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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Connor Garbe M, Bond SL, Boulware C, Merrifield C, Ramos-Hardy T, Dunlap M, Caldwell A, Shearman N, Miller-Fitzwater A. The Effect of Exposure to Reach Out and Read on Shared Reading Behaviors. Acad Pediatr 2023; 23:1598-1604. [PMID: 37391093 DOI: 10.1016/j.acap.2023.06.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Caregiver-child shared reading improves literacy skills, school readiness, familial relationships, and social-emotional development. This multiyear study seeks to evaluate the effect of exposure to Reach Out and Read (ROR) on caregiver reading frequency and behaviors. METHODS Caregivers of children 6 months to 5 years in 427 primary care clinics in North and South Carolina were asked to complete the Reach Out and Read Parent Feedback Survey. Caregivers not previously exposed to ROR were categorized as "new," and those who had previously been exposed to ROR as "returning" to compare reading behaviors between groups. RESULTS From 2014 to 2019, caregivers completed 100,656 surveys. Returning caregivers were more likely to report reading or looking at books every day (adjusted odds ratio [AOR] = 1.27; 95% confidence interval [95% CI], 1.22-1.33). Returning caregivers were more likely to perform behaviors like letting the child turn pages (AOR = 1.71; 95% CI, 1.62-1.79), making up stories about the pictures (AOR = 1.46; 95% CI, 1.39-1.53), asking what is happening in the pictures (AOR = 1.39; 95% CI, 1.32-1.47), helping identify things in the pictures (AOR = 1.57; 95% CI, 1.50-1.65), reading to the child 30 minutes every day (AOR = 1.39; 95% CI, 1.33-1.46), and taking the child to the library (AOR = 1.26; 95% CI, 1.20-1.34). CONCLUSIONS This study shows a significant association between caregivers' exposure to ROR, high-frequency reading, and positive reading behaviors, and is consistent for all 6 years studied.retain-->.
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Affiliation(s)
- M Connor Garbe
- Department of Pediatrics (M Connor Garbe, M Dunlap, and A Caldwell), Section of General and Community Pediatrics, University of Oklahoma Health Sciences Center.
| | - Sally L Bond
- The Program Evaluation Group, LLC (SL Bond), Pittsboro, NC
| | - Callee Boulware
- Reach Out and Read, Inc (C Boulware, C Merrifield, T Ramos-Hardy, and N Shearman), Boston, Mass
| | - Carolyn Merrifield
- Reach Out and Read, Inc (C Boulware, C Merrifield, T Ramos-Hardy, and N Shearman), Boston, Mass
| | - Teandra Ramos-Hardy
- Reach Out and Read, Inc (C Boulware, C Merrifield, T Ramos-Hardy, and N Shearman), Boston, Mass
| | - Marny Dunlap
- Department of Pediatrics (M Connor Garbe, M Dunlap, and A Caldwell), Section of General and Community Pediatrics, University of Oklahoma Health Sciences Center
| | - Alexandria Caldwell
- Department of Pediatrics (M Connor Garbe, M Dunlap, and A Caldwell), Section of General and Community Pediatrics, University of Oklahoma Health Sciences Center
| | - Nikki Shearman
- Reach Out and Read, Inc (C Boulware, C Merrifield, T Ramos-Hardy, and N Shearman), Boston, Mass
| | - Anna Miller-Fitzwater
- Wake Forest School of Medicine (A Miller-Fitzwater), Bowman Gray Center for Medical Education, Winston-Salem, NC
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Uthirasamy N, Reddy M, Hemler JR, Devine KA, Cordoba D, Pai S, Ramachandran U, Mackie TI, Jimenez ME. Reach Out and Read Implementation: A Scoping Review. Acad Pediatr 2023; 23:520-549. [PMID: 36464156 PMCID: PMC10149560 DOI: 10.1016/j.acap.2022.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/18/2022] [Accepted: 11/19/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Reach Out and Read (ROR) is an evidence-based literacy promotion intervention that leverages the near-universal access to children of primary care practices to promote optimal child development. While several studies document ROR's effectiveness, its implementation remains understudied. OBJECTIVE This scoping review examines the existing literature to better understand ROR implementation. DATA SOURCES PubMed, ERIC, Web of Science, Academic Search Premier, ProQuest Education Database, and CINAHL. STUDY SELECTION We included peer-reviewed English-language papers focusing on ROR in an ambulatory setting in North America. DATA EXTRACTION Extracted variables were informed by the Template for Intervention Description and Replication checklist and included publication year, title, author(s), clinic location, study design, study aim, ROR implementation, modifications, implementation assessment, barriers, facilitators, and outcomes. RESULTS Seventy-one papers were included, of which 43 were research articles. We identified substantial variation in ROR implementation including differences in components delivered. A considerable number of research articles did not assess ROR implementation. The most common barriers to ROR implementation were at the system level (ie, financing and inadequate time). Modifications and enhancements to ROR are emerging; most address barriers at the clinician and family level. LIMITATIONS This review was limited to published English language papers focusing on ROR. CONCLUSIONS ROR implementation varies across studies, and many did not assess implementation. Consistent reporting and assessment of ROR implementation could create opportunities to better understand the mechanisms underlying ROR's effects and inform other early childhood interventions that seek to promote optimal development at the population level.
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Affiliation(s)
- Nila Uthirasamy
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (N Uthirasamy, KA Devine, D Cordobaa, S Pai, U Ramachandran, and ME Jimenez), Piscataway, NJ
| | - Mayuri Reddy
- Rutgers New Jersey Medical School (M Reddy), Newark, NJ
| | - Jennifer R Hemler
- Department of Family Medicine and Community Health, Research Division, Rutgers Robert Wood Johnson Medical School (JR Hemler and ME Jimenez), New Brunswick, NJ
| | - Katie A Devine
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (N Uthirasamy, KA Devine, D Cordobaa, S Pai, U Ramachandran, and ME Jimenez), Piscataway, NJ; Rutgers Cancer Institute of New Jersey (KA Devine), New Brunswick, NJ
| | - David Cordoba
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (N Uthirasamy, KA Devine, D Cordobaa, S Pai, U Ramachandran, and ME Jimenez), Piscataway, NJ
| | - Shilpa Pai
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (N Uthirasamy, KA Devine, D Cordobaa, S Pai, U Ramachandran, and ME Jimenez), Piscataway, NJ
| | - Usha Ramachandran
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (N Uthirasamy, KA Devine, D Cordobaa, S Pai, U Ramachandran, and ME Jimenez), Piscataway, NJ
| | - Thomas I Mackie
- Department of Health Policy and Management, School of Public Health, SUNY Downstate Health Sciences University (TI Mackie), Brooklyn, NY
| | - Manuel E Jimenez
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (N Uthirasamy, KA Devine, D Cordobaa, S Pai, U Ramachandran, and ME Jimenez), Piscataway, NJ; Department of Family Medicine and Community Health, Research Division, Rutgers Robert Wood Johnson Medical School (JR Hemler and ME Jimenez), New Brunswick, NJ; Children's Specialized Hospital (ME Jimenez), New Brunswick, NJ.
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Jimenez ME, Hemler JR, Uthirasamy N, Bator A, Forbes DH, Lucas M, Ramachandran U, Crabtree BF, Mackie TI. A Mixed-Methods Investigation Examining Site-Level Variation in Reach Out and Read Implementation. Acad Pediatr 2022:S1876-2859(22)00574-5. [PMID: 36496152 DOI: 10.1016/j.acap.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Reach Out and Read (ROR) is an evidence-based early childhood intervention that has been implemented at scale, yet description of ROR implementation is inconsistent. This study engages implementation science to examine ROR delivery and site-level variation. METHODS As part of an ongoing clinical trial, we conducted a mixed-methods study in 3 community health centers (CHCs) that serve low-income Latino families. We integrated quantitative parent survey data, qualitative data from monthly key informant interviews with ROR site leaders over 1 year, and in-depth interviews with 18 additional clinicians. At enrollment, parents reported whether they received a children's book, guidance on reading, and modeling from clinicians. We analyzed quantitative data using descriptive statistics, and qualitative data iteratively engaging emergent and a priori codes drawn from the Template for Intervention Description and Replication Checklist. RESULTS Three hundred Latino parents (mean age: 31; 75% ≤HS education) completed surveys. The mean child age was 8 months. Overall, most parents reported receiving a book (84%) and guidance (73%), but fewer experienced modeling (23%). Components parents received varied across CHCs. Two themes emerged to explain the variation observed: 1) differences in the perceived purpose of shared reading and book delivery aligned with variation in implementation, and 2) site-level barriers affected what components were implemented. CONCLUSION Because of substantive variation in ROR implementation across sites, systematic descriptions using established frameworks and corresponding measurement to characterize ROR implementation may enhance our understanding of mechanisms underlying ROR's effects, which clinicians and policymakers can use to maximize ROR's impact.
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Affiliation(s)
- Manuel E Jimenez
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (ME Jimenez and U Ramachandran), New Brunswick, NJ; Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School (ME Jimenez, JR Hemler, N Uthirasamy, A Bator, and BF Crabtree), New Brunswick, NJ; Children's Specialized Hospital (ME Jimenez), New Brunswick, NJ.
| | - Jennifer R Hemler
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School (ME Jimenez, JR Hemler, N Uthirasamy, A Bator, and BF Crabtree), New Brunswick, NJ
| | - Nila Uthirasamy
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School (ME Jimenez, JR Hemler, N Uthirasamy, A Bator, and BF Crabtree), New Brunswick, NJ
| | - Alicja Bator
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School (ME Jimenez, JR Hemler, N Uthirasamy, A Bator, and BF Crabtree), New Brunswick, NJ
| | - Darlene H Forbes
- Department of Pediatrics, Jewish Renaissance Medical Center (DH Forbes), Perth Amboy, NJ
| | - Michael Lucas
- Saint Peters University Hospital Pediatric Faculty Group (M Lucas), New Brunswick, NJ
| | - Usha Ramachandran
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School (ME Jimenez and U Ramachandran), New Brunswick, NJ; Department of Pediatrics, Eric B. Chandler Health Center (U Ramachandran), New Brunswick, NJ
| | - Benjamin F Crabtree
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School (ME Jimenez, JR Hemler, N Uthirasamy, A Bator, and BF Crabtree), New Brunswick, NJ
| | - Thomas I Mackie
- Department of Health Policy and Management, SUNY Downstate Health Sciences University (TI Mackie), Brooklyn, NY
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Crosh CC, Barsella A, Van Slambrouck L, Notario PM, Li Y, Parsons AA, Hutton JS. Exploratory Mixed-Methods Study of a Primary Care-Based Intervention Promoting Shared Reading During Infancy. Clin Pediatr (Phila) 2022; 61:475-484. [PMID: 35383480 DOI: 10.1177/00099228221085825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Parent-child "shared" reading can be a rich source of language exposure. Clinic-based programs, notably Reach Out and Read (ROR), are intended to enhance this. However, ROR has been traditionally introduced at 6 months and only recently expanded to younger ages. This study explored efficacy of an intervention delivered during pediatric well visits promoting shared reading prior to 6 months old, in terms of home reading attitudes and routines. The intervention group received children's books and anticipatory guidance about benefits of shared reading, whereas the control group received general age-related anticipatory guidance. Surveys were administered at the child's newborn (pre-intervention) and 6-month (post-intervention) well visits. Significant findings at 6 months included more frequent shared reading (P = .03), greater comfort reading at this age (P = .01), and greater importance attributed to shared reading (P = .04) in the intervention group relative to controls. These support the expansion of early literacy interventions such as ROR into early infancy.
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Affiliation(s)
- Clare C Crosh
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Adam Barsella
- Advocate Children's Hospital-Oak Lawn, Oak Lawn, IL, USA
| | | | | | - Yi Li
- Advocate Aurora Research Institute, Downers Grove, IL, USA
| | - Allison A Parsons
- Division of Critical Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - 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.,University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Daniels D, Wolter-Warmerdam K, Holland S, Hickey F. Reach Out and Read Implementation in a Pediatric Down Syndrome Clinic. J Pediatr Health Care 2022; 36:231-239. [PMID: 34879985 DOI: 10.1016/j.pedhc.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION To examine the first Reach Out and Read (ROR) program in a pediatric Down syndrome (DS) clinic in the United States and the literacy behaviors of young children with DS and their families. METHOD This is a large cohort (n = 747) review of children with DS participating in ROR and a family literacy survey (n = 209). Data from the electronic medical records were included. RESULT On average, children with DS began independently reading at 6.15 years (standard deviation = 1.42). Overall, 36.7% of children with visual/audio impairments required additional encouragement. Time spent reading was impacted by the mother's education level. Differences were found among ROR participants with DS for reported favorite activity. DISCUSSION ROR is an important clinic-based literacy program for children with DS. Children with DS attain independent reading abilities similar to typically developing peers when provided appropriate resources. Additional support is needed to encourage reading enjoyment in this population.
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Hutton JS, Huang G, Wiley C, DeWitt T, Ittenbach RF. Randomized Trial of a Mobile App Introduced During Well-Visits to Enhance Guidance for Reading With Young Children. Acad Pediatr 2021; 21:977-987. [PMID: 34020099 DOI: 10.1016/j.acap.2021.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/28/2021] [Accepted: 05/12/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To estimate feasibility, usability and efficacy of a mobile parenting app (Rx for Success; RxS) to enhance reading guidance provided to parents of young children during well-visits. METHODS This trial was conducted at a clinic serving primarily families of Hispanic ethnicity and low-socioeconomic status (SES) where Reach Out and Read (ROR) is standard practice. It involved 252 parent-child dyads in 2 age groups (~6-months old, ~18-months old) randomized during well-visits to receive RxS or a children's book modeling alternatives to screen time (Control) by research coordinators. RxS involves videos, activities and "push" messages. Follow-up assessments were conducted approximately 6 months later, including impression and use, shared reading behaviors, child language and screen time. RESULTS A total of 217 dyads completed both visits (110 RxS, 107 Control). Time to introduce RxS was under 3 minutes and 32% of parents experienced largely minor performance issues. Parent impression of RxS was favorable for both age groups at baseline and follow-up, though use was infrequent, attributable to a desire for more relevant and updated content. Significant findings favoring RxS included shared reading as a favorite activity, more frequent shared reading reported at 12 months and higher language scores at 24 months. Screen time was equivalent between cohorts, exceeding American Academy of Pediatrics guidelines. CONCLUSIONS A mobile app introduced to parents of young children from low-SES backgrounds was feasible during well-visits, rated as helpful, and effective to enhance shared reading at younger and language at older ages. While a potentially impactful enhancement to ROR, features needing improvement were identified.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio.
| | - Guixia Huang
- Division of Biostatistics and Epidemiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (G Huang and RF Ittenbach), Cincinnati, Ohio
| | - Catherine Wiley
- Community Health Center at Connecticut Children's Hospital (C Wiley), Hartford, Conn
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio
| | - Richard F Ittenbach
- Division of Biostatistics and Epidemiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (G Huang and RF Ittenbach), Cincinnati, Ohio
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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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Kindratt T, Bernard B, Webb J, Pagels P. Parent-provider paediatric literacy communication: A curriculum for future primary care providers. Perspect Med Educ 2019; 8:110-117. [PMID: 30912005 PMCID: PMC6468016 DOI: 10.1007/s40037-019-0503-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Reach Out and Read promotes early literacy and school readiness by incorporating book delivery and anticipatory guidance into well-child visits. There is a need to train future healthcare providers in the knowledge and skills to communicate with parents/caregivers about early childhood literacy. We developed and evaluated a curriculum to improve learners' knowledge, attitudes, and skills towards the incorporation of parent-provider literacy communication into well-child visits. METHODS Family medicine residents (n = 30), physician assistant students (n = 36), and medical students (n = 28) participated in a curriculum consisting of service learning, online didactic training, objective structured clinical exams (OSCEs) and a debriefing session. Standardized patients (SPs; 6 months to 5 years) and standardized patient caregivers were recruited and trained. Learners were evaluated on their abilities to offer books to patients, provide anticipatory guidance, and demonstrate parent-provider communication skills. Knowledge, attitudes, and satisfaction were collected pre- and post-curriculum. RESULTS Significant increases in total knowledge were observed after completing curriculum activities (p < 0.001). All attitudes improved after training (p < 0.05). All learners (100%) recommended that caregivers talk back and forth with their 6‑ to 12-month-old babies and make eye contact. Few (18.2%) learners recommended playing games like 'peek-a-boo' while reading. When caregivers evaluated learners' basic parent-provider communication skills, all reported that the learners treated them with respect and used plain language. DISCUSSION Our curriculum extends beyond previous studies by measuring recommended books, anticipatory guidance, and communication skills using paediatric SPs and standardized patient caregivers. Curriculum activities can be tailored to best promote parent-provider literacy communication training in other programs.
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Affiliation(s)
- Tiffany Kindratt
- Department of Physician Assistant Studies, University of Texas Southwestern Medical Center, School of Health Professions, Dallas, TX, USA.
| | | | | | - Patti Pagels
- Community Health Section, Department of Family and Community Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
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Abstract
Attendance at well-child visits (WCVs) is a sine qua non of preventive care. We hypothesized that Reach Out and Read (ROR) would be associated with better WCV attendance. Parents of children 76 to 72 months at 8 clinics who did not yet have ROR reported how many WCVs their child had attended in the previous year; separate samples at the same clinics were interviewed 16 months after the ROR program was instituted. Comparing 267 parents before ROR and 254 after, the percentage who had attended the minimum number of WCVs required by the American Academy of Pediatrics periodicity schedule rose from 67.4% (180/267) to 78.3% (199/254; P < .01). This difference remained significant after controlling for multiple potential confounding factors (estimated odds ratio = 2.1, 95% confidence interval = 1.3-3.5). The largest differences were among Latino children and children of less-educated parents. Programs to enhance early literacy may increase attendance at WCVs among at-risk families.
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Affiliation(s)
| | - Benard P Dreyer
- 2 New York University, New York, NY, USA
- 3 Bellevue Hospital Center, New York, NY, USA
| | - Perri Klass
- 2 New York University, New York, NY, USA
- 3 Bellevue Hospital Center, New York, NY, USA
| | - Alan L Mendelsohn
- 2 New York University, New York, NY, USA
- 3 Bellevue Hospital Center, New York, NY, USA
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Abstract
Literacy promotion (LP) is an essential component of primary care. This study explored different LP strategies in 2 cohorts of children aged 6 months to 6 years coming for routine care. In cohort 1 (N = 24), LP consisted mainly of advice. In cohort 2 (C2, N = 21), LP prioritized observing parent-child dyads reading aloud and giving feedback. Parents were interviewed 1 to 2 weeks later. LP took longer in C2 (138 ± 66 seconds vs 73 ± 50, P < .001), and parents were more likely to recall having learned about reading aloud (48% vs 8%, P < .001), even after controlling for time spent. More parents in C2 reported uncertainty about their reading aloud skills (73% vs 22%, P < .002) and a desire to learn more about reading aloud (100% vs 17%, P < .001). Observation and feedback may make LP more memorable to parents and is more likely to motivate parents to improve their skills in this area.
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Affiliation(s)
- Robert Needlman
- 1 Case Western Reserve University, Cleveland, OH, USA.,2 MetroHealth Medical Center, Cleveland, OH, USA
| | - Zaeem Lone
- 2 MetroHealth Medical Center, Cleveland, OH, USA.,3 Johns Hopkins University, Baltimore, MD, USA
| | - Ryan Chae
- 2 MetroHealth Medical Center, Cleveland, OH, USA.,4 University of Cincinnati, Cincinnati, OH, USA
| | - Neelab Abdullah
- 2 MetroHealth Medical Center, Cleveland, OH, USA.,5 Baldwin Wallace College, Berea, OH, USA
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Abstract
A considerable percentage of American children and adults fail to learn adequate literacy skills and read below a third grade level. Shared book reading is perhaps the single most important activity to prepare young children for success in reading. The primary objective of this manuscript was to critically review the methodological quality of Read Out and Read (ROR), a clinically based literacy program/intervention that teaches parents strategies to incorporate while sharing books with children as a method of preventing reading difficulties and academic struggles. A PubMed search was conducted. Articles that met three criteria were considered. First, the study must be clinically based and include parent contact with a pediatrician. Second, parental counseling ("anticipatory guidance") about the importance of parent-child book reading must be included. Third, only experimental or quasi-experimental studies were included; no additional criteria were used. Published articles from any year and peer-reviewed journal were considered. Study quality was determined using a modified version of the Downs and Black (1998) checklist assessing four categories: (1) Reporting, (2) External Validity, (3) Internal Validity-Bias, and (4) Internal Validity-Confounding. We were also interested in whether quality differed based on study design, children's age, sample size, and study outcome. Eleven studies met the inclusion criteria. The overall quality of evidence was variable across all studies; Reporting and External Validity categories were relatively strong while methodological concerns were found in the area of internal validity. Quality scores differed on the four study characteristics. Implications related to clinical practice and future studies are discussed.
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