Feasibility and Acceptability of an Online Family Literacy Program in an Under-Resourced Community During the COVID-19 Pandemic.

OBJECTIVE: The objective of this study was to examine the feasibility and acceptability of an online family literacy program (FLP) among low-income Latino families during the COVID-19 pandemic. METHODS: We conducted a mixed methods pilot study. Latino parent-child dyads participated in an 8-week online FLP conducted on video conferencing software, developed through a cross-sector health care-education partnership. We conducted surveys and structured observation to assess feasibility and acceptability and in-depth interviews to gain insight into the context of participants' experiences during the pandemic. RESULTS: The 35 participating parent-child dyads all identified as Latino, 83% reported limited English proficiency, and 60% of parents did not achieve a high school diploma. Nearly two-thirds of families participated in at least half of the sessions. On average, parents welcomed, liked, approved, and found the program appealing. While 86% experienced a technology problem at least once during sessions, all were resolved with minimal assistance. During qualitative interviews, we identified 3 themes that provide insight into their experiences with the FLP within the broader context of the pandemic: (1) disruption in family routine and financial strain caused by COVID-19 intensified family stress, (2) the forced transition to remote learning highlighted the inequities experienced by Latino preschool children, and (3) the FLP empowered parents and enhanced health and education experiences. CONCLUSION: Latino families had high participation levels in an online FLP and found it acceptable. Additional work is needed to understand how similar primary care programs can be leveraged to promote optimal development during a time of heightened need.

Reach Out and Read Implementation: A Scoping Review.

BACKGROUND: Reach Out and Read (ROR) is an evidence-based literacy promotion intervention that leverages the near-universal access to children of primary care practices to promote optimal child development. While several studies document ROR's effectiveness, its implementation remains understudied. OBJECTIVE: This scoping review examines the existing literature to better understand ROR implementation. DATA SOURCES: PubMed, ERIC, Web of Science, Academic Search Premier, ProQuest Education Database, and CINAHL. STUDY SELECTION: We included peer-reviewed English-language papers focusing on ROR in an ambulatory setting in North America. DATA EXTRACTION: Extracted variables were informed by the Template for Intervention Description and Replication checklist and included publication year, title, author(s), clinic location, study design, study aim, ROR implementation, modifications, implementation assessment, barriers, facilitators, and outcomes. RESULTS: Seventy-one papers were included, of which 43 were research articles. We identified substantial variation in ROR implementation including differences in components delivered. A considerable number of research articles did not assess ROR implementation. The most common barriers to ROR implementation were at the system level (ie, financing and inadequate time). Modifications and enhancements to ROR are emerging; most address barriers at the clinician and family level. LIMITATIONS: This review was limited to published English language papers focusing on ROR. CONCLUSIONS: ROR implementation varies across studies, and many did not assess implementation. Consistent reporting and assessment of ROR implementation could create opportunities to better understand the mechanisms underlying ROR's effects and inform other early childhood interventions that seek to promote optimal development at the population level.

Building a Community Partnership in a Pandemic: NJ Pediatric Residency Advocacy Collaborative.

The New Jersey Pediatric Residency Advocacy Collaborative (NJPRAC) is a statewide collaborative with faculty leads from each of the 10 New Jersey pediatric residency programs. The 2 major goals of the collaborative were to build community partnerships between pediatric residency programs and local organizations and develop a core advocacy curriculum. In this article, we focus on how the NJPRAC built community partnerships with Family Success Centers (FSCs) across the state over the course of a 2-year period. FSCs are located within every county in the state and fall under the New Jersey Department of Children and Families, providing resources and supports for families in crisis, with a focus on child abuse prevention services. Amid this growing partnership, the coronavirus disease 2019 (COVID-19) pandemic forced the NJPRAC to swiftly pivot its partnership and develop innovative programs to support families during the COVID-19 pandemic. As FSC leadership communicated families' concerns to the collaborative, we initiated the Virtual House Call webinar, which incorporated pediatricians, community leaders, and allied health professionals to answer COVID-19 questions. These webinars quickly expanded into weekly interprofessional series, with experts in mental health, law, nutrition, and dentistry partnering with pediatricians from various subspecialties. Key to the webinars' success was responding in real time to audience questions, collaborating with the FSC leadership on content, and garnering the support from the local New Jersey Chapter, American Academy of Pediatrics and the national American Academy of Pediatrics. A key challenge remains to meaningfully incorporate pediatric trainees into community partnerships. The NJPRAC plans to continue the Virtual House Call series with continuous input from the FSCs and participating families.

Ready and Healthy for Kindergarten: A Bilingual Family Literacy Program in Primary Care.

PURPOSE: To describe the development and pilot testing of a bilingual family literacy program (FLP) for dual language learners entering kindergarten implemented in a Federally Qualified Health Center (FQHC). DESCRIPTION: The Ready and Healthy for Kindergarten program is an English-Spanish bilingual FLP that uses four parent and pediatrician-prioritized health topics to introduce early English literacy skills to families and promote health behaviors that are important for school readiness while encouraging maintenance of Spanish. We developed an FLP manual, conducted a 16-week single-arm pilot study, and modified the FLP based on family feedback and observation. ASSESSMENT: We recruited 14 parent-child dyads for the pilot through clinician referral. All participating parents identified as Hispanic/Latino and 86% reported limited English proficiency. Two-thirds had less than a high school education. Seventy-one percent of families attended more than half of the sessions. Parents rated the FLP as highly acceptable. During implementation, we made substantive changes to the FLP including increasing the focus on promoting bilingualism, encouraging all participants to share their experiences with the health topics, helping parents identify literacy activities embedded in their daily health routines (e.g., lullabies), and distributing information on health resources. CONCLUSION: We developed and implemented an innovative bilingual FLP in an FQHC that was well-attended and acceptable to families. The FLP has the potential to be replicated in other primary care sites and our findings lay the groundwork for future studies on how to best leverage healthcare settings to promote equity in school readiness.

The Impact of Food Insecurity on Child Health.

Food insecurity (FI) has severe implications on children's health and their future health outcomes. Children with FI have limited access to healthy foods and demonstrate poorer eating behavior, leading to chronic absenteeism, school failure, and chronic disease. Given the health implications of FI, it is imperative for pediatricians to screen all children, and advocate for protecting necessary nutritional programs that exist to mitigate FI and for improved accessibility of nutritious, healthy food options, especially in locations labeled as food deserts. Given the severe consequences of FI, collaboration of multidisciplinary teams is necessary to facilitate enhanced care of all patients.

Training Pediatric Residents in Literacy Promotion: Residency Directors' Perspectives.

Phenomenon: The American Academy of Pediatrics and Canadian Pediatric Society recommend that pediatricians incorporate literacy promotion during well child care, but literacy promotion education during pediatric training remains understudied. We sought to understand how literacy promotion training is currently implemented in pediatric residency programs from the perspective of program directors. Approach: We conducted semistructured interviews with all 9 residency program directors in 1 state. We analyzed data iteratively coding transcripts using an immersion/crystallization approach to identify themes. Findings: We achieved saturation after 9 interviews with 11 participants. We identified 3 major themes: (a) Residency programs rely on an existing primary-care-based literacy promotion intervention (Reach Out and Read) and the resident continuity clinic for literacy promotion training; (b) program directors encourage early and repeated exposure to facilitate literacy promotion education; and (c) service obligations, content specifications, and pressure on faculty create competing time demands that function as key barriers to literacy promotion training. Insights: Residency program directors used an existing, widely used intervention and the infrastructure provided by continuity clinics to facilitate training on literacy promotion, a relatively new pediatric care standard. Additional work is needed to overcome the barriers identified by program directors.

Frequency of Food Insecurity and Associated Health Outcomes in Pediatric Patients at a Federally Qualified Health Center.

Food insecurity (FI) has been recognized as a public challenge not only for developing countries but also for the U.S. POPULATION: The present study was designed to identify the prevalence of FI and the association of household FI with the health status of pediatric patients seen at a Federally Qualified Health Center in New Jersey which provides health care mainly for Latino patients. Patients were included if they were screened for FI at their well visits during a 4-month period following implementation of the 2-item screening tool recommended by American Academy of Pediatrics. We compared demographic and morbidity data of children with FI to those living in food-secure households. The results are presented as the distribution of frequency (%) and odds ratios (OR) with 95% confidence interval (95% CI). FI was detected in 15.8% (95% CI 14.2-17.5%) of 486 studied children. We recorded higher rates of anemia (10.4 vs. 3.2%, p < 0.005), hypercholesterolemia (10.4 vs. 3.4%, p < 0.01), and any morbidity (24.7 vs. 9.3%, p < 0.02) in children living in FI households. Multivariate logistic regression analysis revealed an association of household FI with at least one recorded morbidity independent of the patient's age, gender, and body mass index (OR 1.79, 95% CI 1.31-2.43). No one was diagnosed with diabetes, and only a few with asthma and hypertension. We have concluded that living in households with FI increased the risk for unfavorable health outcomes in a predominantly economically disadvantage community of children within the U.S.

Understanding Barriers to Literacy Promotion Among New Jersey General Pediatricians.

Low literacy is associated with poor health. We sought to examine pediatricians' attitudes and practices regarding literacy promotion in early childhood. We distributed a self-administered 23-item survey to a random sample of 500 board certified or eligible New Jersey primary care pediatricians. 134 surveys were returned, 25 of which were excluded. In all, 91% of pediatricians in our sample agreed that literacy promotion was an essential aspect of practice, and two-thirds agreed that they conduct activities to promote literacy. A total of 77% of pediatricians who completed their training ≤20 years ago agreed that they were adequately trained to promote literacy compared with 58% who completed their training >20 years ago ( P = .04). Physicians reported several barriers including time constraints and insufficient funding. While most pediatricians in our sample support literacy promotion, less conducted activities in practice. Further study is needed to understand how to facilitate implementation of literacy promotion guidelines.

Women and cigarette smoking: does amount of weight gain following a failed quit attempt affect social disapproval?

This study examined the perception of social attractiveness and approval of smoking in a vignette of an American college female smoker after a failed quit attempt. It was hypothesized that she would be perceived more favorably when she was smoking to control her weight, compared to a non-weight related excuse during a failed quit attempt. The design was a 2 (gender: male vs. female)x4 (condition: control, 5, 10, 20 lb gain)x3 (participants' smoking status: never, former, or current smoker) factorial design with the Social Attraction Index and Perception of Smoking Index as dependent variables. Contrary to the hypothesis, perceptions of the female were not affected by her disclosed amount of weight gain. However, consistent with the literature on stigmatization of smokers, smoking participants perceived the female target as most socially attractive and nonsmokers perceived her to be the least attractive.

Deception in prison assessment of substance abuse.

The relationship of The Paulhus Deception Scales (PDS; ) to the Texas Christian University Drug Screen I was investigated in participants screened for a voluntary in-prison substance abuse treatment program. Mean PDS scores for 35 female and 277 male prison inmates were significantly higher than the inmate norms in the test manual. All three PDS scale scores were negatively related to symptom endorsement and to the diagnosis of drug dependence. Almost 37% of participants produced protocols of questionable validity, with 22% faking-good and 14.7% faking-bad. However, over 90% of participants obtained scores that were not covered by the manual's profile typology. These findings underline the importance of deception to correctional assessment and the need for more information on the psychometrics and operating characteristics of the PDS in correctional settings.

Acculturation of Japanese Americans:: Use of the SL­ASIA with a Community Sample.

PURPOSE. The present article summarizes the use of the Suinn­Lew Asian Self Identity Acculturation Scale (SL­ASIA) with a community sample of Japanese Americans. METHODOLOGY. The SL­ASIA was administered to 123 Japanese Americans in Los Angeles, CA. Analyses of internal consistency and concurrent validity were conducted. PRINCIPAL FINDINGS. Results indicated that the mean SL­ASIA score for this sample was 3.25, which according to the scale developers' conceptualization of acculturation, indicates a medium level of acculturation. Analyses revealed no gender differences. Psychometric properties of the SL­ASIA with this community sample of Japanese Americans appear to be adequate. Obtained correlation coefficients were somewhat lower than those found for college students; however, they still were in a reasonable range. Concurrent validity of the SL-ASIA was demonstrated with several other variables such as generational status and self-identification. CONCLUSIONS. This article presented the results of analyses of the SL­ASIA with a community sample of Japanese Americans. Results indicated that, although the correlation coefficients obtained from analyses examining internal consistency and concurrent validity were lower for this sample as compared to those found with college student samples, the SL­ASIA was found to have adequate psychometric properties with this community sample. Thus, results indicate that the SL­ASIA would be an appropriate screening measure to assess acculturation level among Japanese Americans in the community. RELEVANCE TO ASIAN AMERICAN AND PACIFIC ISLANDER POPULATIONS. This article is particularly relevant to Japanese Americans. KEY WORDS. Acculturation, Japanese Americans, moderator variables, psychometric analyses.