Literacy promotion for Hispanic Families in a Primary Care Setting: A Randomized, Controlled Trial

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Publication year

1998

study description

Prospective, randomized, controlled study.

core topic(s)

Reach Out and Read (ROR)

Population Characteristics

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

Exposures, Outcomes, Other

Child Behaviors and Skills , Home Routines , Language and Literacy Development , Parent Behaviors and Skills , Play

metric(s)

MacArthur-Bates Communicative Development Inventories (MB-CDI)

objectives

To evaluate a program of anticipatory guidance in which pediatric residents and nurse practitioners in a continuity practice gave parents books for their young children along with developmentally appropriate educational materials describing why and how to share the books and promoting reading as part of a bedtime routine.

exposure

Reach Out and Read (ROR)

outcomes evaluated

Parent-child reading and literacy behaviors.

setting

Two urban community based health centers serving a low-income and multiethnic population.

methods

We conducted a prospective, randomized, controlled study to evaluate the effectiveness of a literacy promoting intervention delivered to low-income Hispanic families with infants. We consecutively enrolled 135 low-income Hispanic parents of healthy 5 to 11 month old infants. Families were randomly assigned to an intervention (n = 65) or control (n = 70) group. At enrollment and at two consecutive well-child visits, pediatricians gave intervention families: 1) an age-appropriate bilingual children's book, 2) a bilingual handout explaining the benefits of reading to children, and 3) literacy-promoting anticipatory guidance. Ten months after enrollment we reinterviewed 130 parents.

sample size

n=65 (intervention); n=70 (control); n=135 (total); n=52 (exit interviews); n=130 (reinterviews)

measures

Measure of Literacy Behavior: 55 item interview with 15 literacy questions among other questions about children’s play, sleep, and television habits; primary outcomes assessed were:

• • number of days per week parent reads books with their child.
  • reported parental enjoyment of sharing books with the child.
  • number of children’s books and total books in the home.

Measure of Child Expressive and Receptive Language: Spanish version of the short forms of the MacArthur Communicative Development Inventories.

results

Both groups were comparable at baseline. At follow-up, intervention parents were more likely to read books with their child at least 3 days/week (intervention = 66% vs control parents = 24%) and to report that reading books was one of their three most favorite things to do with their child (intervention = 43% vs controls = 13%). Intervention families also had a greater number of children's books and total books at home. Using a multiple logistic regression model, controlling for child and parental age, reading habits, and English proficiency, we found that the odds of parents reading to their child at least 3 days/week were 10 times greater in intervention families (OR 10.1, 95% CI 4.0-25.6) compared with control families.

conclusions

This simple, culturally appropriate intervention significantly increased literacy behaviors in low-income Hispanic families.

limitations

A major limitation of our study is that all dependent measures were obtained by parental report and that because of the young age of the children at follow-up, a measure of their language skills could not be obtained by direct testing using a standardized and validated instrument. Future studies that include home visitation with direct counts of books and the administration of standardized language testing of the children directly may provide more objective data to support our findings....A longer follow-up also is needed to determine whether reading books to Hispanic children starting at a very young age will influence their later reading abilities, language skills, and overall school achievement. Nonetheless, these data indicate that pediatricians should take advantage of well-child visits as a unique opportunity to counsel high-risk parents about the enjoyment and benefits of reading to their young child.