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Pediatrics
By Jimenez ME, Hemler JR, Strickland PO and 16 others.
To test 2 strategies designed to enhance primary care-based literacy promotion (LP): (1) text message reminders (texts), and (2) texts plus referral to community resources.
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We recruited 630 Latino caregiver-infant (aged 6 to 12 months) dyads for an effectiveness-implementation hybrid type 1 randomized trial. Dyads were randomly assigned into (1) LP-only (Reach Out and Read), (2) LP plus text messages (LP+texts), or (3) LP+texts plus referral to Connecting New Jersey (CNJ) (LP+texts+CNJ), which streamlines access to community resources based on the national Help Me Grow model. Participants completed online surveys and assessments at enrollment, and 9 and 18 months after enrollment. Primary outcomes focused on 3 domains: child language and social-emotional development, and parenting behaviors, including reading and verbal responsiveness. We followed the intent-to-treat principle and used step-down minimum P value method to adjust for multiple comparisons.
Among caregivers, 74% had less than or equal to a high school diploma and 88% reported speaking English less than very well. At 18 months after enrollment, the LP+text arm [effect size (ES) = 0.391; adjusted (adj.) P = .001] but not LP+text+CNJ had higher language scores compared with LP-only. At 9 and 18 months after enrollment, the LP plus texts plus CNJ arm had higher scores on social-emotional development than LP-only (ES = 0.267; adj. P = .04 and ES = 0.300; adj. P = .03, respectively), whereas the LP+text arm did not. At 9 months after enrollment, scores were higher for the LP+text+CNJ arm on verbal responsiveness (ES = 0.400; adj. P < .001) and the LP+text arm on reading (ES = 0.415; adj. P = .002) compared with LP-only.
Two strategies with high potential for scale enhanced LP's ability to promote relational and developmental health. Clinicians and policymakers can use this knowledge to optimize LP's impact.
Published in Pediatrics. The abstract is shown as published and remains the work of its authors; read the full article at the source.
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