Access: Institutional Access
study descriptionExploratory qualitative analysis via cross-sectional survey.
core topic(s)Reach Out and Read (ROR)
Population CharacteristicsMedical Providers , Medical Trainees
Exposures, Outcomes, OtherImplementation and Evaluation , Medical Training/Education , Provider Behaviors and Skills , Provider Knowledge, Attitudes, and Beliefs
objectivesTo understand clinician experiences of implementing ROR.
exposureReach Out and Read (ROR).
outcomes evaluatedProvider training and experiences with ROR.
settingPediatric residency programs participating in APA Continuity Research Network (CORNET), a network comprised of 123 pediatric residency programs across the United States and representing more than 6000 trainees providing care for over 1 million pediatric patients.
methodsThis study was a collaboration between ROR and the Academic Pediatric Association's Continuity Research Network. Participants completed an anonymous online survey to evaluate Literacy Promotion activities and training, and were asked “What has been the most meaningful experience you have encountered with using ROR?” and “Is there anything else you would like to add?” Responses were evaluated by researchers and 4 themes were generated through discussion. All responses were divided and coded by researchers working in pairs and subsequently by all researchers until consensus was reached. Data were organized into themes.
sample sizen=473 (faculty and 1216 residents); n=42 (residency programs represented)
Measure of Training and Experience: survey about participant and site demographics, LP training, the perceived influence of various training modalities on practice, adherence to the ROR model, other ROR experiences, perceptions regarding early literacy efforts, and knowledge regarding ROR, including two open ended survey questions:
- “What has been the most meaningful experience you have encountered with using Reach Out and Read?”
- “Is there anything else you would like to add?”
resultsResponses were provided by 592 (35%) participants. Qualitative analysis revealed benefits to participation in ROR within 4 themes: 1) Child/Family Impact (60%): “Seeing a child read for the first time” 2) Physician Impact (16%): “I... use the books... to connect with patients.” 3) Impact on clinic practice (25%): “I... enjoy modeling for parents and use the books to assess... development” 4) Social Determinants of Health (2%): “The books... are an invaluable resource to our under-served population.”
conclusionsClinicians who implement ROR report positive impact on patients, families, and their own satisfaction and methods in practice. Clinicians value that the program addresses social determinants of health and facilitates developmental surveillance. Further study is needed to understand how clinician's perspectives affect and are affected by their experiences.
limitationsFirst, data from this study were initially collected with the intention of understanding LP training and practices, and the association between training modalities and these practices at a national level. As such, the phrasing of the free text questions at the end of the survey was not targeted specifically at assessing clinician experience and clinic impact of implementation of ROR. Additionally, these questions were phrased in a way that may have unintentionally elicited more positive responses... Additionally, these data were collected via anonymous survey without the ability to ask follow-up questions, which could have to led richer and more in-depth exploration of clinician experience and the themes discussed in our analysis. Third, a common link for the survey was used, which may have permitted participants to respond more than once; using individual survey links would have avoided this problem. Lastly, this was a study of pediatric continuity clinic faculty and residents associated with pediatric residency training programs and may not apply to other populations such as those in private practice and other nonacademic clinical sites. Similar surveys directed to these health professionals would be useful.