Burton Heather, Navsaria Dipesh
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin,
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
WMJ. 2019 Dec;118(4):177-181.
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.
“伸出援手阅读”是一项基于初级保健诊所的幼儿识字推广项目，该项目促进围绕识字的讨论，并鼓励在家中进行亲子共读。此前尚无研究考察项目实施对诊所工作人员以及与早期识字相关的诊所价值观、态度和知识的影响。本研究的假设是，“伸出援手阅读”项目的实施不仅能改善幼儿识字推广情况，还能改善临床医生的工作环境。了解该项目对诊所工作人员的潜在影响很重要，因为许多诊所将在不久的将来实施此项目。
对10家开展“伸出援手阅读”项目的研究诊所和7家对照诊所进行了半结构化关键 informant 访谈。访谈内容根据标准定性研究方案进行转录、编码和分析。比较了诊所士气以及对幼儿识字态度方面的差异。二次分析考察了研究诊所的实践和工作场所变化。
编码后的访谈记录显示，大多数研究诊所的临床医生认为该项目提高了诊所士气、增加了提供者满意度、改善了医患关系，并营造了一个识字氛围浓厚的环境。与对照诊所的临床医生相比，研究诊所的临床医生更有可能报告他们在促进识字方面发挥了重要作用，并报告在就诊时有更一致的识字讨论。资金是开展“伸出援手阅读”项目的诊所唯一一致提到的担忧。
了解因“伸出援手阅读”项目可能在诊所发生的潜在变化对于帮助诊所充分为实施过程做好准备至关重要。知道该项目在诊所优点多缺点少可能会鼓励更多参与。进一步的研究应将开展“伸出援手阅读”项目的诊所与对该项目不感兴趣的诊所进行比较，以确定本研究的结果是否能更广泛地推广。
