P2.121: A Curriculum for Physicians in Supporting "Emotional Connection" at Well Child Visits.

Background: Evidence increasingly demonstrates the significant impact that positive relationships between infants and their parents and caregivers, referred to as early relational health (ERH), has on all aspects of children’s development, and future well-being. Additionally, current literature shows that an emotional connection (EC) within the early parent-child relationship is even more central to the future mental health and wellbeing of children.
Pediatric primary care clinicians are in a unique position as trusted sources of guidance for parents. Enhancing the capability of pediatric primary care clinicians in observing and supporting EC and positive parent-child relationships can help promote child development and resilience, and lead to long-term positive outcomes. Reach Out and Read (ROR) is a 30-year-old evidence-based model embedded within pediatric primary care. ROR has developed an ERH training curriculum for pediatric clinicians – the EC curriculum- which includes an adaptation of the Welch Emotional Connection Screen (WECS) developed by the Columbia University Nurture Science program. The EC curriculum trains clinicians to include strategies to support EC and ERH in routine WCV. This study aims to explore the feasibility, acceptability, and effectiveness, of the ROR EC Training for pediatric primary care clinicians in supporting EC and ERH at well child visits (WCV).s

Project Description: About 30 clinicians including Pediatric residents, NPs and Faculty from the DePaul Pediatric ambulatory care clinic, St. Joseph’s Children’s Hospital in Paterson, completed the online training of the EC curriculum. Of that group, 16 clinicians consented to take
part in a semi structured, qualitative interview (about 45 minutes) with a trained study team member to help the study team understand the feasibility and acceptability of the curriculum and their experience with implementing what they learned in the curriculum during WCV. The interviews were digitally recorded and, transcribed verbatim to enable analysis, and analyzed using standard qualitative techniques.

Discussion: All participants (100%) reported that they would integrate at least some elements of the EC training to the WCV and almost all (94%) found it useful. Perceived benefits included improvement of early relational health (25%) and improved detection of developmental delays (25%). Suggested strategies for integration into routine practice include systematic training of clinical staff to adopt techniques during WCV (43%) and help to make parents comfortable before starting observation (25%). Reported barriers and constraints include increased length of WCV (56%) and increased need for cultural sensitivity (12%).

Conclusion: In a pilot of the EC curriculum, clinicians found the curriculum useful and beneficial despite increased length of the visit. Integration of ERH techniques is feasible and acceptable to clinicians when early and appropriate training and support are provided.