Abstract
Background: Identifying factors that affect the implementation quality and implementation outcomes are important, as better implementation is associated with better effects of an intervention. The aim of the present study was to research which factors predicted implementation outcomes in the implementation of the universal socio-emotional learning program Tuning in to Kids for Kindergarten Teachers in Norway, and whether this relationship was mediated by implementation quality. The predictors examined in this study were the teachers’: education level, length of employment in a kindergarten, perception of kindergarten functioning, psychological distress, emotion dysregulation, emotion socialization, and emotional support (observed). Method: Data were collected in a bigger cluster randomized controlled intervention trial. We used quantitative questionnaires and observational data from 344 teachers and leaders in 22 intervention kindergartens. Predictors were measured at baseline (August 2019), implementation quality part way through the implementation period (March 2020) and implementation outcome at the end of implementation (July 2020). We performed general linear model, linear mixed model and multilevel mediation analyses to account for and examine clustering effects at unit level. Results: Teachers and units with a better functioning kindergarten, teachers with more supportive emotion socialization and units consisting of teachers with more mean experience, had better implementation outcomes. Better implementation quality mediated the relationship between the predictors: better kindergarten functioning (teacher & unit level), better emotion socialization (teacher & unit level) and better observed emotional support (unit level), and better implementation outcomes. Individuals and units with better implementation quality had significantly better implementation outcome, for all predictor models. Conclusion: These results indicate that an increased focus on factors that aid in improving the implementation quality may result in better implementation outcomes, and thus better effects from an intervention. Our results showed that the functioning of the kindergarten, factors related to the program techniques and experience of the teachers affected the implementation.