P3.D078: Resident-led Pilot Project to Encourage Reading to Babies in the Neonatal Intensive Care Unit:  Expanding Opportunity for Racially Diverse and Underserved Families in a Public Hospital

Background: Reading to neonates is an effective intervention for improving long-term neurodevelopmental outcomes. Preterm and low-birthweight neonates are at higher risk for developmental delays and disabilities. Children from underserved communities are at significantly increased risk of language and reading delays, leading to poorer school performance. Prior to this project, promotion of reading within our high-risk Neonatal Intensive Care Unit (NICU) was exclusively provider-dependent, and therefore, generally low and inconsistent, with scant observed reading sessions.

Our objective was to conduct a resident-led pilot study to evaluate the feasibility of a reading promotion program within the NICU of an academic public hospital serving a racially diverse and underserved urban population.

Project Description: We applied the COM-B behavioral science framework to implement reading promotion strategies (Figure 1). To increase “Capability,” staff were trained to model reading sessions and provide education. Regarding “Opportunity,” residents capitalized on existing infrastructure by collaborating with established programs -- the department “Reach Out and Read” program and a national “Read-a-thon.” To spur “Motivation,” organizers promoted a friendly competition and prize.

The read-a-thon event was conducted from September 11-21, 2023. A ticketing system tracked individual reading sessions. Participants recorded the patient’s name, date, and whether a staff or family member read during the session.

Discussion: Over the 10 day period, we recorded 421 reading sessions averaging 38.2 reading sessions per infant. An overwhelming majority -- 74% -- of reading sessions were performed by families while only 18% of reading sessions were performed by staff. The highest number of reading sessions (80) were recorded on Sunday, when working parents were likely more free to visit. Anecdotally, staff reported more frequent and longer visiting times by families during this period. Positive incentives for participation included free books available at bedside and a prize basket of books. Since all family members were invited to read, siblings also participated, reflecting potential family benefits including sibling bonding and increased reading time for siblings. This project was limited in time and scope. The enthusiasm observed by staff and families may have been a response to the novelty of this program in the NICU.

Conclusion: The success of this event proved the feasibility of a resident-led “Read-a-thon” to promote reading to racially diverse and historically underserved neonates and their families in an under-resourced public hospital NICU. The behavioral science model COM-B was useful in developing and evaluating our intervention and will inform future expansions of the pilot project. These include establishing a more permanent reading promotion program in the NICU, as well as the creation of longitudinal quality improvement efforts in building long-term sustainability. We also hope to better explore the impact on sibling reading, family visitation time in the NICU, and continuation of NICU reading routines after neonates are discharged home.