Promoting Early Relational Health in Primary Care: A Scoping Review of Interventions and Evidence Gaps

Area of Science:

• Pediatric Primary Care
• Developmental Psychology
• Implementation Science

Background:

• Early relational health, defined by caregiver-child interactions, is crucial for socio-emotional development and lifelong well-being.
• The American Academy of Pediatrics advocates for relationship-centered care in pediatric primary care, yet implementation gaps persist.

Purpose of the Study:

• To systematically map early relational health interventions within pediatric primary care settings.
• To summarize the outcomes, implementation strategies, barriers, and facilitators of these interventions.

Main Methods:

• A comprehensive scoping review was conducted using PubMed, CINAHL, and PsycINFO (2014-2024), with supplemental backward citation searching.
• PRISMA-ScR guidelines were followed, with data synthesized through descriptive and thematic analysis.

Main Results:

• Eighteen studies met inclusion criteria, with interventions implemented in clinic, home, or hybrid settings, often integrated into existing workflows.
• Positive outcomes included enhanced caregiver responsiveness, increased parenting self-efficacy, and improved child language and socio-emotional development.
• Key facilitators were contextual adaptation, strong relational support, and clinical process alignment; barriers included limited sample sizes, reliance on self-report measures, short follow-up, and resource limitations.

Conclusions:

• Early relational health interventions are feasible and effective in pediatric primary care when integrated into routine practice and contextually adapted.
• Overcoming methodological and implementation challenges is vital for advancing relationship-centered pediatric care.