Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA.
Pediatrics. 2011 Apr;127(4):e1067-72. doi: 10.1542/peds.2010-2290. Epub 2011 Mar 14.
The Reach Out and Read (ROR) program promotes early literacy as part of pediatric primary care through the distribution of children's books and anticipatory guidance during early childhood.
To improve the rates of age-appropriate book-giving during well-child care and the delivery of ROR-recommended anticipatory guidance in 6 pediatric clinics.
Three quality-improvement cycles were completed at each site. Practice-level data were shared with participants in iterative sessions to identify methods for improving care. A provider-training DVD was used to promote these ROR activities.
Over the course of the project, the median rate of book-giving increased from 97% to 99% and for anticipatory guidance remained at 89%. Providers reported significantly improved ROR-related skills, particularly self-efficacy for modeling reading aloud and for using children's books to assess development.
Baseline adherence to the ROR program is high, possibly because of the ease of implementation. Quality improvement for ROR is feasible and may be easier to implement for book distribution than anticipatory guidance, although providers reported improved anticipatory-guidance skills. Future quality-improvement efforts should continue to address giving books and anticipatory guidance, both of which are integral to the ROR model.
开展“伸出援手与阅读”（ROR）项目，通过在儿童早期向儿童分发书籍和提供预期指导，将促进早期识字融入儿科初级保健。
提高在儿童保健中发放适龄书籍的比率，以及在 6 家儿科诊所提供 ROR 推荐的预期指导。
在每个地点完成 3 个质量改进周期。在迭代会议中与参与者分享实践层面的数据，以确定改进护理的方法。使用提供商培训 DVD 来促进这些 ROR 活动。
在项目过程中，书籍发放的中位数从 97%增加到 99%，而预期指导的中位数仍为 89%。提供者报告称，他们的 ROR 相关技能显著提高，特别是大声朗读和使用儿童书籍评估发育的自我效能感。
ROR 项目的依从性很高，这可能是因为其实施简单。ROR 的质量改进是可行的，并且可能比预期指导更容易实施，尽管提供者报告说他们的预期指导技能有所提高。未来的质量改进工作应继续关注书籍和预期指导的发放，这两者都是 ROR 模式的重要组成部分。
