221 - Lens of Emotional Connection: Efficacy of a 40-Minute Training to Screen Early Relational Health

Publication Number: 221.5828

Nicole Shearman, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Elena Arduin, Columbia University, New York, NY, United States; Dani Dumitriu, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Andreane Lavallee, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; J. Blakely Amati, Prisma Health/University of South Carolina School of Medicine Greenville, Greenville, SC, United States; Jennifer M. Warmingham, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Elizabeth Erickson, Duke University School of Medicine, Durham, NC, United States; Jessica Sperling, Duke University School of Medicine, Durham, NC, United States; Nikki Shearman, Reach Out and Read, Boston, MA, United States; Doreet Preiss, Duke University, Durham, NC, United States; David W. Willis, Georgetown Univ Thrive Center for Childr, Alexandria, VA, United States; Hajer Nakua, Columbia University Vagelos College of Physicians and Surgeons, New York City, NY, United States

Background: The majority (80-85%) of brain development occurs between prenatal development to age two. The American Academy of Pediatrics (AAP) has stated that Early Relational Health (ERH), secure, responsive, consistent relationships, is foundational to brain development and long-term health outcomes. Research shows that Stable and Supportive Relationships can help buffer Adverse Childhood Experiences which can negatively effect children’s health and developmental outcomes. The AAP policy statement on ERH lacks standardized approaches for clinicians to assess parent child interactions.

Objective: We aim to show the efficacy of our 40-minute online CME- and MOC-2-accredited ERH training designed specifically for pediatric providers to “see through the lens” of Emotional Connection (EC) as an intuitive approach to ERH.

Design/Methods: Physicians in the Reach Out and Read (ROR) network (n=57) voluntarily completed our accredited training online after the training was validated by live administration to participants at three conferences of people interested in ERH, i.e., funders (n=40), home visiting clinicians (n=85), and Zero to Three conference attendees (n=36). Participants completed Qualtrics surveys before, during, and after the training. Survey questions evaluated knowledge, skills, and attitudes relating to observing and rating caregiver-child EC during face-to-face interactions using a sliding scale. We compared the reliability of participants’ EC ratings of standardized mother-infant face-to-face interaction videos against experienced coder ratings, before and after the training, using intra-class correlations (ICC; 2-way mixed model). Before and after training ICCs were compared using paired t-tests.

Results: Significantly higher ICCs were found between participant and experienced coder ratings following training compared to before training amongst funders (t(28) = -4.00, p < 0.001), home visiting clinicians (t(48) = -5.00 , p < 0.001), and Reach Out and Read pediatric providers (t(56) = -3.00, p < 0.001). The higher ICCs indicates higher agreement between participants and experienced coders following the training. We did not find a significant difference in ICC before and after training (t(17) = -2.58, p = .019 ) in the Zero to Three sample.

Conclusion(s): Our results suggest that our 40-minute EC training may be an important and accessible tool to train clinicians to observe and rate EC. Increasing pediatric providers’ ability to observe EC by observing caregiver-child interactions may be a pathway toward operationalizing the recent AAP policy statement on ERH.