Reach Out and Read and developmental screening: using federal dollars through a health services initiative

Oklahoma established the first health services initiative (HSI) to expand Reach Out and Read (ROR), increase developmental screening and improve the quality of well-child visits (Early and Periodic Screening, Diagnostic and Treatment (EPSDT)). ROR uses a book in the exam room to assess development and parent-child interaction, however, little is known about the relationship between this training and using a formal developmental screening tool. The purpose of this study is to see if using federal funding would facilitate ROR expansion and if this expansion would improve developmental screening and EPSDT visits in Oklahoma. Medicaid billing data for state fiscal year (SFY) 2018 and 2019 were analyzed. Standard statistical methods were used to analyze the data descriptively to determine the proportion of developmental screenings performed and EPSDT visits. Comparisons were made between ROR and non-ROR sites. Nine new ROR sites were added with 26 new providers/staff and 130 providers/staff at existing sites trained in ROR from Novenber 2018 to June 2019. In SFY 2018, the developmental screening percentage at non-ROR sites was 33% vs 47% at ROR sites (p<0.0001), in SFY 2019 non-ROR sites were 36% vs 48% at ROR sites (p<0.0001). The EPSDT visit percentage in SFY 2018 was 50% at non-ROR sites vs 69% at ROR sites and in SFY 2019 was 51% at non-ROR sites vs 72% at ROR sites. HSIs are an effective way to fund ROR. Additional funding allowed for increased ROR sites and training. ROR sites are more likely to perform developmental screenings and EPSDT visits.

Do Book Giveaway Programs Promote the Home Literacy Environment and Children’s Literacy-Related Behavior and Skills?

Book giveaway programs provide free books to families with infants to encourage caregivers to begin reading to their children during infancy. This meta-analysis of 44 studies retrieved from 43 articles tests the effects of three major book giveaway programs: Bookstart (n = 11), Reach Out and Read (n = 18), and Imagination Library (n = 15). Effect sizes were aggregated within two domains—home literacy environment and literacy-related behavior and skills—before being averaged across studies. The findings corroborate the assumption that book giveaway programs promote children’s home literacy environment (d = 0.31, 95% CI [0.23, 0.38], k = 30), which subsequently results in more interest in reading and children scoring higher on measures of literacy-related skills prior to and during the early years of school (d = 0.29, 95% CI [0.23, 0.35], k = 23).

Attendance at Well-Child Visits After Reach Out and Read

Attendance at well-child visits (WCVs) is a sine qua non of preventive care. We hypothesized that Reach Out and Read (ROR) would be associated with better WCV attendance. Parents of children 76 to 72 months at 8 clinics who did not yet have ROR reported how many WCVs their child had attended in the previous year; separate samples at the same clinics were interviewed 16 months after the ROR program was instituted. Comparing 267 parents before ROR and 254 after, the percentage who had attended the minimum number of WCVs required by the American Academy of Pediatrics periodicity schedule rose from 67.4% (180/267) to 78.3% (199/254; P < .01). This difference remained significant after controlling for multiple potential confounding factors (estimated odds ratio = 2.1, 95% confidence interval = 1.3-3.5). The largest differences were among Latino children and children of less-educated parents. Programs to enhance early literacy may increase attendance at WCVs among at-risk families.

Evaluation of a Language and Literacy Enhancement Program

Reading aloud to children encourages language development. Pediatricians promote reading practices through Reach Out and Read (ROR) and other methods. This exploratory study sought to examine the value that supplemental materials promoting “Touch, Talk, Read, Play” (TTRP) might provide in addition to ROR. This study was a pre- and postintervention design to assess response to the TTRP curriculum. Caregivers of children ages 12 to 24 months completed the communication portion of the Ages and Stages Questionnaire–Third Edition and a Literacy Education Survey to assess current literacy practices. The caregiver and child were then introduced to the TTRP materials. Data were obtained on 98 subjects preintervention with follow-up data collected on 30 participants 6 months later. Significant differences were found in the Ages and Stages Questionnaire scores and parent-reported importance of reading and conversing frequently with their child. TTRP provides an effective curriculum for literacy promotion in a ROR program.