Promoting Early Language Development Through Parent-child Book Reading in Costa Rica
Condition: Language Development
Study type: Interventional

Summary: 
      The purpose of this study is to analyze the effect of an interactive parent-child book
      reading intervention. The intervention includes two components: the provision of five
      children's books to parent-child dyads and information about how to practice interactive book
      reading. The investigators expect to find an effect of this intervention on a) infants'
      expressive vocabulary, b) reading activity, c) parental expectations and knowledge about
      language development and d) parental use of interactive book reading strategies.
    

Detailed description: 
      The foundations of optimal health, growth and development are forged early in life, when
      income-related gaps in learning opportunities already exist in Costa Rica. It is therefore
      important for the government to mitigate the effects of these gaps through programs targeting
      the development of academic, behavioral, socioemotional and economic abilities. Key to the
      success of such programs is to consider physical health, nutrition, responsive care and early
      learning. Multiple government-led initiatives in Costa Rica had been carried out in order to
      provide adequate programs for infants and young children. Evidence of these efforts are
      observed in the low rates attained in infant mortality, malnutrition and anemia, as well as
      the high coverage of the current immunization program. However, policies targeting early
      learning in children under 36 months of age are incipient and government initiatives in this
      regard are relatively recent.

      The purpose of this study is to promote early language development, a central component of
      early learning. Our goal is to implement and evaluate a low-cost intervention targeting
      parents of infants who benefit from the existing immunization program of the public health
      services offered by the Caja Costarricense del Seguro Social (Costa Rican Social Security
      Fund).

      The investigators will use an experimental design to randomly assign 15- to 17-month-old
      infants and their caregivers to one of two groups: a control group or an experimental group.
      In the experimental group, caregivers will receive a package including five children's books
      and 36 text messages with information on how to practice interactive book reading with their
      children. This information will be delivered over a period of 12 weeks. The control group
      will not receive any treatment during the implementation of the intervention.

      In order to measure the efficacy of the intervention, the investigators will evaluate a)
      infants' expressive vocabulary, b) parent-child reading activity, c) parental expectations
      and knowledge about language development and d) parental use of interactive book reading
      strategies at baseline (15-17 months of age) and at posttest (18-20 months of age) in the
      control and the experimental group. After posttest, the control group will receive the
      complete intervention.

      The investigators expect to find an effect of the interactive book reading intervention on a)
      infants' expressive vocabulary, b) reading activity, c) parental expectations and knowledge
      about language development and d) parental use of interactive book reading strategies.
    

Intervention name(s): Interactive Book Reading
Intervention type(s): Behavioral
Intervention description(s): The intervention is a package including five children's books and information on how to practice interactive book reading. Information includes 36 audiovisual products delivered via text messaging over a 12-week period. Products include:
An introductory video about interactive book reading, along with a written list of recommendations on how to practice interactive book reading.
Two videos of child development experts explaining the benefits of interactive reading.
Thirty written text messages strengthening content provided in the videos.
Three audio messages guiding the progress of the intervention.
Based on Abraham and Michie's (2008) taxonomy of behavior change techniques, one audiovisual product prompts specific goal settings, 13 provide instruction, one provides information on consequences, 10 prompt practice, three use follow-up prompts, one prompts self-monitoring of behavior, one models or demonstrates the behavior and six prompt barrier identification.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: All participants will take baseline measures. After baseline, each participant will be randomly assigned to the control or the experimental group. At posttest, all measures taken at baseline will be evaluated again in all participants.
Masking: Single (Outcomes Assessor)
Primary purpose: Basic Science
Keywords: Book reading; Infancy; Interactive reading; Vocabulary development; Parenting