Early Literacy Research Library (ELRL) - Article

Encouraging Parent–Child Book Sharing: Potential Additive Benefits of Literacy Promotion in Health Care and the Community

Canfield, C. et al. (2020) Encouraging Parent–Child Book Sharing: Potential Additive Benefits of Literacy Promotion in Health Care and the Community. Early Childhood Research Quarterly, 50(1), 221-229.,

Access: Institutional Access

Publication year


study description

Cross-sectional, correlational analysis.

core topic(s)

Reach Out and Read (ROR)

Population Characteristics

Infant/Newborn , Poverty/Low-Income , Toddler/Preschool , Urban

Exposures, Outcomes, Other

Community , Disparity/Adversity , Language and Literacy Development , Libraries and Public Resources , Parent Behaviors and Skills , Parent-Child Relationships/Interactions


The current study examined the impact of a program aimed at promoting language and literacy activities in the home and based in pediatric healthcare, Reach Out and Read (ROR), on parents’ use of community resources that also provide access to print—namely, the public library—in the context of a citywide initiative to link literacy resources for low-income families.


Reach Out and Read (ROR).

outcomes evaluated

Parents use of reading resources and home reading behaviors.


Two urban pediatric clinics, one in a large public hospital, and one at a smaller federally qualified community health center (FQHC). Both were sites of the CFR initiative in which families received ROR and employees were able to provide library cards for interested families.


Effects of both ROR and the library, both individually and combined, on parents’ literacy activities at home were then examined.

sample size

n=98 (children and their primary caregiver)


Measure of Parental Reading Behaviors: yes/no interview questions about the following topics:

    • Literacy programs in the clinic, like ROR: have they received a book, guidance, or support from health care providers or volunteers.
    • Literacy resources in the community, like the public library: have they visited the library with their child, check out books for their child, child participated in library programs, and used library as an adult (internet, classes/workshops, adult books).
    • Home environment including literacy activities in the home: used READ subscale of StimQ Cognitive Home Environment assessment to assess frequency of caregiver-child book sharing, book sharing routines, types of books read, and the quality of book sharing interactions.


Significant associations between receiving ROR, using the public library, and parent–child book sharing were found.


Implications for intervention and policy are discussed.


Because this is a cross-sectional analysis, we cannot make causal inferences. For instance, parents who read more may be more likely to remember their pediatrician speaking with them about reading, rather than the pediatrician’s advice making reading more likely. The exclusive use of parent report may also be problematic because of other biases, including social desirability. The present study only looked at linkages between two platforms—ROR and the library—and might have missed other impacts related to CFR more broadly...Additional follow-up evaluation is currently underway to evaluate the effects of ROR, library programs, and more explicit links between them on parents behavior in the short-and medium-term, as well as whether reinforcing and supportive messaging and resources across additional CFR programs will create greater impacts. Future studies should also examine the quality of this messaging, both by assessing the guidance provided by health care staff in ROR, as well as evaluating access to services and programs (e.g., librarian helpfulness, signage) and program messaging within the library. The sample in the present study was largely Latinx, and thus, these findings may not generalize to other populations. For instance, families in the current study may face additional real or perceived barriers to using the library, including language and immigrant status...Future research with more diverse low-income samples can provide additional information on the impact of early literacy programming across platforms, providing a more complete analysis of programs aimed to address income-related gaps in early literacy and school readiness.