Ready and Healthy for Kindergarten: A Bilingual Family Literacy Program in Primary Care

To describe the development and pilot testing of a bilingual family literacy program (FLP) for dual language learners entering kindergarten implemented in a Federally Qualified Health Center (FQHC).

The Ready and Healthy for Kindergarten program is an English-Spanish bilingual FLP that uses four parent and pediatrician-prioritized health topics to introduce early English literacy skills to families and promote health behaviors that are important for school readiness while encouraging maintenance of Spanish. We developed an FLP manual, conducted a 16-week single-arm pilot study, and modified the FLP based on family feedback and observation.

We recruited 14 parent-child dyads for the pilot through clinician referral. All participating parents identified as Hispanic/Latino and 86% reported limited English proficiency. Two-thirds had less than a high school education. Seventy-one percent of families attended more than half of the sessions. Parents rated the FLP as highly acceptable. During implementation, we made substantive changes to the FLP including increasing the focus on promoting bilingualism, encouraging all participants to share their experiences with the health topics, helping parents identify literacy activities embedded in their daily health routines (e.g., lullabies), and distributing information on health resources.

We developed and implemented an innovative bilingual FLP in an FQHC that was well-attended and acceptable to families. The FLP has the potential to be replicated in other primary care sites and our findings lay the groundwork for future studies on how to best leverage healthcare settings to promote equity in school readiness.