Pediatric Literacy Promotion for Latino Families by Texts and Referrals: A 3-Arm RCT.

Authors

Manuel E Jimenez, Jennifer R Hemler, Pamela Ohman Strickland, Alicja Bator, Daniel Lima, Naomy Azcona, Ysabela Perez, Johan Ayala, Karen Melendez Alas, Jennifer Dillon, Regina M Fasano, Usha Ramachandran, Shilpa Pai, Katie A Devine, Silvia Perez Cortes, Benjamin F Crabtree, Shawna V Hudson, Thomas I Mackie, Alan L Mendelsohn

Published in

Pediatrics. Sep 24, 2026. Epub Sep 24, 2026.

Abstract

To test 2 strategies designed to enhance primary care-based literacy promotion (LP): (1) text message reminders (texts), and (2) texts plus referral to community resources.
We recruited 630 Latino caregiver-infant (aged 6 to 12 months) dyads for an effectiveness-implementation hybrid type 1 randomized trial. Dyads were randomly assigned into (1) LP-only (Reach Out and Read), (2) LP plus text messages (LP+texts), or (3) LP+texts plus referral to Connecting New Jersey (CNJ) (LP+texts+CNJ), which streamlines access to community resources based on the national Help Me Grow model. Participants completed online surveys and assessments at enrollment, and 9 and 18 months after enrollment. Primary outcomes focused on 3 domains: child language and social-emotional development, and parenting behaviors, including reading and verbal responsiveness. We followed the intent-to-treat principle and used step-down minimum P value method to adjust for multiple comparisons.
Among caregivers, 74% had less than or equal to a high school diploma and 88% reported speaking English less than very well. At 18 months after enrollment, the LP+text arm [effect size (ES) = 0.391; adjusted (adj.) P = .001] but not LP+text+CNJ had higher language scores compared with LP-only. At 9 and 18 months after enrollment, the LP plus texts plus CNJ arm had higher scores on social-emotional development than LP-only (ES = 0.267; adj. P = .04 and ES = 0.300; adj. P = .03, respectively), whereas the LP+text arm did not. At 9 months after enrollment, scores were higher for the LP+text+CNJ arm on verbal responsiveness (ES = 0.400; adj. P < .001) and the LP+text arm on reading (ES = 0.415; adj. P = .002) compared with LP-only.
Two strategies with high potential for scale enhanced LP's ability to promote relational and developmental health. Clinicians and policymakers can use this knowledge to optimize LP's impact.

PMID:
42778186
Bibliographic data and abstract were imported from PubMed on 24 Sep 2026.

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