# Addressing Disparities in Language and Social-emotional Skill Acquisition through Literacy Promotion in Primary Care

> **NIH NIH R01** · RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL · 2021 · $606,379

## Abstract

PROJECT SUMMARY/ABSTRACT
Children from low-income Latino backgrounds are at elevated risk for developmental delays that contribute to
persistent disparities in school readiness. Early shared reading improves language and social-emotional skill
acquisition, which are critical for school readiness, but families from low-income, Latino backgrounds are less
likely to engage in this activity. Over the past 30 years, literacy promotion in primary care by encouraging
shared reading has evolved into a pediatric standard of care. However, current primary care literacy promotion
efforts rely on traditional office-based models with limited outreach and linkage to community-based resources
that can help address persistent disparities in early childhood development. In our preliminary work, we
identified an intention to behavior gap as a key barrier; low-income Latino parents considered shared reading
to be important and intended to read but did not engage in this activity regularly. In response we developed
outreach text messages to encourage shared reading beyond the clinic visit in collaboration with key
stakeholders including parents. An initial pilot demonstrated feasibility and a positive but partial effect of
outreach text messages on the home literacy environment beyond standard literacy promotion. We found that
poverty-related life stressors were an important barrier that text messages could not address. Our preliminary
work and theory suggest the need for outreach and integrating primary care literacy promotion with poverty-
reducing efforts that can promote healthy child development. We propose a 3 arm randomized clinical trial to
test strategies designed to enhance literacy promotion for low-income Latino families. We will recruit 630
parent-child dyads from community health centers that serve low-income, Latino families. Parents will be
randomly assigned to one of 3 arms (1) Reach Out and Read (ROR) an evidence-based literacy promotion
intervention that is widely disseminated in primary care; (2) ROR plus tailored outreach text messages; (3)
ROR plus tailored outreach text messages and enhanced access to poverty-reducing resources using a widely
disseminated model that simplifies access and provides care coordination. In Aim 1, we will test our
hypotheses that (1) children in the ROR plus text message arm will have higher scores on validated
assessments of language and social-emotional development compared to standard ROR alone and (2)
children who receive both text messages and enhanced access to poverty-reducing resources will have higher
scores compared to the other two arms. In Aim 2, we will examine mechanisms that underlie the effects of the
interventions. In Aim 3, we will use mixed methods to conduct a process evaluation to understand how the
interventions are implemented, identify barriers, facilitators, and adaptations, and explore parents’ experiences
with the interventions. This information will help facilitate dissemination of lesson...

## Key facts

- **NIH application ID:** 10162382
- **Project number:** 5R01HD099125-02
- **Recipient organization:** RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL
- **Principal Investigator:** Manuel E Jimenez
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $606,379
- **Award type:** 5
- **Project period:** 2020-05-15 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10162382

## Citation

> US National Institutes of Health, RePORTER application 10162382, Addressing Disparities in Language and Social-emotional Skill Acquisition through Literacy Promotion in Primary Care (5R01HD099125-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10162382. Licensed CC0.

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