# ROR Plus: Randomized Trial of a Structured Approach to Parent-Infant Reading (SHARE/STEP) and Limiting Screen Time Delivered via a Multimedia Intervention During Pediatric Well-Visits

> **NIH NIH R21** · CINCINNATI CHILDRENS HOSP MED CTR · 2021 · $238,500

## Abstract

PROJECT SUMMARY
The first year of life is a time of rapid brain development where critical skills, attitudes and routines predictive of
academic, relational and health outcomes are shaped. An infant's home literacy environment (HLE), including
quality of parent-child (“shared”) reading, can be a major source of nurturing in these areas. Screen time in
infancy can displace parent-child interaction and impair learning. The American Academy of Pediatrics (AAP)
recommends shared reading from early infancy and discouraging screen time before 18-months old. While
discussion of reading occurs in primary care, it is inconsistent and shared reading during infancy is modest.
Screen time at this age is prevalent, increasing and hard to address. Reach Out and Read (ROR) provides
books and guidance at well-visits from newborn to 5-years old and serves >5-million families/year. However,
no structured approach to parent-infant reading has been developed. General urging to read at this age may
be ineffective and fuel anxiety and “educational” screen time, especially in families of low-socioeconomic status
(SES) with less experience. The long-term goal of this project is to establish a family-friendly approach to
shared reading and screen time guidance in infancy. The objective of this application is to conduct a clinical
trial of a “how-to” intervention alongside ROR compared to usual ROR, in families of low-SES. Intervention
involves special children's books and videos in a new mobile app (ROR+). These introduce SHARE/STEP, a
novel approach intended to enrich reading routines: Snuggle on lap, Hands on, show Affection, Respond
(Stretch words, Talk about pictures, Explore sounds, Patience), Enjoy. A children's book encourages practice
at home, and 3 animated videos provide extra guidance. ROR+ also encourages parents to set goals, log daily
reading and provides tips, awards and resources tailored to parent needs. Study staff will randomly enroll 93
families/group, collect Baseline data and deliver reading intervention at a Newborn, 1-month or 2-month visit.
At the 6-month visit, screen time intervention will be introduced via the same approach (book, video in ROR+).
Follow-up visits at 6- and 12-months will assess HLE, impression of materials, screen time and language.
Reading and usage data will be accessed from ROR+. Forty families/group will be invited to complete audio
recordings measuring talk and electronic noise at home after 6- and 12-month visits using LENA devices. Our
central hypothesis is that intervention will be feasible during well-visits in early infancy, useful for families and
effective to improve HLE and language and reduce screen time. The rationale is no similar intervention exists,
current guidance is largely ineffective, and ROR+ is synergistic and may be scaled within the ROR program.
This research is significant and innovative in that it involves a novel approach to enhance parent-infant reading
and limit screen time efficiently delivered...

## Key facts

- **NIH application ID:** 10217626
- **Project number:** 1R21HD102702-01A1
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** John S. Hutton
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $238,500
- **Award type:** 1
- **Project period:** 2021-09-24 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10217626

## Citation

> US National Institutes of Health, RePORTER application 10217626, ROR Plus: Randomized Trial of a Structured Approach to Parent-Infant Reading (SHARE/STEP) and Limiting Screen Time Delivered via a Multimedia Intervention During Pediatric Well-Visits (1R21HD102702-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10217626. Licensed CC0.

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