Funded Projects

A Partnership in Child Literacy Promotion

Project Year

2024

City & State

Chapel Hill, North Carolina

Program Name

CATCH Resident

Topic

Literacy

Program Description

Problem: Adverse childhood experiences lead to poor health outcomes. One important health measure and critical developmental milestone among children is kindergarten readiness. Literacy promotion prepares children for school and mitigates childhood adversity by stimulating cognitive development and promoting relational health through shared reading. Pediatricians are uniquely positioned to identify children at risk for adverse childhood experiences and link families to critical supportive literacy services to improve health outcomes.   Primary setting: The University of North Carolina (UNC) Children’s Pediatric Primary and Specialty Care Clinic (UNC Pediatrics Clinic) is a primary care continuity clinic staffed by pediatric residents and faculty preceptors through UNC Health. It will serve as the primary project site for referral as well as the site of routine well child care, where the Surveys of Well-being of Young Children (SWYC) are completed. Family homes will serve as the site for quarterly home literacy coaching visits.  Children affected: We will offer referral to Book Babies to 100% of Medicaid-insured newborns receiving care at UNC Pediatrics Clinic (estimated 140 newborns). Goal enrollment will be 70 infants in 12 months (50% of eligible). Book Harvest will provide data regarding number of enrolled infants.   Project goal: This CATCH project aims to 1) implement a program that will support a new partnership between UNC Pediatrics Clinic and Book Harvest (Durham-based nonprofit literacy promotion organization), and 2) develop a referral mechanism to link vulnerable infants from their pediatrician's office to Book Babies. This novel partnership and linkage pipeline will expand book access, promote early literacy skills, and increase kindergarten readiness among Medicaid-covered children in North Carolina. Because this partnership involves a resident clinic, this project will have the added benefit of educating physicians in training on the importance of early literacy promotion and modeling how to partner with a community organization. About 50% of UNC Pediatric Residents pursue primary care after clinical training so this project is likely to inform practices of many prospective primary care pediatricians.  Proposed intervention: Medicaid-insured newborns will be referred to Book Harvest's Book Babies literacy program through NCCARE360, a statewide electronic directory of community resources. Referrals will be tracked through a manual log. SWYC surveys will be completed as part of routine clinic well care. Book Babies provides enrolled newborns 20 brand-new, age-appropriate and culturally responsive books annually through kindergarten entry. Enrolled newborns will also receive a home library bookshelf and quarterly home visits from trained Literacy Coaches. Literacy Coaches employ a parent-led approach, modeling supportive behaviors and empowering caregivers to set literacy goals. At 6 and 12 months of age, Literacy Coaches will encourage caregivers to complete STIM-Q electronic surveys. Data from SWYC and STIM-Q surveys will assess parental attitudes and reading practices. SWYC Data comparisons will be made between infants enrolled in the Book Babies program and a retrospective group of unenrolled infants to assess the benefit of expanded book access and literacy coaching through the Book Babies program. Children from both groups have access to Reach Out and Read and Imagination Library, however, only enrolled children will participate in Book Babies. (See attached figure for example timeline.)  Anticipated outcomes:  This project supports a new partnership between Book Harvest and the UNC Pediatrics Clinic establishing a novel referral mechanism to link a vulnerable pediatric population to a robust community resource. Families enrolled in this project are expected to increase the frequency of shared reading on average by at least one day/week, with anticipated long-term outcomes of improving relational health, early literacy skills, kindergarten readiness, and health over the lifespan. Children will remain enrolled in the Book Babies program through kindergarten entry.

Project Goal

Promote early childhood literacy skills, kindergarten readiness, and relational health among infants in low resource settings.

Project Objective 1

We will refer 100% of Medicaid-covered newborns (~140 infants) receiving care at UNC Children’s Primary and Specialty Care Resident Continuity Clinic to the Book Babies Program with a goal of 50% enrollment (~70 infants) by year one of the project. Book Harvest will provide data on the number of infants actually enrolled in Book Babies.

Project Objective 2

By 6 months and 12 months of enrollment, families will report having received at least 10 and 20 books, respectively, via electronic STIM-Q parent survey. Literacy Coaches will encourage caregivers to complete STIM-Q survey at 6 months and 12 month meetings.

Project Objective 3

By year one of the project, parents of infants enrolled in Book Babies will report via the Survey of Well Being of Young Children (SWYC) that they are reading to their infant 1 more day per week on average compared to infants not participating in the Book Babies Program. Controls will be comprised of a retrospective cohort of newborn infants who received care in UNC Pediatrics Resident Continuity Clinic with access to Imagination Library and Reach Out And Read, but not enrolled in Book Babies. SWYC is completed be pediatrician at routine well child care for children enrolled in Book Babies and the retrospective group not enrolled.

AAP District

District IV

Institutional Name

University of North Carolina

Contact 1

Maureen Farrell, MD, MS