Link to full text: https://www.nature.com/articles/s41372-022-01539-7
Access: Institutional Access
study descriptionQualitative / Prospective
core topic(s)Early Literacy , Shared Reading
Population CharacteristicsInfant/Newborn , Medical Providers , Medical Trainees , Neonatal/NICU , Urban
Exposures, Outcomes, OtherHome Language/Literacy/Learning Environment , Parent Behaviors and Skills , Parent Knowledge, Attitudes, and Beliefs , Provider Behaviors and Skills , Provider Knowledge, Attitudes, and Beliefs , Reading Frequency
objectivesThis study sought to evaluate attitudes about shared reading, explore parent and staff literacy environments at home and in the NICU, assess which characteristics influence shared reading frequency, and to identify barriers.
exposureReading frequency/duration and shared reading
outcomes evaluatedParental reading attitudes and barriers to reading in the NICU
settingMothers of NICU infants enrolled from a single urban Level IV NICU between May and October 2021.
methodsSurveys were developed by content experts and piloted before circulation. A convenience sample of mothers were approached and consented before discharge. Participants used a 5-point Likert scale to report attitudes about reading in the NICU. Participants were asked to provide free text responses to questions assessing barriers to reading in the NICU. Two analysts performed thematic analysis of free text responses to identify barriers to reading in the NICU. Chi-squared tests were used to evaluate the relationship between demographics, home literacy environment, and other characteristics with frequency of reading and support given in the NICU.
sample sizen=45 (mothers); n=57 (staff: nurses, advanced practice providers, residents, fellows, and attendings)
- Measure of Maternal Perceptions: survey, including 5-point Likert scale and free text questions, about demographics, reading behaviors, and attitudes and barriers around reading in the NICU.
- Measure of Staff Perceptions: survey, including 5-point Likert scale and free text questions, about demographics, reading behaviors, and attitudes and barriers around promoting reading in the NICU.
resultsForty percent of mothers reported reading to their infants in the NICU. Mothers reported reading at bedside on average 3.2 days/week. Thirty-three percent of mothers reported that someone from the medical team spoke with them about shared reading while 47% reported other members of staff, such as CLS or social work, spoke to them about reading. Whether the medical team (p = 0.008) or SW/CLS (p = 0.033) had spoken to mothers about reading had a significant positive association with whether mothers read to their infants. Eighty-five percent of mothers would have read to their infants during their stay if provided with books. Ninety-six percent of medical staff and 98% of mothers believed reading to babies in the NICU could improve infant language and development, and 98% of staff and 91% of mothers believed that reading could help mothers feel more bonded to their baby.
conclusionsMothers are more likely to read to their NICU babies if they receive guidance from staff. The barriers to reading as perceived by mothers and staff had overlapping themes, including concerns about NICU environment suitability, patient fragility and sleep protection. Formal education is needed to overcome barriers and support reading.
limitationsOur study was limited by sample size, and lack of fathers and non-English speakers. Mothers who responded to our survey may differ from those who did not respond. Mothers who were available at the bedside for enrollment may differ from those who weren’t.