Linking Literacy Programs in Pediatric Primary Care to the Community through Partnership with Public Libraries

• In Event: 2-155 - Leveraging Healthcare for Population-Level Prevention of Disparities in Child Development: Linking Across Services and Platforms

Integrative Statement

Delays in language and early literacy disproportionately impact children from low-socioeconomic status (SES) households (Duncan & Brooks-Gunn, 2000), contributing to income-related disparities in school readiness and later academic achievement, and making evidence-based interventions aimed to address these disparities critical. Such interventions, however, have faced difficulty in implementing and scaling due to barriers, such as transportation, time, and childcare, that prevent low-SES families from engaging (Kerkorian et al., 2006). Thus, programs that are likely to have the most impact are those that take place at times and places convenient for parents. Recognizing this, a citywide initiative—City’s First Readers—was initiated to link early literacy programs across platforms, including Reach Out and Read (ROR) in pediatric primary care, a universal access point for low-income families, and the public library system as a community hub for literacy activities and access to print materials (citysfirstreaders.com).

English- and Spanish-speaking mothers with children 0-42 months (n=98) were recruited from pediatric clinics serving primarily low-income and immigrant families. Families received pediatrics-based literacy programs at each well-child visit: 1) Reach Out and Read (ROR): provides books and anticipatory guidance about reading, 2) Video Interaction Project (VIP): interventionist provides a toy/book, videotapes a parent-child interaction, and reviews responsive parenting behaviors exhibited. VIP interventionists also provided families with library cards, told them about library programs in their area, and signed up families up for text message reminders about upcoming literacy events. Interviews assessing demographic and SES characteristics, knowledge and use of literacy programs in the clinic and community, and home literacy activities (StimQ; Mendelsohn et al, 1999) were conducted at baseline (before families had received VIP), with a subsample completing initial follow-up assessments three months later. Two year follow-up interviews are ongoing.

VIP interventionists provided 67 library cards to 42 families in Year 1, and 49 library cards to 25 families in Year 2. ANCOVA analyses of baseline StimQ scores, controlling for child age, indicated that families who received ROR and utilized library resources scored higher on subscales measuring reading frequency, F(2,89)=4.62, p<.05, reading diversity, F(2,87)=7.44, p<.01, reading interaction quality, F(2,89)=4.75, p<.05 (Figure 1). Preliminary paired sample t-tests indicated significant increases at 3 months in overall StimQ reading scores, t=-3.16, p<.01 as well as for reading diversity, t=-2.39, p<.05 and reading quality, t=-3.24, p<.01 for families of infants (<18 months; n=15; Figure 2).

Pediatric primary care is a promising platform for interventions aimed at reducing income-related disparities in child development, and this study provides further evidence for the positive impacts of ROR as one such program. Linking these interventions to community resources has the potential for even greater impact, as it provides access to services and materials in multiple convenient locations and times. The present study provides initial support for this approach, indicating that families who utilize these programs engage in more frequent and more meaningful literacy interactions at home, and underscores the importance of programs that begin in early infancy—promotion of parent-child interactions may be especially beneficial for later language and literacy skills when it begins early.

Authors

• Caitlin Canfield, NY UMC
  Presenting Author

• Erin Roby, NYU School of Medicine
  Non-Presenting Author

• Catherine Workman, NYU School of Medicine
  Non-Presenting Author

• Anne Seery, NYU School of Medicine
  Non-Presenting Author

• Shari Levine, Literacy Inc
  Non-Presenting Author

• Alan L. Mendelsohn, New York University School of Medicine
  Non-Presenting Author