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Jimenez ME, Uthirasamy N, Hemler JR, Bator A, Malke K, Lima D, Strickland PO, Ramachandran U, Crabtree BF, Hudson SV, Mackie TI, Mendelsohn AL. Maximizing the impact of reach out and read literacy promotion:anticipatory guidance and modeling. Pediatr Res 2024; 95:1644-1648. [PMID: 38062258 PMCID: PMC11127791 DOI: 10.1038/s41390-023-02945-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/07/2023] [Accepted: 08/14/2023] [Indexed: 05/26/2024]
Abstract
BACKGROUND Reach Out and Read (ROR) is a multi-component pediatric literacy promotion intervention. However, few studies link ROR components to outcomes. We examine associations between receipt of (1) multiple ROR components and (2) clinician modeling, a potential best practice, with enhanced home literacy environments (EHLEs) among Latino families. METHODS We conducted secondary analyses of cross-sectional enrollment data from a randomized clinical trial at three urban community health centers between November 2020 and June 2023. Latino parents with infants 6-<9 months old were surveyed about ROR component receipt (children's book, anticipatory guidance, modeling) and EHLE (StimQ2- Infant Read Scale). We used mixed models with clinician as a random effect, adjusting for covariates. RESULTS 440 Latino parent-infant dyads were included. With no components as the reference category, receipt of 1 component was not associated with EHLE. Receipt of 2 components (standardized beta = 0.27; 95%CI: 0.12-0.42) and 3 components (standardized beta = 0.33; 95% CI: 0.19-0.47) were associated with EHLE. In separate analyses, modeling was associated with EHLE (standardized beta = 0.16; 95%CI: 0.06-0.26). CONCLUSION Findings support modeling as a core ROR component. Programs seeking to enhance equity by promoting EHLE should utilize such strategies as anticipatory guidance and clinician modeling in addition to book distribution. IMPACT Reach Out and Read, a multi-component literacy promotion intervention, leverages primary care to promote equity in children's early language experiences. However, few studies link Reach Out and Read components to outcomes. Among Latino parent-infant dyads, we found that implementation of two and three components, compared to none, was associated with enhanced home literacy environments, following a dose response pattern. Parent report of clinician modeling was associated with enhanced home literacy environments. Literacy promotion programs seeking to enhance equity by promoting enhanced home literacy environments should utilize strategies in addition to book distribution, including anticipatory guidance and modeling, to maximize impact.
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Affiliation(s)
- Manuel E Jimenez
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
- Children's Specialized Hospital, New Brunswick, NJ, USA.
| | - Nila Uthirasamy
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Jennifer R Hemler
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Alicja Bator
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Keanaan Malke
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Daniel Lima
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | | | - Usha Ramachandran
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Benjamin F Crabtree
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Shawna V Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Thomas I Mackie
- Department of Health Policy and Management, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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Güven Baysal Ş, Büyükavcı MA, Akdemir E, Yağın FH, Doğan D. Shared Reading of the Families With the Children With Chronic Disease. Clin Pediatr (Phila) 2024:99228241248928. [PMID: 38680030 DOI: 10.1177/00099228241248928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
The aim of the study is to evaluate shared reading of families of children with chronic diseases. The mothers of children aged 2 to 6 years with chronic health problems who applied to the pediatric outpatient clinic between January and May 2022 were the study group, and the mothers of children with an acute health problem were the control group. The sociodemographic information form and "Child-Parent Shared Reading Activities Scale" were applied. At the end of the interview, 3 questions about shared reading were asked. A total of 187 children were enrolled in the study: 92 and 95 in the chronic disease group and control group, respectively. 57.6% of mothers of chronically ill children reported that the parents almost never did shared reading with their child. It was found that all mothers knew the importance of reading, but they could not support especially in the risky chronic disease group.
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Affiliation(s)
- Şenay Güven Baysal
- Division of Developmental Pediatrics, Department of Pediatrics, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye
| | - Mehmet Akif Büyükavcı
- Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine, Inonu University, Malatya, Türkiye
| | - Esra Akdemir
- Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine, Inonu University, Malatya, Türkiye
| | - Fatma Hilal Yağın
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, Türkiye
| | - Derya Doğan
- Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine, Inonu University, Malatya, Türkiye
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Crosh CC, Sherman SN, Valley JE, Parsons A, Gentry A, Glusman M, Hutton JS, Copeland KA. Beliefs and Motivations Regarding Early Shared Reading of Parents From Low-Income Households: A Qualitative Study. Acad Pediatr 2024; 24:486-493. [PMID: 38290573 DOI: 10.1016/j.acap.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Parent-child "shared" reading is a catalyst for development of language and other emergent literacy skills. The American Academy of Pediatrics recommends that parents initiate shared reading as soon as possible after birth. Persistent disparities exist in reading resources, routines, and subsequent literacy outcomes, disproportionately impacting low-income households. We sought to understand beliefs, motivations, and experiences regarding shared reading during early infancy among parents from low-income households. METHODS In this qualitative exploratory study, parents of infants aged 0 to 9 months from low-income households who had initiated shared reading ("readers") and those who had not ("nonreaders") were purposefully recruited to participate in individual semistructured virtual interviews. These interviews were coded using inductive thematic analysis by a 3-member team with diverse backgrounds. RESULTS A total of 21 parents participated (57% readers, 86% mothers). Infants were 86% African American/Black, with a mean age of 3 months. Barriers noted by readers and nonreaders were i) competing demands on time, ii) lack of resources, and iii) parental mental health. An additional barrier noted solely by nonreaders was iv) it's too early/baby is not ready. Two benefits of reading were noted by both groups: 1) parents as child's first teachers and 2) reading catalyzes the child's development. Benefits noted exclusively by readers included 3) reading begets more reading, 4) bonding, 5) "it works," and 6) "two-for-one" shared reading (other children involved). CONCLUSIONS This study provided insights into barriers and benefits regarding shared reading by socioeconomically disadvantaged parents of infants and has the potential to inform reading-related guidance and interventions.
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Affiliation(s)
- Clare C Crosh
- Department of Pediatrics and Academic Medicine (CC Crosh), Advocate Children's Hospital - Oak Lawn, Oak Lawn, Ill.
| | | | - Jais E Valley
- Department of General and Community Pediatrics (JE Valley), Children's National Hospital, Washington, DC
| | | | - Arin Gentry
- College of Arts and Sciences (A Gentry), University of Cincinnati, Cincinnati, Ohio
| | - Mariana Glusman
- Northwestern University Feinberg School of Medicine Section of Primary Care (M Glusman), Chicago, Ill
| | - John S Hutton
- Division of General and Community Pediatrics (JS Hutton and KA Copeland), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics (JS Hutton and KA Copeland), College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Kristen A Copeland
- Division of General and Community Pediatrics (JS Hutton and KA Copeland), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics (JS Hutton and KA Copeland), College of Medicine, University of Cincinnati, Cincinnati, Ohio
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Crosh CC, Koripella A, Elleman C, Foley B, Tumin D, Anyigbo C. Early Literacy Developmental Activities and Pre-Kindergarten Learning Skills in the Context of Childhood Adversity. Acad Pediatr 2024:S1876-2859(24)00005-6. [PMID: 38218215 DOI: 10.1016/j.acap.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/15/2024]
Abstract
OBJECTIVE School readiness (SR) encompasses a wide range of skills that affect children's ability to succeed in school and later in life. Shared reading is an important strategy that assists children in gaining SR skills, whereas adverse childhood experiences (ACEs) negatively affect a child's SR. This study assessed if early literacy developmental activities (shared reading, singing, or storytelling) were associated with improved SR among children with and without ACEs. METHODS 2020-2021 National Survey of Children's Health data were used for analysis. We identified children aged 3-5 years to assess their exposure to ACEs, participation in reading/storytelling/singing, and overall SR. RESULTS In a sample of 17,545 children, 29% of children were exposed to one or more ACEs. Seventy-seven percent of children with no ACEs received daily early literacy developmental activities compared to 23% of children who experienced any ACE. On ordinal logistic regression, daily early literacy developmental activities were associated with 56% greater odds of higher SR among children not exposed to ACEs (OR: 1.56; 95% CI: 1.29, 1.88; P < .01). Among children exposed to ACEs, daily early literacy developmental activities were also associated with higher SR (OR: 1.50; 95% CI: 1.06, 2.13; P = .02). CONCLUSIONS Shared reading, storytelling, and singing are associated with improved SR in both children who have and have not been exposed to ACEs. However, children exposed to ACEs had fewer experiences with early literacy developmental activities. Future efforts should address the barriers that limit shared reading, singing, or storytelling for children exposed to ACEs.
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Affiliation(s)
- Clare C Crosh
- Department of Pediatric Primary Care, Advocate Children's Hospital (CC Crosh), Oak Lawn, Ill
| | - Ananya Koripella
- Brody School of Medicine (A Koripella and D Tumin), East Carolina University, Greenville, NC
| | - Chloe Elleman
- University of Michigan Medical School (C Elleman), Univerasity of Michigan, Ann Arbor, Michigan
| | - Benjamin Foley
- Division of General and Community Pediatrics (B Foley and C Anyigbo), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Dmitry Tumin
- Brody School of Medicine (A Koripella and D Tumin), East Carolina University, Greenville, NC
| | - Chidiogo Anyigbo
- Division of General and Community Pediatrics (B Foley and C Anyigbo), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics (C Anyigbo), College of Medicine, University of Cincinnati, Cincinnati, Ohio.
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Guevara JP, Jimenez ME, Jenssen BP, Luethke M, Doyle R, Buttenheim A. Early Literacy Promotion Using Automated Hovering Among Young Minority Children. Acad Pediatr 2023:S1876-2859(23)00414-X. [PMID: 37956737 DOI: 10.1016/j.acap.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/19/2023] [Accepted: 11/08/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE To determine feasibility, acceptability, and explore outcomes of behavioral economic (BE) strategies to increase parent-child shared reading within a Reach Out and Read program. METHODS We conducted rapid-cycle interviews with 10 parents to assess text messages followed by an 8-week randomized controlled trial of 3 BE strategies at 2 urban primary care practices: daily text messages (texting); daily text messages and regret messaging (regret); or daily text messages, regret messaging, and lottery participation (lottery). Parent-child dyads were eligible if children were <24 months old, Medicaid-eligible, and had access to phones capable of receiving and sending text messages. Parents completed the Read Subscale of the StimQ and Parenting Stress Index-short form (PSI-SF) pre- and postintervention, MacArthur Communicative Development Inventory (CDI), Devereux Early Childhood Assessment (DECA), and a satisfaction measure postintervention. Differences between groups were assessed using intention-to-treat analysis. RESULTS Of 45 dyads randomized, 41 (91%) completed the study. Most participants were Black with incomes <$55,000. Parents reported reading on average 4 d/wk with no change in the reading frequency over time. StimQ scores increased over time, but there were no significant differences in StimQ, PSI-SF, CDI, and DECA scores between groups. Parents in all 3 groups reported satisfaction (3.8/5.0) with the intervention. CONCLUSIONS Implementation of BE strategies in 2 Reach Out and Read programs was feasible, near acceptable, and improved home reading environment scores. Future study should investigate BE strategies vis-à-vis usual care and be of sufficient duration and intensity to engage participants to assess its impact on patient and parent outcomes.
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Affiliation(s)
- James P Guevara
- Division of General Pediatrics (JP Guevara, BP Jenssen, and M Luethke), Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, Philadelphia; Leonard Davis Institute of Health Economics (JP Guevara, BP Jenssen, and A Buttenheim), University of Pennsylvania, Philadelphia; Department of Biostatistics, Epidemiology, and Biostatistics (JP Guevara), Perelman School of Medicine, University of Pennsylvania, Philadelphia.
| | - Manuel E Jimenez
- Department of Pediatrics (ME Jimenez), Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Brian P Jenssen
- Division of General Pediatrics (JP Guevara, BP Jenssen, and M Luethke), Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, Philadelphia; Leonard Davis Institute of Health Economics (JP Guevara, BP Jenssen, and A Buttenheim), University of Pennsylvania, Philadelphia
| | - Michael Luethke
- Division of General Pediatrics (JP Guevara, BP Jenssen, and M Luethke), Roberts Center for Pediatric Research, Children's Hospital of Philadelphia, Philadelphia
| | - Rebecca Doyle
- Department of Family and Community Health (R Doyle and A Buttenheim), School of Nursing, University of Pennsylvania, Philadelphia
| | - Alison Buttenheim
- Leonard Davis Institute of Health Economics (JP Guevara, BP Jenssen, and A Buttenheim), University of Pennsylvania, Philadelphia; Department of Family and Community Health (R Doyle and A Buttenheim), School of Nursing, University of Pennsylvania, Philadelphia
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Hutton JS, Huang G, Crosh C, DeWitt T, Ittenbach RF. Shared reading with infants: SharePR a novel measure of shared reading quality. Pediatr Res 2023; 93:976-984. [PMID: 35854086 DOI: 10.1038/s41390-022-02178-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The AAP recommends "shared" reading from early infancy for healthy development. However, many families are uncertain how to read most enjoyably and effectively with infants, especially from underserved backgrounds. Shared reading quality (interactivity) moderates benefits yet is challenging to measure. SHARE/STEP is a new model of shared reading quality at this age incorporating evidence-based behaviors. OBJECTIVE To test the SharePR parent-report measure of caregiver-infant reading quality. METHODS This study involved mother-infant dyads in two unrelated trials in an obstetric (0-2 months old) and pediatric (6-9 months old) clinic. SharePR is a 10-item measure based on the SHARE/STEP model. Analyses involved descriptive statistics, measures of psychometric integrity, and correlations with home literacy environment (HLE). RESULTS There were 99 dyads in the younger (1.2 + 0.5 months) and 108 dyads in the older groups (6.6 + 1.1 months). A majority were of non-white race (73%, 96%) and low-socioeconomic status (56%, 44% in-poverty). SharePR administration time was under 2 min and scores were normally distributed at each age. Psychometric properties were strong in terms of internal consistency and reliability. Scores were positively correlated with HLE for the older group (p < 0.05). CONCLUSIONS SharePR may be an efficient tool to quantify shared reading quality with infants, warranting further investigation. CLINICAL TRIALS Data for these analyses were collected via two unrelated trials led by the lead author (J.S.H.). For the younger cohort, this is registered on the ClinicalTrials.gov website, ID# NCT04031235. For the older cohort, this is registered on the ClinicalTrials.gov website, ID# 2017-6856. IMPACT The AAP recommends caregiver-child ("shared") reading beginning in infancy, yet many families are uncertain how to do so. Verbal and social-emotional interactivity during shared reading ("quality") moderates benefits and is often low in families from disadvantaged backgrounds, yet is challenging to measure. SharePR is a 10-item parent-report measure of shared reading quality based on a novel conceptual model incorporating evidence-based behaviors (SHARE/STEP). SharePR exhibited promising psychometric properties in two separate samples of mothers of younger and older infants. SharePR is a potentially useful measure of shared reading quality at this formative age, for research and to frame early reading guidance.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Guixia Huang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Clare Crosh
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Richard F Ittenbach
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Choi Y, Uthirasamy N, Córdoba D, Morrow LM, Perez-Cortes S, Ramachandran U, Pai S, Lima D, Shelton PA, Jimenez ME. Feasibility and Acceptability of an Online Family Literacy Program in an Under-Resourced Community During the COVID-19 Pandemic. J Dev Behav Pediatr 2023; 44:e104-e110. [PMID: 36750983 PMCID: PMC9930163 DOI: 10.1097/dbp.0000000000001155] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/12/2022] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The objective of this study was to examine the feasibility and acceptability of an online family literacy program (FLP) among low-income Latino families during the COVID-19 pandemic. METHODS We conducted a mixed methods pilot study. Latino parent-child dyads participated in an 8-week online FLP conducted on video conferencing software, developed through a cross-sector health care-education partnership. We conducted surveys and structured observation to assess feasibility and acceptability and in-depth interviews to gain insight into the context of participants' experiences during the pandemic. RESULTS The 35 participating parent-child dyads all identified as Latino, 83% reported limited English proficiency, and 60% of parents did not achieve a high school diploma. Nearly two-thirds of families participated in at least half of the sessions. On average, parents welcomed, liked, approved, and found the program appealing. While 86% experienced a technology problem at least once during sessions, all were resolved with minimal assistance. During qualitative interviews, we identified 3 themes that provide insight into their experiences with the FLP within the broader context of the pandemic: (1) disruption in family routine and financial strain caused by COVID-19 intensified family stress, (2) the forced transition to remote learning highlighted the inequities experienced by Latino preschool children, and (3) the FLP empowered parents and enhanced health and education experiences. CONCLUSION Latino families had high participation levels in an online FLP and found it acceptable. Additional work is needed to understand how similar primary care programs can be leveraged to promote optimal development during a time of heightened need.
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Affiliation(s)
- Yewoon Choi
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Nila Uthirasamy
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - David Córdoba
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Lesley Mandel Morrow
- Graduate School of Education, Rutgers University-New Brunswick, 10 Seminary Place, New Brunswick, NJ 08901
| | - Silvia Perez-Cortes
- The Department of World Languages and Cultures, 405-407 Cooper Street Camden, NJ
| | - Usha Ramachandran
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Shilpa Pai
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Daniel Lima
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Patricia A. Shelton
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Manuel E. Jimenez
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
- The Child Health Institute of New Jersey, 89 French St New Brunswick, NJ, 08901
- Children’s Specialized Hospital, 200 Somerset Street New Brunswick, NJ 08901
- The Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
- Boggs Center On Developmental Disabilities, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
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Guevara JP, Erkoboni D, Gerdes M, Winston S, Sands D, Rogers K, Haecker T, Jimenez ME, Mendelsohn AL. Promoting Early Literacy Using Digital Devices: A Pilot Randomized Controlled Trial. Acad Pediatr 2021; 21:1001-1008. [PMID: 34022425 DOI: 10.1016/j.acap.2021.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/17/2021] [Accepted: 05/12/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine feasibility and explore effects of literacy promotion using e-books versus board books on the home reading environment, book reading, television use, and child development. METHODS Randomized controlled trial comparing digital literacy promotion (DLP) using e-books to standard literacy promotion (SLP) using board books among Medicaid-eligible infants. DLP participants received e-books on home digital devices, while SLP participants received board books at well visits between 6 and 12 months of age. Differences in StimQ Read Subscale (StimQ-Read) scores, parent-reported reading and television use, and Bayley Scales of Infant Development-3rd Edition (Bayley-3) scores between groups were assessed using intention-to-treat analysis. RESULTS A total of 104 Medicaid-eligible infants were enrolled and randomized from 3 pediatric practices. There were no differences in sociodemographic characteristics between groups at baseline. Children in the DLP group initially had lower StimQ-Read scores but showed similar increases in StimQ-Read scores over time as children in the SLP group. Parents in the DLP group reported greater use of digital devices to read or engage their child (65% vs 23%, P < .001) but similar board book reading and television viewing. There were no differences between groups in cognitive or motor scale scores, but DLP participants had marginally lower language scales scores (DLP 85.7 vs SLP 89.7; P = .10) at the 6-month follow-up. CONCLUSIONS/DISCUSSION Literacy promotion using e-books was feasible and associated with greater e-book usage but no difference in board book reading, television viewing, or home reading environment scores. A potential adverse impact of e-books on language development should be confirmed in future study.
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Affiliation(s)
- James P Guevara
- Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at Penn, Roberts Center for Pediatric Research (JP Guevara, D Erkoboni, and M Gerdes), Philadelphia, Pa.
| | - Danielle Erkoboni
- Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at Penn, Roberts Center for Pediatric Research (JP Guevara, D Erkoboni, and M Gerdes), Philadelphia, Pa
| | - Marsha Gerdes
- Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at Penn, Roberts Center for Pediatric Research (JP Guevara, D Erkoboni, and M Gerdes), Philadelphia, Pa
| | - Sherry Winston
- Department of Pediatrics, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research (S Winston and D Sands), Philadelphia, Pa
| | - Danielle Sands
- Department of Pediatrics, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research (S Winston and D Sands), Philadelphia, Pa
| | - Kirsten Rogers
- Reach Out and Read Greater Philadelphia, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research (K Rogers), Philadelphia, Pa
| | - Trude Haecker
- Department of Pediatrics, Reach Out and Read Greater Philadelphia, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research (T Haecker), Philadelphia, Pa
| | - Manuel E Jimenez
- Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, Child Health Institute of New Jersey (ME Jimenez), New Brunswick, NJ
| | - Alan L Mendelsohn
- Departments of Pediatrics and Population Health, New York University School of Medicine (AL Mendelsohn), New York, NY
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Jimenez ME, Crabtree BF, Hudson SV, Mendelsohn AL, Lima D, Shelton PA, Veras J, Lin Y, Pellerano M, Morrow L, Strom BL. Enhancing Reach Out and Read With a Video and Text Messages: A Randomized Trial in a Low-Income Predominantly Latino Sample. Acad Pediatr 2021; 21:968-976. [PMID: 33618060 PMCID: PMC8349760 DOI: 10.1016/j.acap.2021.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the effect of adding a video and text messages to Reach Out and Read (ROR) on parent-reported literacy activities compared to the standard version. STUDY DESIGN We conducted a mixed methods hybrid type I effectiveness-implementation randomized trial in a community health center that serves low-income Latino families. We assessed shared reading frequency and the StimQ Reading subscale, at enrollment and 6-month follow-up and the StimQ Parent Verbal Responsivity subscale, Parent Reading Belief Inventory, and Survey of Wellbeing of Young Children-Milestones at follow-up. We randomized 160 parent-child dyads to ROR or ROR plus video and text messages (enhanced ROR). We collected process data on ROR and engagement with texts. We interviewed 15 enhanced ROR participants. We analyzed quantitative data using regression and qualitative data using immersion/crystallization. RESULTS One hundred thirty-seven parent-child dyads completed the study (87% Latino, mean child age 9 months). We found differences in the StimQ Reading subscale (B = 0.32; P = .034) and marginal differences in attitudes about reading favoring enhanced ROR. Between-group differences for shared reading frequency, verbal responsivity, and developmental delay were not significant. Qualitative themes provided insight into the enhanced ROR including how it encouraged parents, remaining barriers like competing priorities and lack of social support, and unanticipated benefits (ie, parent appreciation for attention on their families' wellbeing). CONCLUSIONS A video and text message enhancement to ROR resulted in modest improvements in the home literacy environment over ROR alone. Additional strategies are needed to overcome potent barriers faced by low-income families.
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Affiliation(s)
- Manuel E Jimenez
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (ME Jimenez, D Lima, and PA Shelton), New Brunswick, NJ; Boggs Center on Developmental Disabilities, Rutgers Robert Wood Johnson Medical School (ME Jimenez), New Brunswick, NJ; Child Health Institute of New Jersey, Rutgers Robert Wood Johnson Medical School (ME Jimenez), New Brunswick, NJ; Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School (ME Jimenez, BF Crabtree, SV Hudson, and M Pellerano), New Brunswick, NJ; Children's Specialized Hospital (ME Jimenez), New Brunswick, NJ.
| | - Benjamin F Crabtree
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School (ME Jimenez, BF Crabtree, SV Hudson, and M Pellerano), New Brunswick, NJ
| | - Shawna V Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School (ME Jimenez, BF Crabtree, SV Hudson, and M Pellerano), New Brunswick, NJ
| | | | - Daniel Lima
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (ME Jimenez, D Lima, and PA Shelton), New Brunswick, NJ
| | - Patricia A Shelton
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (ME Jimenez, D Lima, and PA Shelton), New Brunswick, NJ
| | - Julissa Veras
- School of Medicine and Dentistry University of Rochester (J Veras), Rochester, NY
| | - Yong Lin
- Rutgers School of Public Health (Y Lin), Piscataway, NJ
| | - Maria Pellerano
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School (ME Jimenez, BF Crabtree, SV Hudson, and M Pellerano), New Brunswick, NJ
| | - Lesley Morrow
- Rutgers Graduate School of Education (L Morrow), New Brunswick, NJ
| | - Brian L Strom
- Rutgers Biomedical Health Sciences (BL Strom), Newark, NJ
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Exploratory Qualitative Analysis of Early Literacy Engagement in Latinx Parents of a Child With a Cleft. J Craniofac Surg 2021; 32:1817-1821. [PMID: 34319683 DOI: 10.1097/scs.0000000000007550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Literacy interventions are needed for children born with orofacial clefts, particularly for Latinx children who may experience multiple risk factors. To collect formative data for intervention design, focus groups and interviews were completed with 18 Latinx parents of children ages 13 to 49 months with orofacial clefts. Interviews focused on literacy experiences and practices. Six themes were identified through inductive qualitative analysis: child reading skills were highly valued; parents were motivated to improve on their childhood reading experiences; bilingualism was a goal for all parents; parents noted challenges in building child reading skills; reading engagement was broadly defined; and impact of cleft diagnosis was wide-reaching. Implications for intervention include a bilingual strength-based approach incorporating cleft-specific speech concerns, play, parallel online programming, behavioral strategies, and social support options. Use of telephone and online intervention with mailed materials can also help address family resource and time limitations.
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Kinney JE, Jimenez ME, Mandel Morrow L, Pai S. Training Pediatric Residents in Literacy Promotion: Residency Directors' Perspectives. TEACHING AND LEARNING IN MEDICINE 2020; 32:45-52. [PMID: 31002003 DOI: 10.1080/10401334.2019.1598866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Phenomenon: The American Academy of Pediatrics and Canadian Pediatric Society recommend that pediatricians incorporate literacy promotion during well child care, but literacy promotion education during pediatric training remains understudied. We sought to understand how literacy promotion training is currently implemented in pediatric residency programs from the perspective of program directors. Approach: We conducted semistructured interviews with all 9 residency program directors in 1 state. We analyzed data iteratively coding transcripts using an immersion/crystallization approach to identify themes. Findings: We achieved saturation after 9 interviews with 11 participants. We identified 3 major themes: (a) Residency programs rely on an existing primary-care-based literacy promotion intervention (Reach Out and Read) and the resident continuity clinic for literacy promotion training; (b) program directors encourage early and repeated exposure to facilitate literacy promotion education; and (c) service obligations, content specifications, and pressure on faculty create competing time demands that function as key barriers to literacy promotion training. Insights: Residency program directors used an existing, widely used intervention and the infrastructure provided by continuity clinics to facilitate training on literacy promotion, a relatively new pediatric care standard. Additional work is needed to overcome the barriers identified by program directors.
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Affiliation(s)
- Joanna Elizabeth Kinney
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Manuel E Jimenez
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Lesley Mandel Morrow
- Rutgers University Graduate School of Education, Rutgers University, New Brunswick, New Jersey, USA
| | - Shilpa Pai
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
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12
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Jimenez ME, Crabtree BF, Veras J, Shelton PA, Mendelsohn AL, Mackie TI, Guevara JP, Pellerano M, Lima D, Hudson SV. Latino Parents' Experiences With Literacy Promotion in Primary Care: Facilitators and Barriers. Acad Pediatr 2020; 20:1177-1183. [PMID: 32795690 PMCID: PMC7655684 DOI: 10.1016/j.acap.2020.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 07/27/2020] [Accepted: 08/06/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Literacy promotion is a pediatric standard of care in which clinicians provide guidance on shared reading. Latino parents are more likely to hear advice to read with children but are less likely to do so. We sought to understand literacy promotion from the perspective of Latino parents and to identify facilitators and barriers. METHODS We purposively sampled Latino parents who participated in Reach Out and Read (ROR) for a qualitative, semistructured interview study. We identified themes using immersion/crystallization and achieved thematic saturation after 21 interviews. RESULTS Two thirds of participants had less than high school education; half of whom had not completed eighth grade. The mean child age was 16.4 months. Primary facilitators of engagement were advice from a pediatrician during a clinical encounter and receipt of the ROR book. Barriers identified included: 1) parents' perceptions that their children were not developmentally ready and that their children's behavior (eg, activity) indicated they were not interested in shared reading; 2) self-perceived limited literacy and/or English proficiency; 3) parenting demands occurring in the context of poverty; and 4) continued child media use despite advice from pediatricians to choose alternate activities such as shared reading instead. CONCLUSIONS Parent-clinician relationships are central to ROR's impact but clinicians need to pay more attention to factors in a child's broader environment to strengthen literacy promotion. Specifically clinicians should emphasize skill building during the clinical encounter (eg, sharing knowledge about child development and modeling) and work collaboratively with other stakeholders to address poverty-related stressors.
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Affiliation(s)
- Manuel E. Jimenez
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854;,Boggs Center on Developmental Disabilities, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854;,Child Health Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854;,Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854;,Children’s Specialized Hospital, 200 Somerset St. New Brunswick, NJ 08901
| | - Benjamin F. Crabtree
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Julissa Veras
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Patricia A. Shelton
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Alan L. Mendelsohn
- Department of Pediatrics, New York University School of Medicine/Bellevue Hospital Center, 462 First Avenue, New York, NY 10016
| | - Thomas I. Mackie
- Rutgers School of Public Health, 683 Hoes Ln W, Piscataway, NJ 08854
| | - James P. Guevara
- Department of Pediatrics, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd. Philadelphia, PA 19104
| | - Maria Pellerano
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Daniel Lima
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Shawna V. Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
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