An Amazingly Innovative Approach to Reaching Parents of Young Children

Background:  An estimated 1 in 6 children in the United States has a developmental delay or disability. Many children show signs of delay by age two years; however, fewer than half of these children are identified before they start school and even fewer receive early intervention. Acting early can make a big difference in improving children’s long-term outcomes, but many parents lack the knowledge of child development to know when they should be concerned and may be reluctant to bring their concerns to their child’s doctor.

Program background:  The Centers for Disease Control and Prevention’s (CDC) Learn the Signs. Act Early. (LTSAE) program offers health communication messages and materials designed to raise awareness of developmental milestones and facilitate developmental monitoring and early action on concerns. To reach busy parents of 3-year-olds, the LTSAE team developed a children’s book: Amazing Me--It’s Busy Being 3!, which combines a children’s story with information for parents about developmental milestones.

Evaluation Methods and Results:  Feasibility, acceptability, and impact of distributing Amazing Me in pediatric healthcare clinics was evaluated in two phases. In the first phase, 250 clinics received copies of Amazing Me to be distributed through an existing book distribution program called Reach Out and Read (RoR). Clinic leadership was given a web survey, which showed that distributing Amazing Me through the RoR program was feasible and acceptable to these clinics. The second phase of evaluation more closely examined the distribution of Amazing Me to six pediatric clinics (half RoR, half non-RoR). Surveys and interviews of clinic staff provided further evidence of acceptability and feasibility: almost all books were distributed to parents of children around three years of age, and all clinics said they would like to continue distributing Amazing Me. Although clinic administrators did not feel that the book resulted in more discussion with parents about developmental milestones, they felt that it facilitated the discussion by making the topic easier to explain to parents and that it successfully encouraged parents to work with their children to achieve milestones.

Conclusions:  This phase also comprised a survey and focus groups with parents who received the book. While only a very small (n=68, 8.2%), and non-representative sample of the parents who received Amazing Me responded to the online survey, respondents provided overwhelmingly positive responses. Amazing Me was very well-liked by respondents and focus group participants: they liked distribution through pediatric clinics, they liked the story and illustrations, most found the book informative and encouraging, and for many, it raised their awareness of the full range of developmental milestones.

Implications for research and/or practice:  It is challenging to reach busy parents of young children with health education messages, so finding alternatives to traditional communication mediums is important. Findings from this pilot intervention indicate that using a children’s book format to reach parents can be a feasible and effective method of increasing awareness about developmental milestones. Integrating messages into a children’s book is something other health communicators might consider to expand their reach.