Conference Program

Caregiver-child shared book-reading interventions are considered an evidence-based approach for improving children's language and literacy skills. However, impacts on child outcomes are conditioned on caregiver implementation of the intervention. Caregivers implementing shared-reading interventions have the responsibility of maintaining regular shared-reading sessions and incorporating specific behaviors to enhance the activity. Many barriers can impede caregiver implementation, such as (1) time pressures, (2) lack of knowledge of benefits, and/or (3) discomfort with shared-reading activities. These barriers can impede caregiver implementation of shared-reading interventions, and studies find generally high levels of attrition from such interventions. Consequently, shared-reading interventions do not reach all caregivers and children and can increase inequities between implementers and non-implementers.

An implementation-science framework can be used to identify barriers of caregiver implementation of shared book-reading interventions, and introduce enablers to increase implementation. Enables comprise behavior-change strategies that can overcome barriers and increase implementation and, as a result, child outcomes from interventions.

In this paper, I present evidence identifying common barriers to caregiver implementation of shared book-reading interventions, as well as behavior-change strategies designed to overcome these barriers. For instance, a common barrier is time pressures, and a behavior-change strategy that overcomes time pressure is financial incentives. I then present findings from a randomized controlled trial (RCT) designed to test four specific behavior-change strategies and their effects on caregiver implementation of a shared book-reading intervention. The RCT involved caregivers and their 4-year-old children with developmental language disorder (DLD). Study findings showed that two behavior-change strategies - financial incentives and encouraging texts - increased caregivers' implementation and mediated intervention effects on children's literacy skills. Finally, I share initial results from a larger-scale RCT testing long-run impacts of behavior-change strategies on literacy growth of children with DLD as a function of caregiver behavior-change strategies.

The overall premise of this paper is that evidence-based caregiver-focused book-reading interventions can increase inequities between caregivers who can and caregivers who cannot sustain the intervention. Researchers must attend to barriers that inhibit "uptake" of such interventions and test strategies that enhance caregivers' capabilities in maintaining interventions. An implementation-science framework is imperative to conducting research addressing barriers and enhablers of caregivers' engagement in shared-reading interventions.