Hablame Bebe: Improving health information access for low-income Hispanic children's early language environments

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PROJECT SUMMARY Hispanic infants whose families live in poverty are at a significantly elevated risk of poorer cognitive development and academic achievement. Research shows that this is explained in part by their early language environment: children from lower socioeconomic status (SES) homes often experience less high-quality language input than children from higher SES homes, which in turn may lead to delays or gaps in later language skills. Unfortunately, these circumstances can be worse for Hispanic children whose immigrant caregivers believe that they should switch from Spanish to English as a result of assimilation pressure or misinformed advice. Additionally, Hispanics parents are more than twice as likely to have low health literacy and significantly less likely to attend well-child care check-ups. In response to this disparity, our interdisciplinary team created Háblame Bebé, the first mobile phone application that reduces the word gap and promotes Spanish-English bilingualism for low-income Hispanic children. In 2017, Háblame Bebé was selected as the winner of the U.S. HRSA Bridging the Word Gap Challenge. For this Challenge, we developed two prototypes and tested them with 32 low-income Hispanic families. In this study, we learned that although our app was effective in improving overall outcomes for children, parents who had experienced linguistic racism were not as likely to give “Language Nutrition” to their babies in their native Spanish. Only after we created a sociolinguistic pride component in the app did it lead to caregivers providing significantly more “Language Nutrition” to their children. Based on our team’s research on the impact of Háblame Bebé, we need to make additions to the app in order to maximize outreach and effectiveness for low-income, low-literacy Hispanic caregivers. The proposed project seeks to serve this high-risk group by developing, disseminating, and evaluating health information pertaining to early developmental milestones and language environments for low- income Hispanic families. We have partnered with a health sciences librarian as well as the Miami-Dade County Public Library System, and together, will do this by: (Aim 1) improving the deliverability, usability, and understandability of early child development information to low-SES Hispanic families; (Aim 2) developing additional educational content targeting low health literacy and cultural representation; and (Aim 3) assessing the effectiveness of the Háblame Bebé phone app using quantitative and qualitative analyses. Our goal is to design the most impactful evidence-based app intervention to eliminate the word gap in low-income Hispanic children in the United States and to deliver better, culturally relevant, and usable health information to low-income Hispanic families to reduce disparities in their children. The new content developed will assist in making the Háblame Bebé phone app ready for clinical trial testing upon conclusion of the project. !