480 - Understanding Pediatricians' Advocacy for Well-Being, Diversity, and Inclusion Through Reach Out and Read

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 480
Publication Number: 480.217

Sabrina M. Gonzalez, Perelman School of Medicine at the University of Pennsylvania & Children's Hospital of Philadelphia, Whitehouse Station, NJ, United States; Nicole F. Miller, Children's Hospital of Philadelphia, Malvern, PA, United States; Danielle Sands, Childrens Hospital of Philadelphia, Oreland, PA, United States; Danielle Erkoboni, Childrens Hospital of Philadelphia, Blue Bell, PA, United States

Presenting Author(s)

Sabrina M. Gonzalez, B.S. (she/her/hers)

Medical Student
Perelman School of Medicine at the University of Pennsylvania & Children's Hospital of Philadelphia
Whitehouse Station, New Jersey, United States

Background: Early exposure to books and reading aloud is vital to children’s development of language and literacy. Additionally, shared reading between caregiver and child fosters the formation of healthy relationships, a cornerstone of early childhood development. Books depicting racial, ethnic, and topic diversity allow parents and providers to nurture children’s socioemotional growth. However, historically, books with diverse characters and themes (hereafter referred to as “diverse books”) have been inaccessible to many families.

Objective: This study sought to distill pediatric primary care providers’ current routines, clinical perspectives, perceived challenges, and possible solutions on the integration of diverse books into well child care.

Design/Methods: Pediatric primary care providers recruited from 81 Reach Out and Read (ROR) practices within a large metro area completed semi-structured interviews. After thematic saturation was reached, interviews were analyzed in NVivo software by two researchers with confirmed inter-coder reliability using modified grounded theory. Providers also completed a brief demographic survey prior to participation.

Results: Participants included 20 pediatric primary care providers (17 MD/DO, 2 NP, 1 PA); 85% identified as female, 20% as a non-white race, and 10% as Hispanic/Latinx (see Table 1). Several key themes emerged; see example quotes in Table 2. When discussing book distribution through ROR, providers agreed: (1) books function best when they serve as a mirror for children and their families; and, (2) it is important for all children to receive diverse books. Provider routines demonstrated: (3) approaches to conversations surrounding emotional health versus race/ethnicity differed regardless of books; and, (4) a subset of providers felt some diverse books were too complex for children under 5 years who receive books through ROR. When asked about challenges and solutions, providers felt: (5) relationships with families are a key factor for approaching diverse books and corresponding discussions; (6) logistical challenges with limited well visit time and purchasing constraints disincentivize the distribution of diverse books through ROR; and, (7) there are opportunities for interventions and innovations to support pediatric primary care providers in incorporating diverse books into well child care.

Conclusion(s): Pediatric primary care providers are empowered to incorporate diverse books in well visits through ROR, but require increased access, associated messaging, and innovative approaches to implement this fully.