Link to full text: https://journals.sagepub.com/doi/pdf/10.1177/14687984231212722
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Download the full text: Stone_2023
study descriptionQualitative study
core topic(s)Early Literacy , Pediatric Primary Care , Reach Out and Read (ROR) , Shared Reading
Population CharacteristicsMedical Providers , Urban
Exposures, Outcomes, OtherAnticipatory Guidance , Community , Implementation and Evaluation , Parent-Child Relationships/Interactions , Reading Frequency
objectivesThe primary objective of this study was to explore clinic group culture surrounding Reach Out and Read (ROR) at a pediatric clinic recognized as successful in ROR implementation.
outcomes evaluatedAnalyzing clinic group culture through semi-structured interviews regarding staff perceptions and feelings surrounding ROR
settingPediatric Primary Care
methodsIn examining clinic group culture, we worked alongside a ROR regional representative and a pediatrician spearheading effective ROR implementation. Together, we developed a semi-structured interview protocol to delve into staff perceptions and sentiments regarding ROR. Subsequently, we conducted these interviews with twelve non-physician staff members within the pediatrician's clinic.
sample size12 clinic staff members
resultsA two-phase grounded theory analysis revealed an ingroup/outgroup relationship that created two distinct cultural groups related to ROR. Participants described themselves as ingroup members and the patients receiving ROR as outgroup members. The ingroup included community organizations, doctors, and study participants, working together to give books and information to parents and medical students, who made up the outgroup
conclusionsThis study reveals how book-gifting initiatives like Reach Out and Read (ROR) can unintentionally create 'us and them' dynamics. Examining non-physician staff perspectives in a pediatric clinic, it underscores cultural nuances impacting ROR implementation. Recognizing these dynamics is crucial to prevent discrimination as these initiatives expand. As ROR advocates aim for an "equity lens," acknowledging literacy advocacy complexities becomes vital, aligning with calls to explore structural inequities through diverse methods.
limitationsThis study has several limitations. Firstly, the data were collected from a single site. Secondly, information was exclusively obtained through individual interviews with 12 volunteer participants, likely motivated by their interest in ROR. Thirdly, member checks involved research partners instead of individual participants. Fourthly, recruitment materials positively highlighted ROR, potentially affecting participants' inclination to associate with the program and possibly discouraging staff not involved in ROR from participating. Additionally, each interview emphasized the characteristics of ROR, and the blend of celebratory language and the emphasized importance of ROR factors may have introduced a desirability bias influencing participants' interview responses (Brewer and Gardner, 1996).