Prescription for Play: Implementing a pediatric play promotion intervention in federally qualified health centers

Area of Science:

• Pediatrics
• Public Health
• Implementation Science

Background:

• Caregiver-directed play is crucial for child development.
• Social impact programs aim to enhance play engagement during early childhood.
• Federally Qualified Health Centers (FQHCs) serve vulnerable populations.

Purpose of the Study:

• To evaluate the impact of the Prescription for Play (P4P) program on caregiver outcomes.
• To assess the feasibility and implementation fidelity of P4P in safety-net settings (FQHCs).

Main Methods:

• An interrupted time series design analyzed caregiver survey data pre- and post-P4P implementation (n=180 pre, n=262 post).
• Mixed methods evaluation included staff surveys (n=27), interviews (n=25), and clinic observations (n=44) to assess implementation.
• Statistical analyses (independent samples t-tests) and qualitative data triangulation were employed.

Main Results:

• Caregivers consistently reported positive views and strong desire for play before and after P4P implementation.
• No statistically significant differences were found in caregiver survey outcomes between pre- and post-implementation groups.
• P4P demonstrated successful implementation to fidelity across diverse FQHC settings and was well-accepted by clinic staff.

Conclusions:

• Prescription for Play (P4P) is a feasible program for implementation in FQHCs, supporting its delivery in safety-net settings.
• While P4P did not significantly shift caregiver attitudes towards play, its successful implementation is a key finding.
• The study provides evidence for the practical application of P4P in real-world clinical environments.