The Latino School Readiness Gap: Engaging Families in Design Thinking for Primary Care Interventions

Among Latino families with a recent kindergartener, we 1) qualitatively explored school readiness (SR) journeys and 2) used design thinking to understand their preferences, usability, and acceptability of primary care-based SR interventions (checklist, coordinator, coaching, texting, preschool, library referrals, parenting groups, and Reach out and Read).

Focus groups and interviews were completed at 4 Oregon pediatric clinics over 2 sessions: 1) narrative inquiry of SR stories through journey maps and 2) SR intervention assessment through design thinking. Sessions were led by an English/Spanish bilingual-bicultural facilitator, recorded, and transcribed. Iterative team-based coding with inductive analysis was conducted in the source language.

Participants (N = 33) were primarily Spanish-speaking (58%) mothers (76%) born in Mexico (64%) with at least a high school degree (69%), with US-born children (55%) who attended preschool (81%). Journey maps revealed a positive educational foundation of teaching values, culture, and language for kindergarten preparation, with strong beliefs that school will teach life skills. Compared to English-speaking parents, Spanish-speaking parents focused more on social-emotional development than specific early literacy or math activities, reporting less confidence in teaching cognitive skills. Parents identified a longitudinal model with SR interventions at multiple points. Themes regarding targeted SR support, hesitancy to request help, and bilingualism were integrated into a prior framework to promote SR (Figure).

Participating families encouraged school success in their children before kindergarten and focused on social-emotional, cultural, and linguistic development. Caregivers identified a variety of acceptable and feasible clinic-based SR interventions that build on Latino families' social strengths.