Baker also trains one or two school psychology predoctoral interns in the context of their LAS*PIC Summer Rotation.

“My greatest privilege as the team leader has been to train my students,” Dr. Baker said. “I have an incredible group of ten to fifteen students each year, ranging from undergraduates to postdoctoral fellows. Their contributions to our team, our community-based research, and my own continued growth and development as a psychologist are considerable. Although I’m always sad to see them go, they move on to do truly amazing things, from attending top graduate and professional programs to working in world-renowned research labs to developing their own independent research and practice careers,” she said.

Dr. Baker’s research program is guided by the fields of dissemination and implementation science and prevention science. She strives to bridge the gap between research and practice.

Implementation science addresses the use of strategies to integrate evidence-based interventions and change practice patterns within specific settings. The approach involves taking a multilevel approach and understanding the context into which the intervention is to be implemented. Adapting interventions when needed to address contextual factors, while preserving the essential core elements of the interventions, is one goal.

Dissemination involves the distribution of an intervention or innovation to a specific audience. One of Dr. Baker’s main research goals is to disseminate findings nationally via conference presentations, invited presentations, and publications in academic journals and books. Project DIRECT’s undergraduate and graduate students are actively involved in this effort.

Some of publications are:

Baker, C. N., Peele, H., Daniels, M., Saybe, M., Whalen, K., Overstreet, S., & the New Orleans Trauma-Informed Schools Learning Collaborative. (in press). The experience of COVID-19 and its impact on teachers’ mental health, coping, and teaching. School Psychology Review;

Baker, C. N., Brown, S. M., Overstreet, S., Wilcox, P. D., and the New Orleans Trauma-Informed Schools Learning Collaborative. (in press). Validation of the Attitudes Related to Trauma-Informed Care (ARTIC) Scale. Psychological Trauma: Theory, Research, Practice, and Policy;

Robey, N., Margolies, S., Sutherland, L., Rupp, C., Black, C., Hill, T., & Baker, C. N. (in press). Understanding staff- and system[1]level contextual factors relevant to trauma[1]informed care implementation. Psychological Trauma: Theory, Research, Practice, and Policy;

Wagner, A. C., Bartsch, A. A., Manganaro, M., Monson, C. M., Baker, C. N., & Brown, S. M. (in press). Trauma-informed care training with HIV and related community service workers: Short and long term effects on attitudes. Psychological Services;

and Wittich, C., Rupp, C., Overstreet, S., Baker, C. N., & the New Orleans Trauma-Informed Schools Learning Collaborative. (2020). Barriers and facilitators of the implementation of trauma-informed schools. Research and Practice in the Schools, 7, 33- 48.

She also has earned funding from numerous sources, including:

• Center for Supportive and Compassionate Schools (Category II Center) – SAHMSA, National Child Traumatic Stress Initiative, Co-PI, $3,000,000;
• An Efficacy Trial of Pre-K TIPS in Preschools Serving Low-Income Children (Initial Efficacy) – U.S. Department of Education, Institute of Education Sciences, PI, $3,796,673; and
• Development and Pilot Testing of PD Camp: An Experiential Classroom Behavior Management Training (Development and Innovation) – U.S. Department of Education, Institute of Education Sciences, PI, $1,950,797.

What are some of the challenges she and her team have faced?

“My two greatest challenges as a community-based researcher are funding and time,” said Dr. Baker. “Though we’ve been lucky in terms of funding, it is increasingly difficult to win federal grants. In addition, although the need for community[1]based research is clear, funding mechanisms generally continue to favor biologically-focused projects. Efforts at increasing translational science, including not only ‘bench to bedside,’ but also ‘bedside to best-practices,’ are laudable but have yet to swing the pendulum in any meaningful way toward community-based research. This is true even as it becomes increasingly clear how critically important it is to consider the social determinants of health, which is another word for the contextual and social factors that shape each individual’s exposure to risk and resilience.”

What plans does she have for future efforts and activities?

“We always have a number of things in the pipeline, of course! We’d love to get our large randomized controlled trial of the PreK TIPS program I mentioned above funded. That would solidify the evidence that the program works and open the doors for it to become available nationally (and for free!).

“We are also invested in developing and testing best practices for systems like schools and hospitals that aim to reduce the impact of trauma, stress, and adversity on children and families,” she said. “This intervention is called trauma-informed care, and it is really understudied. We are doing our best to move the needle on this lack-of[1]evidence problem by developing validated instruments, exploring the “black box” of how trauma-informed care works, and determining the effectiveness of the intervention.

“I would love for our future work to bring together trauma-informed care, which sprung from the experiences of individuals who came up through systems they found harmful rather than healing, with best practices in measurement, research, and evaluation.”