P2.H149: The Implementation of Reach Out and Read in a NICU Follow-Up Clinic: Increasing Word Exposure for High-Risk Children

Background: Increased word exposure during infancy and early childhood is correlated with improved neurodevelopment(1). Participation in Reach Out and Read (ROR) is associated with significant increases in expressive and receptive language in early childhood(2). Most published ROR studies focus on the general pediatric population, but early word exposure also benefits high-risk populations, such as former preterm infants(3). Our Neonatal Intensive Care Unit (NICU) Follow-up Clinic at Good Samaritan Hospital in Cincinnati, Ohio serves high-risk infants and toddlers, including former preterm infants born < 33 weeks gestation and opioid exposed infants. We established a ROR reading program with the primary aim of increasing the percentage of families who read to their children.

Methods: Our reading program was implemented in July 2022 and includes provision of a new, developmentally appropriate book at every clinic visit and an educational bookmark at the first clinic visit (Figure 1). Our providers underwent ROR training and utilize the books to assess development, model reading, and provide education during the clinic visit. Reading practices were assessed via cross-sectional parental survey at two time points, before and one year after program implementation. Completion of the anonymous survey was voluntary. Our survey utilized a subset of the STIMQ2-Infant(4); the Bookreading Quantity Subdimension Score (BQSS; score 0-9) was calculated for each survey result. Descriptive statistics were used to summarize survey results. Chi-square, Wilcoxon rank tests, and multiple regression analysis were used for group differences. This study was considered exempt from IRB review (IRB#23-029).

Results: One hundred and sixty-three surveys were completed; 122 pre-implementation and 41 post-implementation. There was no significant difference in the percentage of families who read to their children pre- and post-implementation (94% vs. 100%). There were no overall differences in reading practices among families of former preterm infants vs. opioid exposed infants. In the former preterm infant cohort, the number of books in the home and the BQSS were significantly higher post-implementation (Table 1). Families with less books and lower BQSS were more likely to report that book donation would change their reading habits.

Conclusion: Implementation of our NICU Follow-up Clinic ROR reading program led to more books in the home and a higher BQSS score for families of former preterm infants. Even before our program was implemented, the percentage of our families who read was higher and the frequency of reading greater as compared to rates previously reported in the general population(5,6). We suspect this may reflect our NICU book donation program and targeted reading education. Limitations include small number of post-intervention survey results (data collection ongoing) and use of self-reported data, which may overestimate reading practices due to fear of judgment. Future efforts will evaluate the effect of enhanced modeling of reading on the language development of our population(7).