Pediatric Literacy Promotion for Latino Families by Texts and Referrals: A 3-Arm RCT.

چکیده اصلی

OBJECTIVE: To test 2 strategies designed to enhance primary care-based literacy promotion (LP): (1) text message reminders (texts), and (2) texts plus referral to community resources. METHODS: We recruited 630 Latino caregiver-infant (aged 6 to 12 months) dyads for an effectiveness-implementation hybrid type 1 randomized trial. Dyads were randomly assigned into (1) LP-only (Reach Out and Read), (2) LP plus text messages (LP+texts), or (3) LP+texts plus referral to Connecting New Jersey (CNJ) (LP+texts+CNJ), which streamlines access to community resources based on the national Help Me Grow model. Participants completed online surveys and assessments at enrollment, and 9 and 18 months after enrollment. Primary outcomes focused on 3 domains: child language and social-emotional development, and parenting behaviors, including reading and verbal responsiveness. We followed the intent-to-treat principle and used step-down minimum P value method to adjust for multiple comparisons. RESULTS: Among caregivers, 74% had less than or equal to a high school diploma and 88% reported speaking English less than very well. At 18 months after enrollment, the LP+text arm [effect size (ES) = 0.391; adjusted (adj.) P = .001] but not LP+text+CNJ had higher language scores compared with LP-only. At 9 and 18 months after enrollment, the LP plus texts plus CNJ arm had higher scores on social-emotional development than LP-only (ES = 0.267; adj. P = .04 and ES = 0.300; adj. P = .03, respectively), whereas the LP+text arm did not. At 9 months after enrollment, scores were higher for the LP+text+CNJ arm on verbal responsiveness (ES = 0.400; adj. P < .001) and the LP+text arm on reading (ES = 0.415; adj. P = .002) compared with LP-only. CONCLUSION: Two strategies with high potential for scale enhanced LP's ability to promote relational and developmental health. Clinicians and policymakers can use this knowledge to optimize LP's impact.

ترجمه فارسی چکیده

هدف این مطالعه بررسی دو استراتژی برای بهبود ترویج سواد (LP) در مراقبت‌های اولیه: (۱) یادآوری‌های پیامکی و (۲) پیامک همراه با ارجاع به منابع محلی. در این مطالعه، ۶۳۰ زوج مراقب-نوزاد (سن ۶ تا ۱۲ ماه) لاتین به‌صورت تصادفی به سه گروه تقسیم شدند: LP فقط، LP همراه با پیامک، و LP همراه با پیامک و ارجاع به Connecting New Jersey. نتایج نشان داد که در ۱۸ ماهگی، گروه LP+پیامک نمرات زبانی بالاتری نسبت به گروه LP فقط داشت (اندازه اثر = ۰.۳۹۱؛ P اصلاح‌شده = .001). گروه LP+پیامک+ارجاع نمرات بهتر در توسعه اجتماعی-عاطفی نسبت به گروه LP فقط داشت (ES = ۰.۲۶۷؛ P اصلاح‌شده = .04 و ES = ۰.۳۰۰؛ P اصلاح‌شده = .03 در ۹ و ۱۸ ماهگی). همچنین، در ۹ ماهگی، گروه LP+پیامک+ارجاع نمرات بهتری در پاسخ‌گویی شفاهی و گروه LP+پیامک نمرات بهتری در خواندن داشتند.

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