Protocol for a cluster-randomized control trial of a remote workplace resilience intervention for early care and education providers: The OnWARD trial.

The OnWARD trial is designed as a cluster randomized control trial targeting early care and education (ECE) providers using remote delivery.

• The trial includes 80 centers consisting of approximately 640 ECE workers.
• Centers are randomly assigned to either a remotely delivered resilience intervention or a physical activity attention control program.
• The trial duration is 15 months total.
• Trial is registered with ClinicalTrials.gov (NCT06919952) and approved by the University of North Carolina at Chapel Hill IRB (IRB# 25-0016).

Measures will be collected at four timepoints throughout the trial.

• Data collection occurs at baseline (0 months), post-intervention (3 months), and two long-term maintenance timepoints (9 and 15 months).
• The primary outcomes focus on changes in resilience assets and resources for ECE staff.
• Secondary outcomes include changes in well-being, physical activity, organizational support, absenteeism, and turnover.
• Potential moderators of treatment effects will also be explored.

The RE-AIM Framework will be used to evaluate the program's potential for reach, adoption, implementation, and maintenance.

• RE-AIM will assess outcomes at both the individual (staff) level and the organizational (center) level.
• The framework evaluation will address both reach and adoption, as well as implementation and maintenance of the two programs.
• This framework application is intended to determine the potential for scaling the intervention to other workforce segments.

Work-related stressors disproportionately affect under-resourced, low-paid essential workforce segments such as ECE staff.

• ECE staff are described as a 'marginalized segment of the workforce' in critical need of well-being resources.
• Existing resilience programs are described as 'constrained by time and resource-intensive implementation strategies that are challenging to scale' for this population.
• The authors identify ECE staff as an underserved population with limited access to current resilience programming.

The trial is designed to fill key gaps in prior resilience research by using remote program delivery for an underserved workforce population.

• Prior resilience programs are characterized as difficult to implement and scale for marginalized workforce segments.
• The remote delivery model is intended to address feasibility and scalability challenges.
• Results are expected to have implications for remote programming in other segments of the workforce beyond ECE.
• The trial specifically targets the feasibility and impact of remote programming as a key research question.