Evaluating the Effect of Reach Out and Read on Clinic Values, Attitudes, and Knowledge.

Reach Out and Read is a primary care clinic-based early childhood literacy promotion program that facilitates discussion around literacy and encourages shared reading at home. No prior studies have examined the effect of program implementation on clinic staff and clinic values, attitudes, and knowledge related to early literacy. The hypothesis of this study was that Reach Out and Read implementation not only improves early childhood literacy promotion, but also improves aspects of the clinician's work environment. Understanding the potential effects of this program on clinic staff is important, since many clinics will implement this program in the near future. Semistructured key informant interviews were performed with 10 study clinics with Reach Out and Read and 7 control clinics. Interviews were transcribed, coded, and analyzed according to standard qualitative research protocol. Comparisons were made for differences in clinic morale and attitudes towards early childhood literacy. A secondary analysis examined practice and workplace changes in study clinics. The coded transcripts showed that clinicians at the majority of the study clinics believed that the program boosted clinic morale, increased provider satisfaction, improved patient-clinician relationships, and promoted a literacy-rich environment. Compared to clinicians in control clinics, clinicians in study clinics were more likely to report that they played a large role in promoting literacy and reported having more consistent literacy discussion in visits. Funding was the only concern mentioned consistently by clinics with Reach Out and Read. Understanding potential changes that can occur in clinics because of the Reach Out and Read program is crucial to help clinics adequately prepare for the implementation process. Knowing that this program has many advantages and few disadvantages in clinics may encourage more participation. Further studies should compare clinics with Reach Out and Read to those with no interest in the program to determine if results from this study can be more broadly generalized.

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