Thakur Kripa, Sudhanthar Sathyanarayan, Sigal Yakov, Mattarella Nina
Dept. of Pediatrics and Human Development, College of Human Medicine, Michigan State University, USA.
BMJ Qual Improv Rep. 2016 May 5;5(1). doi: 10.1136/bmjquality.u209772.w4137. eCollection 2016.
Reach out and Read program (ROR) prepares young children to succeed in school by partnering with physicians and training them in handing out age appropriate books and to counsel parents about the importance of reading aloud to their children. Children served by ROR enter kindergarten with stronger vocabulary and language skills. The aim of this project was to improve the rate of distribution of books and physician advice about reading, to the families at each well child visit in the age range of six months to five years. This Quality Improvement (QI) project was conducted in a large inner-city pediatric residency clinic serving a lower socio-economic status under-served population. After reviewing the data from the past two years, we noticed that there was a tremendous drop in the percentage of books handed out at well visits and advice given to parents about benefits of reading aloud and self-reporting of parents reading to their child for four or more days in a week. Two goals were established: 1. To increase the rate of distributing books at every well child visit (WCV) from six months to five years of age by at least 80%. 2. To improve the rate of counseling given by the resident physicians to the families by at least 75%. A workflow was created to efficiently distribute books at well visits. A presentation about the ROR program was attended by all the physicians and residents. Reading tips in each exam room were posted to serve as a reminder for all providers and for the parents. A three question survey was collected from the families at the end of their well visit. A total of 210 surveys were collected from parents over a six month period. The percentage of handing out books at all well child visits increased from 30% to 96%. The rate of providers giving advice about the benefits of reading increased from 26% to 87%. The percentage of parents reading to their child greater than four days per week increased from 56% to 80%. Reading aloud is widely recognized as the single most important activity leading to literacy acquisition. With the above interventions, families participating in the ROR model at our clinic were more likely to read to their children, more likely to report reading aloud at bedtime, and to read aloud four or more days per week.
“伸出援手阅读”项目（ROR）通过与医生合作并培训他们发放适合儿童年龄的书籍，以及为家长提供关于大声朗读给孩子听的重要性的咨询，帮助幼儿为学业成功做好准备。接受ROR服务的儿童进入幼儿园时拥有更强的词汇量和语言技能。本项目的目的是提高在六个月至五岁年龄段的每次健康儿童检查时，向家庭发放书籍以及提供医生关于阅读的建议的比例。这个质量改进（QI）项目是在一家大型市中心儿科住院医师诊所开展的，该诊所服务于社会经济地位较低、服务不足的人群。在审查了过去两年的数据后，我们注意到在健康检查时发放书籍的比例以及向家长提供关于大声朗读的益处和家长每周给孩子读书四天或更多天的自我报告的建议大幅下降。确立了两个目标：1. 将六个月至五岁的每次健康儿童检查（WCV）时发放书籍的比例至少提高80%。2. 将住院医师向家庭提供咨询的比例至少提高75%。创建了一个工作流程，以便在健康检查时有效地发放书籍。所有医生和住院医师都参加了关于ROR项目的介绍会。在每个检查室张贴了阅读小贴士，以提醒所有医护人员和家长。在健康检查结束时，从家庭收集了一份包含三个问题的调查问卷。在六个月的时间里，共从家长那里收集了210份调查问卷。在所有健康儿童检查中发放书籍的比例从30%提高到了96%。提供关于阅读益处建议的医护人员比例从26%提高到了87%。家长每周给孩子读书超过四天的比例从56%提高到了80%。大声朗读被广泛认为是导致识字能力获得的最重要的单一活动。通过上述干预措施，在我们诊所参与ROR模式的家庭更有可能给孩子读书，更有可能报告在睡前大声朗读，并且每周大声朗读四天或更多天。
