Effectiveness of a primary care intervention to support reading aloud: a multicenter evaluation.

OBJECTIVE Failure to read at grade level predicts life-long economic and social disability. Early exposure to reading aloud may prevent reading problems. This study seeks to determine whether institution of Reach Out and Read (ROR) programs is associated with increased reading aloud in a national sample. DESIGN Before-after intervention study: separate convenience samples were studied before and after institution of ROR programs at multiple sites. PARTICIPANTS AND SETTING A convenience sample of parents of children age 6-72 months seeking routine health care at 19 clinical sites in 10 states. INTERVENTIONS The ROR model incorporates anticipatory guidance about reading aloud and distribution of free picture books at health supervision visits from 6 months through 5 years as well as reading aloud in the waiting room. MAIN OUTCOME MEASURES Parents were interviewed about their attitudes and practices related to reading aloud, using questions drawn from validated instruments. RESULTS The sample included 1647 subjects (730 intervention, 917 comparison). After controlling for multiple potential confounding factors, significant associations were found between exposure to ROR and reading aloud as a favorite parenting activity (Adjusted Odds Ratio [AOR] 1.6, P < .001); reading aloud at bedtime (Adjusted Odds Ratio [AOR*rsqb; 1.5, P < .001); reading aloud 3 or more days per week (AOR 1.8, P < .001); and ownership of > or = 10 picture books (AOR 1.6, P < .001). CONCLUSIONS In a national sample, implementation of ROR programs was associated with increased parental support for reading aloud. This study provides evidence of the effectiveness of a primary care intervention strategy to promote reading aloud to young children.