A Text-Based Intervention to Promote Literacy: An RCT

Abstract

BACKGROUND AND OBJECTIVES: Children entering kindergarten ready to learn are more likely to thrive. Inequitable access to high-quality, early educational settings creates early educational disparities. TipsByText, a text-message-based program for caregivers of young children, improves literacy of children in preschool, but efficacy for families without access to early childhood education was unknown. METHODS:We conducted a randomized controlled trial with caregivers of 3-and 4-year-olds in 2 public pediatric clinics. Intervention caregivers received TipsByText 3 times a week for 7 months. At pre-and postintervention, we measured child literacy using the Phonological Awareness Literacy Screening Tool (PALS-PreK) and caregiver involvement using the Parent Child Interactivity Scale (PCI). We estimated effects on PALS-PreK and PCI using multivariable linear regression. RESULTS:We enrolled 644 families, excluding 263 because of preschool participation. Compared with excluded children, those included in the study had parents with lower income and educational attainment and who were more likely to be Spanish speaking. Three-quarters of enrollees completed pre-and postintervention assessments. Postintervention PALS-PreK scores revealed an unadjusted treatment effect of 0.260 (P 5 .040); adjusting for preintervention score, child age, and caregiver language, treatment effect was 0.209 (P 5 .016), equating to $3 months of literacy gains. Effects were greater for firstborn children (0.282 vs 0.178), children in 2-parent families (0.262 vs 0.063), and 4-year-olds (0.436 vs 0.107). The overall effect on PCI was not significant (1.221, P 5 .124). CONCLUSIONS:The health sector has unique access to difficult-to-reach young children. With this clinicbased texting intervention, we reached underresourced families and increased child literacy levels.

Kinder Ready Clinics: A Collaborative Model for Creating Equitable and Engaged Early Learning Environments for Low-income Families

“…We explore other opportunities to promote SR through the addition of new programs and evidence-based interventions (e.g., TipsbyText). [23][24][25] Additionally, partners internal and external to the collaborative explore opportunities to bring various programs to new clinical sites. The Little Libraries; Talk, Read, Sing; and Murals have spread beyond the collaborative to other clinical sites similarly interested in creating Kinder Ready clinics.…”

A Lost Pandemic Generation: Only If We Do Not Act Now

“…Interventions that strengthen socialemotional development in children are not only effective but also reduce special education costs. 4 The pediatric medicine community has a special role to play in creating new collaborative initiatives that integrate the health and early childhood education systems.…”

“…There are also diverse strategies proven to ameliorate the detrimental impact of family adversity on child development, including home nurse visitation programs, increasing books and learning materials in the home, high-quality preschool, and innovative clinic-based interventions, including school readiness coaching and parent texting programs. Interventions that strengthen social-emotional development in children are not only effective but also reduce special education costs . The pediatric medicine community has a special role to play in creating new collaborative initiatives that integrate the health and early childhood education systems.…”