Exploring Teacher Practices and Perceptions of Implementing Anxiety-Focused Supports in Low-Income Urban Elementary Schools.

Surging rates in child internalizing problems require teachers to serve as frontline responders, especially in marginalized urban communities where structural barriers constrain access to healthcare resources. The current mixed methods study examined teachers' use and perceptions of tools for addressing anxiety in urban elementary schools serving predominately low-income and Black and Hispanic youth. Across surveys (N = 82) and interviews (n = 12), teachers were asked about their current practices, their perceptions of the most common evidence-based practice elements for youth anxiety, and their preferences for professional development (PD) materials going forward. All teachers endorsed use of evidence-based practices for anxiety. Among the practices assessed, teachers were most enthusiastic about using modeling, praise/rewards, cognitive coping, and relaxation strategies, and were least enthusiastic about exposure, self-monitoring, and psychoeducation. In interviews, teachers noted key facilitators (e.g., keeping strategies time-limited), and highlighted other "setting up for success" strategies (e.g., building relationships with students) that work to minimize anxiety in classrooms. Teachers with higher self-efficacy and sense of personal accomplishment perceived evidence-based practices for student anxiety as more usable, underscoring the importance of teachers' job-related wellness in student mental health promotion. Teachers preferred PD materials that were time-limited, asynchronous, and engaging. Taken together, findings indicate that many teachers are already incorporating evidence-based anxiety practices into their routines. Results inform policy and practice recommendations, and suggest value in leveraging teachers' existing practices and opinions to develop relevant PD materials that optimize practices for addressing child anxiety in urban schools.