P3B371: Developing Resident-community Partnerships to Promote Early Relational Health

Background: Toxic stress describes biological and developmental outcomes of adverse childhood experiences, which can have profound health consequences across one's lifespan. However, mitigators like strong parent-child relationships can buffer the effects of these stressors. The current AAP policy on toxic stress encourages pediatricians to promote safe, stable, nurturing relationships among families and communities by partnering with them. This project aimed to strengthen resident skills in building community partnerships to promote early relational health.

Project Description: Two Pediatric and two Family Medicine residents from programs across the state participated in this project and were mentored by the NJAAP Early Childhood Chapter Champions. The residents developed parent workshops on strengthening early relational health in collaboration with local community organizations that support families from diverse socioeconomic, ethnic, and racial backgrounds. They developed curricula tailored to family needs identified by organizational leadership. Residents utilized supplemental materials, like books and developmental toys, to augment the workshops and distributed brochures on positive parenting, integrating logical and emotional brain, behavior, and emotional intelligence. Anonymous pre and post-workshop parent surveys were utilized to evaluate the sessions. Feedback from parent leaders and other house staff was obtained on materials and presentations for future improvements.

Discussion: A total of 29 families participated in three parent workshops, each held at a different community organization. Residents used interpreters during sessions for families who were not comfortable with English. Pre-intervention data showed that parents felt that spending quality time with their children was essential, and most were satisfied with the available time. However, we noted that the frequency of reading with children was low. Post-intervention data demonstrated that parents felt more confident in supporting their child's development, along with an increase in the reported reading frequency. However, many families were lost to follow up and did not complete the post-surveys. This limited evaluation of the workshop. Future efforts could include same-day feedback strategies, rather than having parents complete the post-session surveys at a later time. Modified survey questions could assess whether participants learned something new and plan to implement it, rather than asking about actual change in behaviors after the session. Incentives for completed post-session surveys might increase response rates. Despite these challenges, verbal feedback from community leaders and parents was excellent, with multiple requests to continue sessions in the future, and to expand the topics covered. Future sessions with improvements, and involving more residents, are being planned.

Conclusion: This project helped residents establish community relationships and understand community strengths and needs, to develop culturally respectful strategies in promoting relational health, tailored to specific populations. Targeting toxic stress through promoting early relational health is essential in fostering relationships and building resilient communities and is a critical element of medical training.