Ready and Healthy for Kindergarten: A Bilingual Family Literacy Program in Primary Care Patricia Shelton, Boggs Center Trainee Manuel Jimenez, MD, MS, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School BACKGROUND RESULTS • Family literacy programs (FLPs) improve school readiness for • Fourteen of 20 eligible parent-child dyads enrolled in the study. All children and encourage parent engagement in educational parents identified as Hispanic/Latino and 86% reported limited activities.1,2 English proficiency. Two thirds had less than a high school education. • Low participation in FLPs particularly among low-income Latino • Nearly all families attended at least one session, 71% attended more families limits their impact3 and few FLPs are designed for bilingual than half of the sessions, and half attended 7 or 8 sessions. Seventy- families.4 nine percent completed the study. • Pediatricians are uniquely positioned to promote literacy Table 1: Parent Acceptability

development—they have frequent near-universal access to 10 The program met my approval. 5,6 7 children and are a trusted source of information for parents. The program was appealing to me. • There is growing evidence that family health routines (e.g., physical I liked the program. activity, sleep) make critical contributions to children’s cognitive question I welcome what I learned in the program. IMPLICATIONS 8,9 Acceptability Acceptability of development. 0246810

• Pediatric primary care is an innovative platform to deliver Measure Intervention # of parents • We found that a bilingual FLP developed through an educator- Agree Strongly Agree preventative parenting interventions that promote literacy pediatrician partnership and implemented in an FQHC was well development and family health routines. attended and acceptable. • Parents rated the FLP as highly acceptable and reported that they • Our findings represent a first step in understanding how FLPs can appreciated watching and participating in their children’s learning, be used to leverage healthcare settings to promote equity in school PURPOSE learning alongside their children, and learning techniques to support readiness. their children’s development. Representative quotes are below. • Future FLPs could identify children who may be at risk for difficulty • To develop and assess feasibility and acceptability of a bilingual FLP in school due to developmental delays or behavioral concerns and that leverages a primary care setting to introduce early literacy skills “My experience with “Together with my “I learned a lot of connect families to health professionals and school district child and promote health routines. the program was son, I am learning a things like spending study teams. excellent because I lot.” more time with my was able to interact kids and ways to with my son while he teach them more. I APPROACH was learning new loved this program.” REFERENCES things.” 1. Sénéchal, M., & Young, L. (2008). The Effect of Family Literacy Interventions on Children’s Acquisition of Reading From • We developed an FLP teaching manual based on socio-cultural Kindergarten to Grade 3: A Meta-Analytic Review. Review of Educational Research, 78(4), 880-907. doi:10.3102/0034654308320319 theory and incorporated the priorities of literacy educators, 2. van Steensel, R., McElvany, N., Kurvers, J., & Herppich, S. (2011). How Effective Are Family Literacy Programs?: pediatricians, and families. Results of a Meta-Analysis. Review of Educational Research, 81(1), 69-96. doi:10.3102/0034654310388819 3. Morrow LM, Mendelsohn AL, Kuhn MR. Characteristics of Three Family Literacy Programs That Worked. In: Dunsmore • The FLP has 3 components: (1) parent-child workshops, (2) take- K, Fisher D, eds. Bringing Literacy Home. Newark, DE: International Reading Association; 2010:83-104. 4. Hirst, K., Hannon, P., & Nutbrown, C. (2010). Effects of a preschool bilingual family literacy programme. J Early home activity kits, and (3) reminder text messages. Childhood Literacy, 10(2), 183-208. doi:10.1177/1468798410363838 • We conducted a 16-week single arm study of the FLP from May to Watching and Learning how to 5. Cates, C. B., Weisleder, A., & Mendelsohn, A. L. (2016). Mitigating the Effects of Family Poverty on Early Child Learning Development through Parenting Interventions in Primary Care. Acad Pediatr, 16(3 Suppl), S112-120. participating in support their doi:10.1016/j.acap.2015.12.015 September 2019. We hosted two 8-week cohorts of the FLP at Eric alongside their their children’s children’s 6. Hagan, J. F., Shaw, J. S., & Duncan, P. M. (2017). Bright futures: guidelines for health supervision of infants, children, B. Chandler Health Center, an FQHC in New Brunswick, NJ. children during and adolescents (Fourth edition. ed.). Elk Grove Village, IL: Bright Futures/American Academy of Pediatrics. learning development 7. Barkin, S. L., Finch, S. A., Ip, E. H., Scheindlin, B., Craig, J. A., Steffes, J., . . . Wasserman, R. C. (2008). Is office-based • We recruited children reportedly entering kindergarten in September sessions counseling about media use, timeouts, and firearm storage effective? Results from a cluster-randomized, controlled trial. Pediatrics, 122(1), e15-25. doi:10.1542/peds.2007-2611. 2019 and their parents through clinician referral from within the 8. Donnelly, J. E., Hillman, C. H., Castelli, D., Etnier, J. L., Lee, S., Tomporowski, P., . . . Szabo-Reed, A. N. (2016). FQHC. • We made substantive changes to the FLP including increasing the Physical Activity, Fitness, Cognitive Function, and Academic Achievement in Children: A Systematic Review. Med Sci Sports Exerc, 48(6), 1197-1222. • We collected data on study enrollment, session attendance, and focus on promoting bilingualism, encouraging parents and children to 9. Ferretti, L. K., & Bub, K. L. (2017). Family Routines and School Readiness During the Transition to Kindergarten. Early Education and Development, 28(1), 59-77. doi:10.1080/10409289.2016.1195671 retention to evaluate feasibility and assessed parent acceptability. share their experiences with the health topics, helping parents identify 10. Weiner, B. J., Lewis, C. C., Stanick, C., Powell, B. J., Dorsey, C. N., Clary, A. S., . . . Halko, H. J. I. S. (2017). literacy activities embedded in their daily health routines (e.g., Psychometric assessment of three newly developed implementation outcome measures. Implement Sci, 12(1), 108. doi:10.1186/s13012-017-0635-3 lullabies), and distributing information on health resources. Clipart from Canva.