Pairing Parents and Providers to Examine Early Relational Health in Academic Pediatric Primary Care Clinics

By Jenna Russo, M.S. & Dayna Long, M.D., FAAP

Heart rate, blood pressure, and respiratory rate — these are all key vital signs that are checked in the pediatric exam room, although a key vital sign that often goes overlooked is early caregiver-child relationships. Emerging research highlights the role of early caregiver-child relationships on lifelong health, although such research has yet to be integrated into training curricula for emerging pediatric professionals. 

Pediatric trainees are well positioned to promote this key vital sign in their practice to improve child health trajectories. However, trainees must first understand early caregiver-child relationships and the foundational concepts and practices encompassed by Early Relational Health (ERH) — the state of emotional well-being that grows from the positive emotional connection between young children and their caregivers when they experience strong, positive, and nurturing relationships with each other.

A workgroup convened by the Center for the Study of Social Policy (CSSP) is aiming to make that vision a reality by integrating conversations about ERH into academic pediatric primary care. Insight is being drawn from existing resources that utilize an ERH framework, such as Healthy Steps and Reach Out & Read, as well as existing literature that highlights factors such as reflective supervision and cultural humility training for effective curriculum development. 

However, the workgroup noted a lack of co-creation with families and determined that a better understanding of families’ experiences and perspectives is necessary to effectively train and equip future child health providers to promote ERH. The workgroup is uniting academic medical centers with caregivers to discuss how to talk about ERH during pediatric visits. Specifically, through a series of listening sessions, the workgroup aims to understand caregiver perspectives on the principles of ERH and the best opportunities to build on family strengths in the exam room. 

This shared vision with Nurture Connection to promote ERH, and specifically, to collaborate with families to teach ERH in academic pediatric primary care, has the potential to transform service delivery, inform new policies, and inspire relationship-driven change across all sectors — leading to better and more equitable outcomes for all children and families.