Early relational health (ERH) describes the state of emotional well-being between an infant or young child and their parents or primary caregivers. ERH represents the presence of safe, stable, and nurturing relationships in an infant’s early environment, that positively shape a child’s growth and development. A critical component in supporting ERH is promoting early opportunities for face-to-face bonding and social-emotional engagement between mother and infant. However, NICU hospitalizations disrupt this critical period of development, by physically separating mother and infant, altering the traditional parental role and complicating the infant’s exposure to basic early social interaction. NICU follow-up clinics have a unique role in following mother-preterm infant dyads after discharge home, and therefore have an important responsibility to assess ERH risk.
We have created a digital screening and tracking protocol for ERH risk for mother-preterm infant dyads in our UMass NICU Follow-Up clinic, where we monitor neurodevelopmental outcomes for high-risk preterm infants from 0-3 years of age. Validated parent-reported measures include screening questionnaires for infant/child development (Ages and Stages Questionnaire: Social-Emotional), maternal mental health (Edinburgh Postnatal Depression Scale and Postpartum Bonding Questionnaire), and social drivers of health (WE CARE). These measures assess critical aspects of the early relational environment and have been embedded into the infant’s electronic medical record (EMR) so that providers can quickly identify mother-preterm infant dyads at high ERH risk during a busy clinical workflow.
For the next phase of our ongoing quality improvement project, we are seeking a medical student interested in supporting our clinic with the administration and tracking of screening measures. Responsibilities for this role include:
- Weekly distribution of digital screening tools (approximately 6–8 per week)
- Weekly outreach to families by phone (approximately 6–8 calls per week) to introduce and explain the screening process in advance of upcoming visits
- Monthly and quarterly reporting of screening completion rates and response data extracted from the electronic medical record (EMR)
This role requires approximately 30–60 minutes of remote/independent work per week, along with a 30-minute monthly check-in meeting with the team to review progress, discuss updates to the screening process, and monitor data collection efforts.
There will also be opportunities for continued involvement with the clinic through ongoing and future research initiatives focused on preterm infants and their families.