223 - Expanding Reach Out and Read's Bilingual Adaptation: Barriers, Facilitators, and Needs for Supporting Home Language Maintenance in Chinese-Speaking Families in the U.S.

Publication Number: 3215.223

Yu Chen, New York University Grossman School of Medicine, New York, NY, United States; Milton Guendica, Northwestern University, Lincolnwood, IL, United States; Siqi Zhu, New York University Grossman School of Medicine, New York, NY, United States; Yuk Man Tang, New York University Grossman School of Medicine, Brooklyn, NY, United States; Adriana Weisleder, Northwestern University, Evanston, IL, United States; Mariana Glusman, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Anna Miller-Fitzwater, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Caitlin F. Canfield, NYU Grossman School of Medicine, New York, NY, United States

Background: Children in non-English-speaking families in the U.S. often lose their home language and become English-dominant as they grow older, leading to difficulties in parent-child communication and relationship and lower social-emotional wellbeing. Meanwhile, a high-quality home language environment fosters early development across domains and is particularly important for minority children as it mitigates the negative impacts of structural disparities. To promote home language maintenance (HLM), Reach Out and Read (ROR)-a primary care prevention based on shared reading for ages 0 to 5-developed a Spanish bilingual adaptation (Leyendo Juntos), including pediatrician training and parent resources. However, it has not incorporated Chinese, the 2nd most common non-English language spoken in U.S. homes. Expanding this model to other language/cultural groups is essential to achieving broader reach and impact among families facing disparities.

Objective: To explore the deeper context and describe the prevalence of barriers, facilitators, and needs for supporting HLM in Chinese-speaking families, as initial steps to inform strategies for expanding ROR bilingual adaptation.

Design/Methods: An ongoing mixed methods study with a convenience sample of 80 parents in Sunset Park, Brooklyn, who primarily speak Chinese and have a child under 5 years. Semi-structured interviews, conducted and transcribed in Chinese and translated into English for coding, probed parents' language use and shared reading with child, beliefs about Chinese skills and bilingualism, and expectations of and interactions with pediatricians in promoting HLM. Survey items measured the same constructs. Findings from thematic analysis (QUAL) and descriptive statistics (quan) were integrated to determine convergence and divergence (Figure 1).

Results: 20 parents (Table 1) completed the study at the time of this submission. Integrated findings between QUAL and quan (Table 2) showed confirmation on the benefits of Chinese skills, expansion on several key barriers, facilitators, and needs (e.g., misconceptions of bilingualism, misleading advice from pediatricians, family language policy, and audio bilingual books), and discordance on the expectation of pediatricians in promoting HLM.

Conclusion(s): Potential strategies for expanding ROR bilingual adaptation to Chinese-speaking families may include providing Chinese-English (audio) bilingual books, giving information on HLM and bilingualism, and training pediatricians in incorporating bilingualism into anticipatory guidance and promoting high-quality home language environments (e.g., shared reading in Chinese).

Figure 1. Convergent Mixed Methods Design


Table 1. Sample Characteristics (n = 20)
Note. Percentages for each item may not add up to 100% due to missing data.

Table 2. Joint Display of Qualitative and Quantitative Findings with Convergence Level