221 - Association Between Clinician Modeling during Reach Out and Read and Enhanced Caregiver-clinician Relationships among Latino Families

Publication Number: 3213.221

Naomy Azcona, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Regina M.. Fasano, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Pamela A. Ohman Strickland, Rutgers School of Public Health, Piscataway, NJ, United States; Alicja Bator, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Usha Ramachandran, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Katie A. Devine, Rutgers Cancer Institute, New Brunswick, NJ, United States; Alan L. Mendelsohn, New York University Grossman School of Medicine, New York, NY, United States; Manuel E.. Jimenez, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, United States

Background: Caregiver-clinician relationships make important contributions to family engagement in pediatric care and child health outcomes. Families with preferred languages other than English are at elevated risk for poor caregiver clinician-relationships. Despite prior qualitative studies that suggest Reach Out and Read (ROR) may enhance caregiver-clinician relationships, prior work has not examined links between ROR components that are implemented and caregiver rating of this relationship. Clinician modeling of reading, in particular, is associated with enhanced home literacy environments and may enhance the caregiver-clinician relationship by encouraging open communication and fostering collaborative holistic care.

Objective: This study investigates associations between (1) comprehensive ROR implementation (i.e., 3 components), and (2) the presence of clinician modeling and caregiver-clinician relationships among Latino families who speak Spanish.

Design/Methods: We analyzed enrollment data from a larger randomized clinical trial that included 551 Spanish-speaking Latino caregiver-infant (6-12 months) dyads recruited from three urban health centers. Participants completed surveys assessing self-reported receipt of ROR components (book, anticipatory guidance, and clinician modeling) and caregiver-clinician relationship quality using the Physician-Parent Communication Questionnaire Interest (PPCQI) subscale. We defined comprehensive ROR implementation as 3 components (versus 0-2 components). We used mixed models with clinician as a random effect to examine associations between (1) comprehensive ROR implementation, and (2) receipt of clinician modeling with PPCQI scores, adjusting for clinic, caregiver age and education. This study was approved by the Rutgers IRB.

Results: Nearly all caregivers were mothers (98.4%); they were on average age 31 years old, and 62.2% had ≥ high school diploma. Only 15.3% of caregivers reported receiving three ROR components; 16.7% reported clinician modeling. In adjusted models, comprehensive ROR implementation was associated with higher perceived relationship quality (B = 0.51, p=0.04); the presence of clinician modeling was also associated with higher perceived relationship quality (B =0.52, p=0.03).

Conclusion(s): Comprehensive ROR implementation and clinician modeling specifically are associated with stronger perceived caregiver-clinician relationships among Spanish-speaking Latino families. These findings suggest that ROR effects may extend beyond shared reading and child development and support implementation of ROR and preventive models more broadly in healthcare.