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发展迅速的时期 学术，关系和健康成果的形状。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。屏幕时间在 婴儿期可以取代亲子的互动和损害学习。美国儿科学会（AAP） 建议从婴儿期开始的共享阅读，并在18个月之前灰心的屏幕时间灰心。尽管 在初级保健中进行阅读的讨论是不一致的，在婴儿期间共享阅读是适中的。 这个年龄的屏幕时间很普遍，不断增加且难以解决。伸出手来阅读（ROR）提供 从新生儿到5岁的新生儿的书籍和指导，每年为500万个家庭服务。然而， 尚未开发出父母读取的结构化方法。一般敦促在这个年龄阅读可能 无效和燃料动画和“教育”屏幕时间，尤其是在低社会状态的家庭中 （SES）经验较少。该项目的长期目标是建立一种家庭友好的方法 婴儿期共享的阅读和屏幕时间指导。该应用的目的是进行临床 与通常的ROR相比，在低调家庭中，与ROR一起进行的“操作方法”干预的试验。 在新的移动应用程序（ROR+）中涉及特殊儿童读物和视频。这些引入共享/步骤，一个 旨在丰富阅读惯例的新颖方法：在腿上依ugg，动手，表现出感情，回应 （拉伸单词，谈论图片，探索声音，耐心），享受。一本儿童读鼓励练习 在家里和3个动画视频提供了额外的指导。 ROR+还鼓励父母设定目标，每天记录 阅读并提供满足父母需求的提示，奖励和资源。学习人员将随机注册93 家庭/小组，收集基线数据并在新生儿1个月或2个月的访问中提供阅读干预。 在为期6个月的访问中，将通过相同的方法（书，ror+）引入屏幕干预。 6个月和12个月的后续访问将评估材料的印象，屏幕时间和语言。 阅读和使用数据将从ROR+访问。将邀请四十个家庭/小组完成音频 录音在6个月和12个月后使用Lena设备来测量家里的谈话和电子噪声。我们的 中心假设是，在婴儿早期的良好访问期间，干预措施将是可行的，对家庭和 有效地提高HLE和语言并减少屏幕时间。理由不存在类似的干预措施， 当前的指导在很大程度上是无效的，ROR+是协同作用的，可以在ROR计划中缩放。 这项研究具有重要的和创新性，因为它涉及一种新颖的方法来增强父母的阅读 并限制在初级保健期间有效提供的屏幕时间，加强AAP指南和地址 NICHD/CDBB优先研究领域。预期的结果是在关键期间成功测试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。