Intended Outcomes and Core Components of Primary Care-Based Literacy Promotion as Defined by Experts
Bibliographic record
Abstract
OBJECTIVE: Primary care-based literacy promotion enhances caregiver-child shared reading and child language outcomes, yet variation in implementation may dilute its impact. This study examines expert perspectives on intended outcomes of literacy promotion, as well as its core components, those necessary to achieve intended outcomes, and components that are recommended but adaptable to context. METHODS: We purposively sampled health care and policy experts in primary care-based literacy promotion from the United States and Canada for online, in-depth interviews. Interviews were recorded, transcribed verbatim, and analyzed iteratively, engaging emergent and a priori codes based on the Components and Rationales for Effectiveness fidelity method and the team's prior work to identify themes. RESULTS: We achieved saturation after 22 interviews with 24 participants (16 US participants, 8 Canadian). We identified 4 themes: 1) Traditionally, literacy promotion focused on enhancing preliteracy skills and school readiness. Over time, this outcome has evolved to include fostering early relational health as a foundational goal; 2) core components include a trusted clinician delivering a strength-based, family-centered message, while modeling developmentally-informed shared reading; 3) components that are adaptable to setting and context include literacy-rich clinical environments and community resource referrals; 4) experts diverged on whether providing a children's book during literacy promotion is essential, but there was congruence that book provision alone is insufficient. CONCLUSIONS: Experts identified strength-based, family-centered guidance from a trusted clinician with developmentally-focused modeling as core to support intended outcomes of early relational health and school readiness. This understanding can inform training and health care improvement activities aimed at optimizing primary care-based literacy promotion.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".