Implementation of Emotional Connection Training in Pediatric Primary Care: Mixed Methods Study

Abstract Background In 2021, the American Academy of Pediatrics released a policy statement spotlighting the health-promoting and stress-buffering effects of early relational health (ERH) and calling for universal ERH promotion in pediatric primary care. However, little educational content for the observation and promotion of ERH is available, highlighting the need for scalable ERH training modules. Objective This study aims to investigate the acceptability, feasibility, and impact of the “Lens of Emotional Connection,” a self-paced, asynchronous, ~45-minute ERH training module codeveloped by Reach Out and Read and the Center for Early Relational Health at Columbia University. The module introduces practitioners to emotional connection, an observable component of ERH, through written and video didactic content and experiential rating of emotional connection in videos of parent-child dyads interacting face-to-face. Methods The evaluation was conducted by the Carolinas Collaborative. Pediatric providers across 8 clinical sites were invited to participate and responded to embedded pre-post surveys. Focus groups conducted with participants further examined the educational experience. Results Of 653 invited clinicians, 207 (31.7%) participated in the module. Individual survey responses were available for 44-75 participants, depending on the question. Of responders, 64 out of 69 (93%) reported the module was a good way to learn about emotional connection, and 63 out of 69 (91%) felt the module provided valuable knowledge. Overall, 60 out of 69 respondents (87%) reported satisfaction with the module length, and 36 out of 44 respondents (82%) reported they would recommend this training to other clinicians. Focus groups echoed these findings. Comparison of pre-post data showed the greatest changes were in familiarity with emotional connection (n=75, pre mean 54.20, SD 18.59; post mean 73.99, SD 14.73; Cohen d =1.14; P