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Maximizing the impact of reach out and read literacy promotion:anticipatory guidance and modeling

Pediatric Research (2023)Cite this article

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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Data availability

Deidentified quantitative data and associated documentation may be made available to interested readers conducting non-profit research consistent with National Institutes of Health policy through the establishment of data sharing agreements. The timeline for release of data will be after the study is completed and main study findings from the final data set are published in peer-reviewed journals. De-identified data will be made available to researchers from accredited institutions who provide a methodologically sound proposal for use in achieving the goals of the approved proposal.

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Acknowledgements

The authors thank the families and clinicians who participated in the study, and Nikki Shearman, PhD, for her helpful comments on a draft of this manuscript.

Funding

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD099125), the National Center for Advancing Translational Sciences (UL1TR003017), the US Department of Health and Human Services/Health Resources and Service Administration (U3DMD32755), and the Robert Wood Johnson Foundation (74260). The content is solely the responsibility of the authors and does not necessarily represent the official views of these organizations.

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Authors and Affiliations

  1. Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Manuel E. Jimenez, Nila Uthirasamy, Keanaan Malke, Daniel Lima & Usha Ramachandran

  2. Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Manuel E. Jimenez, Jennifer R. Hemler, Alicja Bator, Benjamin F. Crabtree & Shawna V. Hudson

  3. Children’s Specialized Hospital, New Brunswick, NJ, USA

    Manuel E. Jimenez

  4. Rutgers School of Public Health, New Brunswick, NJ, USA

    Pamela Ohman Strickland

  5. Department of Health Policy and Management, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA

    Thomas I. Mackie

  6. NYU Grossman School of Medicine, New York, NY, USA

    Alan L. Mendelsohn

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Contributions

All authors meet ICJME criteria for authorship as follows: M.E.J., N.U. and J.R.H. contributed to the conceptualization and design of the research, the acquisition and interpretation of data, and the draft and revision of the manuscript. A.B. contributed to the extraction and interpretation of data, revision of data tables, and the draft and revision of the manuscript. K.M. and D.L. contributed to acquisition and interpretation of data, revision of data tables, and revision of the manuscript. B.F.C., T.I.M., A.L.M., P.O.S., U.R. and S.V.H. contributed to the conceptualization and design of the research, interpretation of data, and critical review and revision of the manuscript. The publication of the work described is approved by all authors. All authors approved the final manuscript and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Manuel E. Jimenez.

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Competing interests

The authors have no conflicts of interest to disclose. Findings were presented in part at the 2023 Pediatric Academic Societies Meeting in Washington, DC.

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Jimenez, M.E., Uthirasamy, N., Hemler, J.R. et al. Maximizing the impact of reach out and read literacy promotion:anticipatory guidance and modeling. Pediatr Res (2023). https://doi.org/10.1038/s41390-023-02945-z

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