A Book a Day Keeps the Doctor Away: A Look at the Implementation and Effects of Reach Out and Read, a Pediatric Clinic-Based Early Literacy Promotion Program

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Publication year

1999

study description

Cross-sectional, quasi-experimental study.

core topic(s)

Reach Out and Read (ROR)

Population Characteristics

Poverty/Low-Income , Race, Ethnicity, and Culture

Exposures, Outcomes, Other

Home Language/Literacy/Learning Environment , Implementation and Evaluation , Parent Behaviors and Skills , Parent Knowledge, Attitudes, and Beliefs , Play , Provider Behaviors and Skills

objectives

To examine the effects of Reach Out and Read (ROR) on the literacy beliefs and behaviors of caretakers of children ages 9 to 60 months. Doctors' beliefs about literacy and parent behavior were also examined.

exposure

Reach Out and Read (ROR).

outcomes evaluated

Literacy beliefs and behaviors of parents and providers.

setting

Three clinics were identified, one participating in the ROR program, and two that did not. All three clinics serve mostly a low-income multiracial population that was over 50% Latino.

methods

Extensive structured interviews consisting of open-ended as well as scaled questions were conducted with parents of children between 9 and 60 months attending a well child check and with several of the doctors who conducted these well child checks. Interviews were then audiotaped, transcribed, and coded for analysis. Children over the age of 2 years 10 months were administered a standardized emergent literacy measure in their native language.

sample size

ROR Clinic (n=1): n=22 (caretakers); n=5 (doctors) | Non-ROR Clinics (n=2): n=15 (caretakers); n=2 (doctors)

measures

Measure of Beliefs and Behaviors: Interview including 60-items that assessed demographics, children’s play activities, parents’ knowledge and attitudes about literacy, literacy practices at home, and beliefs about the patient-doctor relationship.

 

Measure of Emergent Literacy: children over the age of 2 years 10 months were administered a standardized emergent literacy measure in their native language.

results

At least 85% of the caregivers were the mothers of the children involved. Findings suggested thar ROR caregivers accepted an expanded definition of the parent/doctor social contract, one that included doctors fiving advice about literacy practices, and that ROR caregivers were more likely than non-ROR caregivers to name doctors as a source of information about literacy. Doctors and caregivers had different ideas of what constituted literacy, but had similar ideas about parent responsibilities with regard to literacy. Findings also revealed inconsistencies in doctors' literacy knowledge, awareness of parent practices, and implementation of the program.

conclusions

Considering the growing number of Reach Out and Read sites and the increasing numbers of families and children being reached by the program, it is critical to continue to evaluate how this program can be made more effective.

limitations

The study was cross-sectional and did not measure literacy practices pre- and post-treatment. Although the control group was equivalent to the experimental group in educational level and self-rated language and literacy skills, it was a non-randomized study and therefore there was no true control group to measure the intervention's effects. The number of families interviewed provided rich qualitative data but were not numerous enough to provide substantial statistical power in the analysis. The low number of doctors interviewed provided rich qualitative data but did not allow for statistical analysis. Additionally, home literacy practices and well child check up visits were not observed as part of the study and therefore, our results are based on parent and doctor self-report of literacy beliefs, behaviors, and advice.