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Randomized Trial of a Mobile App Introduced During Well-Visits to Enhance Guidance for Reading With Young Children
John S Hutton1, Guixia Huang2, Catherine Wiley3
1Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio.
Insights
A mobile parenting app (Rx for Success; RxS) is feasible and effective for enhancing early reading skills and language development in low-SES families. While helpful, content updates are needed for optimal engagement.
Area of Science:
- Pediatric Health
- Digital Health Interventions
- Early Childhood Development
Background:
- The Reach Out and Read (ROR) program is standard practice in pediatric well-visits.
- Low socioeconomic status (SES) and Hispanic ethnicity are prevalent in the study population.
- Parenting apps offer a potential avenue to enhance reading guidance during healthcare visits.
Purpose of the Study:
- To assess the feasibility, usability, and efficacy of a mobile parenting app (Rx for Success; RxS).
- To determine if RxS can improve reading guidance for parents of young children during well-visits.
- To evaluate the app's impact on shared reading behaviors, child language, and screen time.
Main Methods:
- A randomized trial involving 252 parent-child dyads (ages ~6 and ~18 months) at a low-SES clinic.
- Intervention group received the RxS app; control group received a book modeling alternatives to screen time.
- Follow-up assessments occurred approximately 6 months post-intervention, measuring app impression, use, reading behaviors, language, and screen time.
Main Results:
- The RxS app was feasible to introduce in under 3 minutes with minor parent-reported issues.
- Parental impression of RxS was favorable, but app usage was infrequent due to content relevance concerns.
- The RxS group showed increased shared reading frequency and higher child language scores at follow-up.
- Child screen time exceeded recommended guidelines in both groups.
Conclusions:
- The mobile parenting app (RxS) is feasible, helpful, and effective for enhancing shared reading and language development in young children from low-SES backgrounds.
- RxS shows potential as an enhancement to existing programs like Reach Out and Read.
- Improvements in app features, particularly content relevance and updates, are recommended for greater impact.
Objective:
To estimate feasibility, usability and efficacy of a mobile parenting app (Rx for Success; RxS) to enhance reading guidance provided to parents of young children during well-visits.
Methods:
This trial was conducted at a clinic serving primarily families of Hispanic ethnicity and low-socioeconomic status (SES) where Reach Out and Read (ROR) is standard practice. It involved 252 parent-child dyads in 2 age groups (~6-months old, ~18-months old) randomized during well-visits to receive RxS or a children's book modeling alternatives to screen time (Control) by research coordinators. RxS involves videos, activities and "push" messages. Follow-up assessments were conducted approximately 6 months later, including impression and use, shared reading behaviors, child language and screen time.
Results:
A total of 217 dyads completed both visits (110 RxS, 107 Control). Time to introduce RxS was under 3 minutes and 32% of parents experienced largely minor performance issues. Parent impression of RxS was favorable for both age groups at baseline and follow-up, though use was infrequent, attributable to a desire for more relevant and updated content. Significant findings favoring RxS included shared reading as a favorite activity, more frequent shared reading reported at 12 months and higher language scores at 24 months. Screen time was equivalent between cohorts, exceeding American Academy of Pediatrics guidelines.
Conclusions:
A mobile app introduced to parents of young children from low-SES backgrounds was feasible during well-visits, rated as helpful, and effective to enhance shared reading at younger and language at older ages. While a potentially impactful enhancement to ROR, features needing improvement were identified.
