A Mixed-Methods Investigation Examining Site-Level Variation in Reach Out and Read Implementation

Area of Science:

• Implementation Science
• Early Childhood Intervention
• Pediatric Health

Background:

• Reach Out and Read (ROR) is an evidence-based early childhood intervention.
• Implementation of ROR has been inconsistent, hindering a clear understanding of its delivery.
• This study uses implementation science to explore ROR delivery and site-level variations.

Purpose of the Study:

• To examine the delivery of Reach Out and Read (ROR) in community health centers.
• To identify and understand site-level variations in ROR implementation.
• To explore factors contributing to inconsistent ROR implementation.

Main Methods:

• A mixed-methods study was conducted in 3 community health centers serving low-income Latino families.
• Data included quantitative parent surveys, qualitative interviews with ROR site leaders and clinicians.
• Analysis involved descriptive statistics for quantitative data and iterative coding for qualitative data using the TiDReC checklist.

Main Results:

• 300 parents reported receiving books (84%) and guidance (73%), but fewer experienced reading modeling (23%).
• Significant variation in ROR component delivery was observed across community health centers.
• Themes explaining variation included differing perceptions of shared reading and site-level barriers.

Conclusions:

• Substantive variation in ROR implementation across sites necessitates systematic descriptions.
• Utilizing established frameworks and measurement can enhance understanding of ROR's mechanisms of effect.
• Improved characterization of ROR implementation can help clinicians and policymakers maximize its impact.