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Promoting Early Relational Health in Primary Care: A Scoping Review of Interventions and Evidence Gaps
Sarah Behrens1, Stephen Lauer1, Brenda J Salley1
1Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kans.
Background:
Early relational health - the quality of caregiver-child interactions - is foundational for socio-emotional development and long-term wellbeing. The American Academy of Pediatrics has called for a paradigm shift toward relationship-centered care in pediatric primary care, yet a gap remains between this vision and real-world implementation.
Objectives:
To map early relational health interventions implemented in pediatric primary care, summarize reported outcomes and identify implementation strategies, barriers, and facilitators.
Data Sources:
PubMed, CINAHL, and PsycINFO were searched for studies published between 2014 and 2024, supplemented by backward citation searching.
Study Eligibility Criteria, Participants, And Interventions:
A scoping review methodology following PRISMA-ScR guidelines was used. Data were charted and synthesized using descriptive and thematic analysis.
Results:
Eighteen studies met inclusion criteria. Interventions were delivered in clinic, home, or hybrid settings and were commonly integrated into routine workflows. Reported outcomes included improvements in caregiver responsiveness, parenting self-efficacy, and child language and socio-emotional development. Implementation strategies included staff training, workflow integration, fidelity monitoring, and community partnerships. Key facilitators were contextual responsiveness, strong relational supports, and alignment with clinical processes. Barriers included small or homogeneous samples, reliance on parent-report outcomes, short follow-up periods, and resource constraints.
Conclusions And Implications Of Key Findings:
Early relational health interventions are feasible and show promise in pediatric primary care when embedded into routine care and adapted to context. Addressing methodological and implementation challenges is essential to advancing relationship-centered pediatric practice.
Scoping Review Registration:
Open Science Framework (OSF), DOI: https://doi.org/10.17605/OSF.IO/ZCGVA.
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