Latino Parents' Experiences With Literacy Promotion in Primary Care: Facilitators and Barriers

Links between booksharing and early vocabulary development in Costa Rica

Early vocabulary development is crucial for future cognitive and academic outcomes, and parent-child booksharing has been recognized as a powerful home literacy practice to promote word learning. However, evidence about the link between booksharing and language development in diverse cultural and socioeconomic settings is currently limited, hindering the formulation of a broadly applicable framework to understand the favorable conditions for early vocabulary development. This study explores the relationship between booksharing and early receptive and expressive vocabulary in a sample of 183 mothers and their toddlers in Costa Rica, a context where reading is not a common practice and children have limited access to books. Mothers completed an interview about their booksharing practices and reported children's receptive and expressive vocabulary. Results demonstrated a positive link between maternal booksharing and children's expressive vocabulary. Child gender moderated the link between booksharing and receptive vocabulary, exhibiting a stronger association in girls than in boys. Mothers with lower education levels reported higher expressive vocabulary scores for their children than mothers with higher education levels. These findings underscore the significance of booksharing in the home literacy environment, even in cultural contexts with distinct reading practices. Moreover, they highlight the need to incorporate sociocultural factors into comprehensive accounts concerning the role of booksharing in early word learning.

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

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.

Reach Out and Read Implementation: A Scoping Review

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.

Ready and Healthy for Kindergarten: A Bilingual Family Literacy Program in Primary Care

PURPOSE

To describe the development and pilot testing of a bilingual family literacy program (FLP) for dual language learners entering kindergarten implemented in a Federally Qualified Health Center (FQHC).

DESCRIPTION

The Ready and Healthy for Kindergarten program is an English-Spanish bilingual FLP that uses four parent and pediatrician-prioritized health topics to introduce early English literacy skills to families and promote health behaviors that are important for school readiness while encouraging maintenance of Spanish. We developed an FLP manual, conducted a 16-week single-arm pilot study, and modified the FLP based on family feedback and observation.

ASSESSMENT

We recruited 14 parent-child dyads for the pilot through clinician referral. All participating parents identified as Hispanic/Latino and 86% reported limited English proficiency. Two-thirds had less than a high school education. Seventy-one percent of families attended more than half of the sessions. Parents rated the FLP as highly acceptable. During implementation, we made substantive changes to the FLP including increasing the focus on promoting bilingualism, encouraging all participants to share their experiences with the health topics, helping parents identify literacy activities embedded in their daily health routines (e.g., lullabies), and distributing information on health resources.

CONCLUSION

We developed and implemented an innovative bilingual FLP in an FQHC that was well-attended and acceptable to families. The FLP has the potential to be replicated in other primary care sites and our findings lay the groundwork for future studies on how to best leverage healthcare settings to promote equity in school readiness.