Abstract
Objective
Reach Out and Read (ROR) is an evidence-based early childhood intervention that has
been implemented at scale, yet description of ROR implementation is inconsistent.
This study engages implementation science to examine ROR delivery and site-level variation.
Methods
As part of an ongoing clinical trial, we conducted a mixed-methods study in 3 community
health centers (CHCs) that serve low-income Latino families. We integrated quantitative
parent survey data, qualitative data from monthly key informant interviews with ROR
site leaders over 1 year, and in-depth interviews with 18 additional clinicians. At
enrollment, parents reported whether they received a children's book, guidance on
reading, and modeling from clinicians. We analyzed quantitative data using descriptive
statistics, and qualitative data iteratively engaging emergent and a priori codes
drawn from the Template for Intervention Description and Replication Checklist.
Results
Three hundred Latino parents (mean age: 31; 75% ≤HS education) completed surveys.
The mean child age was 8 months. Overall, most parents reported receiving a book (84%)
and guidance (73%), but fewer experienced modeling (23%). Components parents received
varied across CHCs. Two themes emerged to explain the variation observed: 1) differences
in the perceived purpose of shared reading and book delivery aligned with variation
in implementation, and 2) site-level barriers affected what components were implemented.
Conclusion
Because of substantive variation in ROR implementation across sites, systematic descriptions
using established frameworks and corresponding measurement to characterize ROR implementation
may enhance our understanding of mechanisms underlying ROR's effects, which clinicians
and policymakers can use to maximize ROR's impact.
Keywords
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Article info
Publication history
Published online: December 07, 2022
Accepted:
November 30,
2022
Received:
September 6,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report no conflicts of interest, financial or otherwise, in the production of this manuscript. This manuscript or parts of this manuscript have not been published elsewhere.
Identification
Copyright
Copyright © 2022 by Academic Pediatric Association
