Early Literacy Research Library (ELRL) - Article

Clinician Perceptions on Literacy Promotion in Pediatric Continuity Clinics

Erickson, E., et al. (2022) Clinician Perceptions on Literacy Promotion in Pediatric Continuity Clinics. Academic Pediatrics, 22(7), 1192-1199.,

Access: Institutional Access

Publication year


study description

Anonymous cross-sectional national survey.

core topic(s)

Reach Out and Read (ROR)

Population Characteristics

Medicaid , Medical Providers , Medical Trainees , Urban

Exposures, Outcomes, Other

Medical Training/Education , Provider Knowledge, Attitudes, and Beliefs


We describe literacy promotion (LP) perceptions of pediatric and internal medicine/pediatrics residents and faculty and determine the relationship between LP training and perceptions of LP. Reach Out and Read (ROR) is a widely implemented evidence-based literacy promotion (LP) intervention. Recent data have shown that there is variability in both LP training for pediatric residents and implementation of ROR. However, little is known about the perceptions regarding LP and the relationship with training.


Reach Out and Read (ROR).

outcomes evaluated

Literacy promotion perceptions.


Pediatric residency programs providing education at more than 120 individual clinics, most located in an urban setting. The patients served by the respondents were mostly insured by Medicaid. Ninety-nine percent of respondents reported that their clinic currently implements ROR.


Faculty and residents at participating sites completed an anonymous online survey on LP perceptions and training. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression modeling.

sample size

n=473 (faculty); n=1216 (residents); n=42 (training programs)


Measure of LP and ROR Training, Experience, and Perceptions: anonymous electronic REDCap survey to capture data on: participant and site demographics, LP training, the perceived influence of various training modalities, adherence to the ROR model, other ROR experiences (such as fundraising and volunteering), perceptions regarding early literacy efforts, and knowledge regarding ROR.


A total of 473 faculty and 1216 residents at 42 pediatric training programs participated. Faculty versus resident status was a significant predictor of almost all perception questions. Most faculty (65.3%) and residents (44.3%) completely agreed that it is the job of pediatricians to assess and encourage reading (P < .0001). Most faculty (69.6%) and residents (51.5%) completely agreed that LP is as important as advice about car seats, bike helmets, and “back-to-sleep” (P < .0001). More faculty (65.8%) than residents (46.6%) completely agreed with the statement “discussing sharing books with children at health supervision visits can be an effective early intervention strategy” (P < .0001). More faculty (34%) compared to residents (18.2%) completely agreed they felt confident modeling reading for parents during the visit (P < .0001).


Faculty status predicted most favorable LP perceptions, while continuity clinic training and learning in-clinic from others predicted some favorable LP perceptions.


It was an anonymous electronic survey sent and answered via a common survey link. Thus, there is the possibility that a respondent could have responded more than once to this survey via the link. Additionally, adjustments for multiple comparisons were not made. Our study only assessed LP perceptions and LP training among residents and faculty within pediatric continuity clinics. Thus, our findings may not be generalizable to other groups of pediatric clinicians (eg, fellows, subspecialists, and those in nonacademic practices). Further, our study assessed a small number of LP perceptions; future studies will need to assess a broader range of attitudes, such as those that pertain to early parent/caregiver-child relationships.