Date of Doctor of Nursing Practice Project Completion

2026

Faculty Advisor

Linda Cole DNP, RN, APRN, CCNS, CNE, FCNS

Abstract

Purpose

The purpose of this scholarly project was to address a gap in early literacy promotion for rural children by incorporating the Reach Out and Read program. This program bolsters foundational literacy by providing a book and anticipatory guidance at every well-child visit from birth through age 5. This project was expected to decrease no-show well-child attendance rates and improve provider morale.

Background

The project was implemented in an established rural pediatric primary care clinic in Northeast Texas. 

Methodology

Process implementation was measured through books distributed and EHR documentation of the intervention. Process objectives were measured by no-show rates for eligible well-child events compared to the same period one year prior. Provider morale was measured using the Mini Z 2.0 pre- and post-intervention.

Results

During the 8-week implementation period, 93% of eligible visits received the intervention, totaling 1,236 books distributed. No-show rates declined by 3% compared to the same timeframe the prior year. Clinician morale scores were consistent pre and post implementation for job satisfaction, burnout level and job stress. However, clinicians’ perception of workplace atmosphere improved by 0.97 on a 5-point scale.

Implications

Integration of a literacy intervention is feasible in pediatric primary care. Despite added steps, clinicians maintained high fidelity and stable stress levels. The intervention improved the workplace environment and is sustainable through stakeholder funding for books.

Key words: literacy promotion, pediatric primary care, health literacy

Keywords

Literacy promotion, pediatric primary care, health literacy, rural primary care, social determinants of health

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