Doctors and nurses influence low-income families to read more books

A new study in the current issue of the Archives of Pediatric Adolescent Medicine shows that low-income parents of toddlers read to their children more often after receiving children's books and reading-promotion handouts from residents and nurses during well-child checkups.

PROVIDENCE, R.I. -- When pediatric residents and nurses promote literacy with low-income families, parents read to their children more often, says a new study in the Archives of Pediatric Adolescent Medicine.

Because reading failure unequally affects children from disadvantaged families, the study suggests that primary care providers have a unique opportunity to encourage greater literacy in these at-risk groups.

"If messages come through a physician that you, your child, books and book-sharing are valued, then families feel the message strongly," said Pamela High, M.D., clinical associate professor of pediatrics in the Brown University School of Medicine. High and colleagues conducted the study at a primary-care pediatric clinic in Hasbro Children's Hospital, Providence, R.I.

The researchers interviewed families who visited the clinic for regular well-child checkups. One control group of 51 Hispanic, black or white low-income parents of healthy children 12- to 38-months of age was interviewed before the clinic began a program to promote book sharing and bedtime routines.

Once the literacy/bedtime program began, a second group of 100 families with same-aged children and similar race and income qualities was interviewed after receiving two sturdy board books and educational materials at all 6- to 36-month checkups. The educational materials, specific to the age of a child at each visit, detailed why, how and when to share books with children.

The researchers found that parents in the literacy/bedtime program were 4.7 times more likely to be reading with their children compared to control group parents. Book sharing as part of a bedtime routine was also more likely in the literacy group.

Overall, 21 percent of parents in the literacy/bedtime program said that one of their child's three favorite activities included books, compared to 8 percent of parents in the control group. Moreover, 42 percent of parents in the program said that one of their three favorite activities with their child was book sharing, compared with 22 percent of the parents interviewed before the program began.

During the study, 68 pediatric residents and three nurse practitioners distributed more than 1,200 new children's books. Besides containing colorful pictures of children from culturally diverse backgrounds or friendly animal figures and relatively few words, many books had polyester-film mirrors, finger puppets, peek-a-boo holes or flaps.

"Our aim was to select books that parents would enjoy sharing with their child and books that included abundant pictures that could be used by parents who were comfortable reading and parents who were not," High said. "We hoped that parents with limited knowledge of English might find these books a useful introduction to the language."

The researchers found no evidence that the intervention sufficiently affected how children fell asleep, nor did it affect potential sleep-related problems. No significant differences were found among the groups in prolonged bedtime struggles, parent-child cosleeping, frequent night waking or how children fell asleep.

The study's other researchers were Marita Hopmann, clinical assistant professor of pediatrics, Linda LaGasse, adjunct assistant professor of psychology, and Holly Linn, a former research assistant who is now a medical student Tufts University. Hopmann is based at Rhode Island Hospital. High and LaGasse are based at Women & Infants Hospital of Rhode Island. High is also affiliated with Hasbro Children's Hospital.