1. Reach Out and Read Fresno: Ongoing benefits in early literacy practices among underserved families Lydia Herrera-Mata, MD Susan Hughes, MS April 27, 2012

2. Reach Out and Read (ROR) Prepares America's youngest children for school by partnering with medical providers Components: – Medical providers give advice & encouragement about early literacy & model book sharing – Give children a free age & culturally appropriate book during each well-child visit from 6 months to 5 years of age – Literacy-enriched waiting rooms

3. ROR Fresno Began in Fresno County 2002 Currently over 20 underserved clinic sites – Rural and urban – Community health centers and private offices Over 24,000 developmentally appropriate books distributed in 2011

4. Benefits of Early Literacy The earlier efforts begin, the more profound the effect on children

5. Purpose To determine if ROR Fresno continues to impact childhood literacy outcomes in underserved settings

6. Study Design Setting: two outpatient community clinics/residency training sites – one urban (Children’s Health Center in Fresno) – one rural (Adventist Community Care—Selma) Population: parents/caregivers of a child 0 to 36 months old (enrolled 9/2010 – 2/2011)

7. Surveys Collected September 2010 to May 2011 Baseline (in-person, at clinic) – 11-item questionnaire (literacy practices, medical care, etc.) Follow-ups (telephone) – 4 & 8 months after baseline – Identical to baseline with added question on book-sharing Majority of surveys conducted by one bilingual ROR staff member

8. Analysis Book Sharing: Simple percentage of perceived program effect Reading Frequency: Two categories based on reading frequency created (>3 times a week vs. <3) Comparison groups classified by 4-month age increments McNemar’s tests used to test for differences in reading frequency over time by age groups – Non-independent version of chi-squared

9. Children’s demographics n=234 n=74

10. Caregiver demographics Education levelLanguage preference Caregiver was Mother: 84% Fresno 93% Selma

11. Age groups enrolled

12. Read ≥ 3 times a week by age group (age in months) * Baseline to follow-up statistically different at 5% significance level n = 307n = 61n = 308

13. More Book Sharing Reported 4-month follow-up survey n = 307

14. Reading changes Baseline to 4-month follow-up

15. Conclusions ROR Fresno continues to positively impact early literacy practices Parents/caregivers report more book sharing with their young children after the ROR intervention Parents/caregivers demonstrate a statistically significant increase in reading frequency with their young children, both at the onset of the intervention and beyond Residency training programs can influence these practices and contribute to their evaluation

16. Acknowledgments First 5 Fresno County, for funding Study sites – Adventist Community Care—Selma – Children’s Health Center, Fresno Cristal Suarez, Summer Biomedical Institute Intern, for initial data analysis and write-up