REACH OUT AND READ Achieving Local Outcomes as a Nationally Evidence-Based Program Callee Boulware, Executive Director Reach Out and Read Carolinas

What We Know BOOKS BUILD BETTER BRAINS Being read to, and growing up with books, literacy, and language are major components essential to eventual academic success for children.

What? What is Reach Out and Read? What are we doing to help children get to school ready for success?

Reach Out and Read

5 Our Mission To prepare America’s youngest children to succeed in school by partnering with doctors to prescribe books and encourage families to read together Our Vision We are working toward the day when all children enter kindergarten with highly-engaged parents, performing at grade level, and prepared to excel

6 Three-Part Model Pediatrician Guidance In the pediatric exam room, pediatricians speak to parents about the importance of reading aloud to their children every day, and offer age-appropriate literacy tips and encouragement. Prescribe a Book At each regular checkup from 6 months through 5 years of age, the child receives a new, culturally- and developmentally- appropriate book to take home and keep. Parents Read Aloud at Home Parents incorporate advice received through pediatric visits and make reading aloud part of their daily routine. Our families read up to 350 hours with their children prior to kindergarten.

7 How We Reach Families Leverage pediatric care providers’ unique access 90% of children ages 6 months through 5 years visit their healthcare provider regularly Influence parental behavior Parents view pediatrician as a trusted advisor Reach Out and Read engages children early, before learning deficits are accrued

Prevention Works – Immunizing Children Against Illiteracy “Furthermore, it has been shown that interventions for at-risk children are most effective when they begin during infancy.” Preschool foundations of early reading acquisition Susan Rvachew, PhD S-LP(C) 1 and Robert Savage, PhD 2

9 Evidence-Based, Research-Tested Fifteen published, peer-reviewed research studies support the efficacy of our model, a more extensive body of research than for any other psychosocial intervention in general pediatrics.

National Outcomes Parents served by Reach Out and Read are four times more likely to read aloud with their children. Reach Out and Read reaches the child through effectively teaching the parent to start lifelong learning in the home. During the preschool years, children served by Reach Out and Read score three to six months ahead of their non- Reach Out and Read peers on vocabulary tests. These early foundational language skills help start children on a path of success when they enter school.

American Academy of Pediatrics Policy Statement- June, 2014

We needed AND wanted more… Needed to balance the demand for local outcomes with the responsible use of resources. How to achieve this?

Local Outcomes Short-term outcomes – how we are “moving the needle” Model fidelity and quality implementation

Assistance of Experts Nonprofit Finance Fund – With the help of the i(c)s 1.What is our mission? 2.What data do we collect? 3.What results we actually commit to?

Review/update of Theory of Change Theory of Change (ToC) is a specific type of methodology for planning, participation, and evaluation that is used in the philanthropy, not-for-profit and government sectors to promote social change. Theory of Change defines long-term goals and then maps backward to identify necessary preconditions.[1] Theory of Change explains the process of change by outlining causal linkages in an initiative, i.e., its shorter-term, intermediate, and longer-term outcomes.

What data do we collect? Review of all evaluation tools – Semi-annual progress report – Site observation assessment – Parent Survey – Provider Survey Matrix of what data we collect – Outputs Children Quality/model fidelity – Short-term outcomes? Identify holes in our current evaluation methods

Results… 1.New Theory of Change 2.New Logic Model 3.New Parent Survey tool 4.New Quality Matrix/Evaluation methodology

Parent Survey Did not find old survey useful (Nationally designed) Reviewed NCPC survey tool Goal: design a tool that will fulfill the needs of our partners (NCPC) and ROR Carolinas AND answer the questions that we wanted to ask

Parent Survey 1. Ease of implementation Parents ROR Clinical Locations 2. Meaningful Data 3. Historical Knowledge of program

Methodology How often to administer? In-clinic administration/instructions? How many surveys to collect? How to tally data? How to interpret data? How to house data for institutional memory and future evaluation?

What is the data showing us?

Quality/Model Fidelity How do we consistently quantify? Quantitative Data? Qualitative Data? Correlate with short-term outcomes? …needed a new software to manage -

How to implement in our day-to- day operations? 1.Adoption of and training in new evaluation matrix/methodology 2.Education to our programs and providers 3.Shift in organizational culture = Data Driven Decisions

What we can now do… 1.Provide quantitative measures of program quality and model fidelity 2.Relate this data to short-term outcomes with parents and families 3.Establish individualized action plans for each program 4.More successfully allocate resources across program needs

Benefits of new software system 1. Track all quality and evaluation data in one place 2. Trending in program quality 3. Relate this trending to parent survey data and interventions by program specialists

…and ultimately… With confidence, provide data around local short-term outcomes and model fidelity. Understand the data sets that we CAN provide, and make more appropriate commitments to our investors around accountability for these pieces of data.

Do we need long-term outcomes data locally? Significantly more resources? Additional staffing? To what goal? Evaluation goals moving forward

Questions?