ROR Plus: Randomized Trial of a Structured Approach to Parent-Infant Reading (SHARE/STEP) and Limiting Screen Time Delivered via a Multimedia Intervention During Pediatric Well-Visits

ROR Plus：结构化亲子阅读方法（分享/步骤）和通过儿科健康访问期间多媒体干预限制屏幕时间的随机试验

• 批准号: 10217626
• 负责人: John S. Hutton
• 金额: $ 23.85万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10217626
• 关键词: 5 year old; Academy; Address; Adherence; Advocacy; Advocate; Age; American; Anxiety; Area; Attitude; Award; Behavior; Books; Brain; Categories; Child; Child Language; Child Rearing; Childhood; Clinic; Clinical; Clinical Trials; Code; Cognitive; Data; Development; Devices; Emotional; Enrollment; Environment; Evidence based program; Family; Foundations; Frequencies; Goals; Guidelines; Health; Health Promotion; Home; Impairment; Infant; Infant Health; Infrastructure; Instruction; Intervention; Journals; Knowledge; Language; Learning; Life; Measures; Methods; Multimedia; National Institute of Child Health and Human Development; Newborn Infant; Noise; Notification; Nursery Schools; Oral; Outcome; Parent-Child Relations; Parents; Pediatrics; Positive Reinforcements; Poverty; Primary Health Care; Provider; Public Health; Randomized; Reader; Reading; Recommendation; Reporting; Research; Research Priority; Resources; Risk; Source; Speech; Stretching; Structure; Testing; Time; Training; Visit; Well Child Visits; Writing; acronyms; affection; base; cognitive ability; design; experience; follow-up; impression; improved; infancy; innovation; interest; kindergarten; literacy; low socioeconomic status; meetings; mobile application; novel; novel strategies; pilot trial; programs; randomized trial; recruit; skills; social; sound; success; tv watching; usability

PROJECT SUMMARY The first year of life is a time of rapid brain development where critical skills, attitudes and routines predictive of academic, relational and health outcomes are shaped. An infant's home literacy environment (HLE), including quality of parent-child (“shared”) reading, can be a major source of nurturing in these areas. Screen time in infancy can displace parent-child interaction and impair learning. The American Academy of Pediatrics (AAP) recommends shared reading from early infancy and discouraging screen time before 18-months old. While discussion of reading occurs in primary care, it is inconsistent and shared reading during infancy is modest. Screen time at this age is prevalent, increasing and hard to address. Reach Out and Read (ROR) provides books and guidance at well-visits from newborn to 5-years old and serves >5-million families/year. However, no structured approach to parent-infant reading has been developed. General urging to read at this age may be ineffective and fuel anxiety and “educational” screen time, especially in families of low-socioeconomic status (SES) with less experience. The long-term goal of this project is to establish a family-friendly approach to shared reading and screen time guidance in infancy. The objective of this application is to conduct a clinical trial of a “how-to” intervention alongside ROR compared to usual ROR, in families of low-SES. Intervention involves special children's books and videos in a new mobile app (ROR+). These introduce SHARE/STEP, a novel approach intended to enrich reading routines: Snuggle on lap, Hands on, show Affection, Respond (Stretch words, Talk about pictures, Explore sounds, Patience), Enjoy. A children's book encourages practice at home, and 3 animated videos provide extra guidance. ROR+ also encourages parents to set goals, log daily reading and provides tips, awards and resources tailored to parent needs. Study staff will randomly enroll 93 families/group, collect Baseline data and deliver reading intervention at a Newborn, 1-month or 2-month visit. At the 6-month visit, screen time intervention will be introduced via the same approach (book, video in ROR+). Follow-up visits at 6- and 12-months will assess HLE, impression of materials, screen time and language. Reading and usage data will be accessed from ROR+. Forty families/group will be invited to complete audio recordings measuring talk and electronic noise at home after 6- and 12-month visits using LENA devices. Our central hypothesis is that intervention will be feasible during well-visits in early infancy, useful for families and effective to improve HLE and language and reduce screen time. The rationale is no similar intervention exists, current guidance is largely ineffective, and ROR+ is synergistic and may be scaled within the ROR program. This research is significant and innovative in that it involves a novel approach to enhance parent-infant reading and limit screen time efficiently delivered during primary care, reinforces AAP guidelines and addresses NICHD/CDBB priority research areas. The expected outcome is successful testing of ROR+ during a critical span of cognitive, relational and brain development, providing a foundation for further research and application.

项目摘要 生命的第一年是大脑快速发育的时期，关键技能，态度和惯例预示着 形成学术、关系和健康成果。婴儿的家庭识字环境（HLE），包括 亲子（“共享”）阅读的质量，可以成为这些领域培养的主要来源。内时间的 婴儿期可能取代父母与子女之间的互动，影响学习。美国儿科学会（AAP） 建议从婴儿早期开始分享阅读，并在18个月大之前劝阻屏幕时间。而 关于阅读的讨论发生在初级保健中，它是不一致的，婴儿期的共同阅读是适度的。 这个年龄段的屏幕时间很普遍，越来越多，很难解决。Reach Out and Read（ROR） 在从新生儿到5岁的油井访问中提供书籍和指导，每年为500多万个家庭提供服务。然而，在这方面， 还没有开发出父母-婴儿阅读的结构化方法。一般敦促阅读在这个年龄可能 无效，并助长焦虑和“教育”屏幕时间，特别是在低社会经济地位的家庭 (SES)经验较少。该项目的长期目标是建立一种关爱家庭的方法， 在婴儿期分享阅读和屏幕时间指导。本申请的目的是进行临床 在低社会经济地位的家庭中，与常规ROR相比，ROR的“如何”干预试验。干预 在新的移动的应用程序（ROR+）中包含特殊的儿童书籍和视频。这些介绍了SHARE/STEP， 一种新的方法，旨在丰富阅读程序：依偎在膝盖上，动手，显示感情，回应 （拉伸单词，谈论图片，探索声音，耐心），享受。儿童读物鼓励练习 3个动画视频提供额外的指导。ROR+还鼓励父母设定目标，每天记录 阅读，并提供适合家长需要的提示，奖励和资源。研究人员将随机招募93名 家庭/组，收集基线数据，并在新生儿、1个月或2个月访视时提供阅读干预。 在6个月访视时，将通过相同的方法（ROR+中的书籍、视频）引入屏幕时间干预。 6个月和12个月的随访访视将评估HLE、材料印象、筛选时间和语言。 将从ROR+访问阅读和使用数据。将邀请四十个家庭/团体完成音频 使用LENA设备在6个月和12个月访视后测量家中的谈话和电子噪音的记录。我们 中心假设是，在婴儿早期的井访期间，干预是可行的，对家庭有用， 有效改善HLE和语言，减少屏幕时间。理由是不存在类似的干预措施， 目前的指导在很大程度上是无效的，ROR+是协同的，可以在ROR计划中进行扩展。 本研究的创新之处在于为促进亲子阅读提供了一种新的途径 并限制在初级保健期间有效提供的屏幕时间，加强了AAP指南， NICHD/CDBB优先研究领域。预期的结果是在关键时期成功测试ROR+。 认知，关系和大脑发展的跨度，为进一步的研究和应用提供了基础。