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ROR Research

ROR Research. Works in Progress Iman Sharif, MD, MPH. Reach Out and Read (2007). Founded in 1989 Over 3,289 sites Over 46,000 providers trained Over 2.8 million children reached annually Over 4.6 million books distributed per year. Cycle of Success. The more you read. Practice.

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ROR Research

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  1. ROR Research Works in Progress Iman Sharif, MD, MPH

  2. Reach Out and Read (2007) • Founded in 1989 • Over 3,289 sites • Over 46,000 providers trained • Over 2.8 million children reached annually • Over 4.6 million books distributed per year

  3. Cycle of Success The more you read Practice Pleasure Proficiency The more you want to read The better you read From Jim Trelease, “The Read-Aloud Handbook”

  4. Benefits of reading aloud • Recognize letters • Understand meaning of print • Processes of reading • Story structures • Phonological awareness • Literacy conventions (syntax & grammar) • Which lead to later reading success… Summarized in Duursma, Augustyn, Zuckerman. Arch Dis Child 2008

  5. ROR Research Findings • Practice • Exposed children 2-10x more likely to be read to • Needlman 1991, High 1998, Golova 1998, Sanders 2000, Jones 2000, Weitzman 2004 • Pleasure • Exposed children 2-4x more likely to cite reading as a favorite activity • High 1998, Golova 1998, Jones 2000, Sharif 2002, Weitzman 2004 • Proficiency • Better expressive and receptive vocabulary in toddlers (High, 2000) • About 8.6 points higher receptive vocabulary in preschoolers • (Mendelsohn 2001; Sharif 2002) • 4.3 points higher expressive vocabulary in preschoolers • (Mendelsohn 2001)

  6. Early Reading Skills(Sharif, Huberman, Mendelsohn unpublished data) • Randomized Controlled Trial • 519 children enrolled at 4-6 months • Enrollment 2000-2005 • Randomized to: • Nutritional counseling + gift • ROR • ROR + ASQ/BB

  7. Prospective Data • NYC 3rd grade reading tests • PENDING

  8. Health Literacy

  9. Health Literacy • An individual’s ability to read and interpret health information needed to make health decisions • In adults, health literacy has been demonstrated to be an independent predictor of better health. • (AFTER adjusting for income, education, etc.) • No published studies in children

  10. Child Health Literacy & Health Outcomes • Unpublished data • Cross-sectional survey of overweight children (n=78, age 7-18) • Reading nutritional labels is an important part of weight management • Is there a relationship between child body mass index and literacy?

  11. Sharif & Blank. Data presented at the Pediatric Academic Societies Meeting, 2007. Manuscript in progress.

  12. Analysis adjusted for parental education, literacy, and self-efficacy

  13. Implications • Children’s own literacy is related to their health outcomes • Children’s ability to make their own health-related decisions is an important target for intervention

  14. ROR Research – National Data • Needlman, 2005 • Multi-site evidence from 19 clinical sites in 10 states • Implementation of ROR associated with: • 1.6 increased odds of reading as a favorite parental activity • 1.5 increased odds of reading at bedtime • 1.8 increased odds of reading 3 or more days per week • 1.6 increased odds of owning 10 or more picture books

  15. ROR Research – National Data • Any effects on reading proficiency??

  16. ROR Reach • On average, ROR reached 14.3% of children in each state • Median 10.3% • Lowest: 0.6% • Highest: 79.6%

  17. National Center for Education Statistics • 4th grade reading Scores from 1998 to 2007 • (Oldest ROR exposed kids were in 4th grade in 1998)

  18. Relationship between ROR Reach and change in reading scores Sharif, unpublished analysis- holds after adjustment for per capita income r=0.32, p=0.04

  19. Relationship between ROR Reach and change in reading scores p=0.05 n=31 states n=10 states

  20. States with biggest increasesin readingscores Arizona California Colorado D.C. Hawaii Massachusetts New York Rhode Island South Carolina Virginia

  21. States with biggest increasesin readingscores Arizona California Colorado D.C. Hawaii Massachusetts New York Rhode Island South Carolina Virginia States with highest reading scores Massachusetts New Jersey New Hampshire Vermont Connecticut Virginia Montana Pennsylvania North Dakota Ohio

  22. Summary • ROR research has shown positive effects on reading • Practice • Pleasure • Proficiency

  23. Future Directions • The RE-AIM Framework (Glasgow, et al) • Reach • Efficacy • Adoption • Implementation • Maintenance

  24. The RE-AIM Framework (Glasgow, et al) • Reach • Which children get it? • Efficacy • What are the outcomes? • Adoption • Which clinics/providers do it? • Implementation • What are people actually doing with ROR? How closely do they adhere to the model? • Maintenance • Does it become/stay the clinic’s routine?

  25. Future Directions… • How does ROR improve outcomes for children? • Better reading success • Better graduation rates • Better employment • Higher income • Better health

  26. isharif@montefiore.org

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