In‐the‐moment ratings on the Early Relational Health Screen: A pilot study of application in home visiting and primary care

Early infant‐parent interaction sets a critical foundation for young children's well‐being, and evidence regarding the protective role of secure early relationships has led to increased interest in effective screening and promotion of early relational health in pediatric primary care and home visiting settings. We report findings from two pilot studies conducted in the United States that describe the reliability and validity of a relational health screening tool, the Early Relational Health Screen (ERHS), implemented in two different contexts: an innovative model of relational health promotion in pediatric primary care (Study 1) and an Infant Mental Health Home Visiting (IMH‐HV) model (Study 2). Across both studies, a trained clinician rated the ERHS following real‐time observation of interaction (i.e., “in‐the‐moment” ratings). Reliability was assessed by comparing “in‐the‐moment” ERHS ratings to subsequent coding of the same interaction from video by an independent evaluator. In addition, Study 2 data permitted evaluation of the validity of “in‐the‐moment” ERHS ratings. Results from both studies indicated reliability of “in‐the‐moment” ERHS ratings. In addition, Study 2 clinician “in‐the‐moment” ratings were associated with maternal depression and ratings of child‐parent interaction derived from a separate observational task coded by independent evaluators using a different well‐validated research‐based measure. Discussion highlights the potential of the ERHS as a screening, promotion, and prevention tool that may be feasibly administered by providers across pediatric primary care and home visiting settings. Resumen La temprana interacción infante‐progenitor establece una fundación esencial para el bienestar de los niños pequeños, y la evidencia sobre el papel de protección de tempranas relaciones receptivas ha aumentado el interés en la efectiva detección y promoción de la salud de la relación en el cuidado pediátrico primario y los escenarios de visitas a casa. Reportamos los resultados de dos estudios experimentales que describen la confiabilidad y validez de la Temprana Detección de la Salud de la Relación (ERHS) implementada en dos contextos: un modelo innovador de promoción de la salud de la relación en el cuidado primario (Estudio 1) y un modelo de salud mental infantil de visitas a casa (Estudio 2). A lo largo de ambos, un profesional clínico entrenado evaluó ERHS siguiendo una observación de interacción en tiempo real (v.g. puntajes asignados “e