Thousands of doctors and nurses across the country, in large urban hospitals and small rural clinics, tell us that Reach Out and Read has become an essential part of their pediatric practices. By introducing a beautiful new book at the beginning of a well-child visit, providers find they can better engage and calm the child, provide meaningful, positive messages to the parent, and build connections with the family. Using the book in the exam room opens up the opportunity to talk about other issues - healthy routines, sleep issues, and even school readiness, and also offers providers a new and valuable tool for assessing the child's development. Becoming a Reach Out and Read Program will mean that your clinic offers new and valuable benefits to your patients and their families' important developmental guidance, beautiful, age-appropriate books, enrichment in the waiting room - and also gives your providers new ways to strengthen their relationships with the families of young children.

The Reach Out and Read model for pediatric literacy intervention has three key elements:

• Primary care providers (doctors and nurses) are trained to deliver early literacy guidance to parents of children 6 months through 5 years of age during each well-child visit. This guidance centers on age-appropriate strategies, including: how to enjoy looking at board books and naming pictures with infants, the importance of rhyme and repetition to toddlers, and open-ended questions to use when reading with preschoolers.
• During the well-child visit, in the exam room, the provider gives the child a new, developmentally-appropriate children's book to take home, building a collection of 10 new books in the home before the child goes to kindergarten.
• Many Reach Out and Read Programs also create literacy-rich waiting rooms, including gently-used books for waiting room use or for siblings to take home. In many of these waiting rooms, Reach Out and Read volunteers model for parents the pleasures and techniques of reading aloud to very young children.

Reach Out and Read is an evidence-based intervention. Peer-reviewed and published studies show that literacy promoting interventions by the pediatrician, using the Reach Out and Read model, have a significant effect on parental behavior, beliefs, and attitudes toward reading aloud. Studies also show that parents who get books and literacy counseling from their pediatricians are more likely to read to their young children and provide more books in the home. Several studies also show improvements in the expressive and receptive language scores of young children receiving this intervention. Check the Impact & Research section of the Reach Out and Read website for additional information on Reach Out and Read related research.

The number of new books you need depends on your Annual Book Commitment (ABC), which is equivalent to the annual number of well-child visits for children ages 6 months through 5 years. On average, Reach Out and Read Programs' books cost approximately $2.75. To determine your estimated Annual Book Budget, multiply your annual number of well-child visits for children aged 6 months through 5 years old (we used 620 in the below example) by $2.75. During your first year, some of the books for your Program may be provided by a Reach Out and Read Coalition and/or other sources, thus lowering the number of books you will need to purchase each year. After a Program has completed two brief biannual Progress Reports (see Question #12), it may be eligible for books from the Reach Out and Read National Center.

There are lots of ways to raise money for your Reach Out and Read Program. Many small Programs hold an annual fundraiser, such as a bake sale or a pancake breakfast. Still others seek funding from wealthy individuals in their communities or from small businesses, large corporations, or charitable foundations that support local causes. The kind of fundraising plan that you need will depend on the size of your population and your budget. www.myROR.org provides templates for fundraising letters and grant applications that you can personalize for your own Program. Reach Out and Read Coalitions can also assist with your fundraising efforts. Click here to see if there is a Coalition in your area.

Local community groups can help your Reach Out and Read Program with fundraising for books, volunteer recruitment, community visibility, and publicity. There are other people in your community working to promote literacy, and there are many service organizations that might want to link up with you locally. Reach Out and Read Programs often work with the following groups:

• Libraries
• Faith-based organizations
• High school and college community service leaders
• Civic groups (e.g., Rotary Club, Kiwanis, Junior League)
• Municipal literacy initiatives

The Reach Out and Read model is designed to be implemented by medical professionals who provide primary care to children, ages 6 months through 5 years, as part of the well-child checkup. We at the Reach Out and Read National Center feel strongly that the message about the importance of reading aloud is important for every young child and every family - and, of course, that books are important for every child. We are eager to work with any clinic or practice which wants to implement the program. However, our funds are limited, and our federal funding in particular is designated for children at-risk.

Each Reach Out and Read Program has a Reach Out and Read Medical Director - a doctor or nurse who is responsible for the job of training medical colleagues, connecting with the executive leadership of the clinic, and generally serving as the medical "face" of the Program. The Medical Director is supported by a Program Coordinator who is responsible for the administrative aspects of running the Reach Out and Read Program (i.e. ordering books, stocking exam rooms, coordinating volunteer readers). The Reach Out and Read Coordinator can be any interested staff member familiar with the clinic, the staff, and the patient population. Both roles are most often voluntary in nature and take very little time each month.

• Review information about the Reach Out and Read model at www.reachoutandread.org.
• Identify an on-site Reach Out and Read Medical Director.
• Talk to your clinic's administration and pediatric staff to engage their support.
• Begin to gather demographic information on your clinic population - ages 6 months through 5 years. (You will also need to determine a rough approximation of the percent of families living at or near 200% of the poverty level, or give us other demographic information to indicate whether you serve a substantial number of children who should be considered at-risk.)
• Develop and implement a fundraising plan to generate support for your books. You will need to demonstrate in your Reach Out and Read application that you have secured at least 75% of your Annual Book Commitment (ABC) for the first year.
• Find out if you are located within a Reach Out and Read Coalition. Click here to see a list of Coalitions.

Begin an online application.

Reach Out and Read training for pediatric primary care providers offers practical, concrete, and effective strategies for talking to parents about books and for using books in the well-child visit. All Reach Out and Read providers need to complete the Reach Out and Read training before they can be approved to begin implementing the program. There are two options for training. Each provider who will participate in implementing the program will receive their own personal login information for Reach Out and Read's online portal; from there, providers may complete an individual, computer-based training. This training may also be completed for CME credit, if desired. In rare instances, Reach Out and Read will pre-approve an in-person training at certain Sites for six or more providers in attendance.

The Reach Out and Read model calls for the provider to give a new, age- and culturally-appropriate book in the exam room at each well-child visit. There are a number of ways that you can procure books for your Program.

Reach Out and Read publishes a book catalog available exclusively to approved Programs with books at substantially discounted prices. The catalog is organized by child's age to make the book selection process easy. Reach Out and Read Programs may also choose to purchase high quality children's books from book specials offered by publishers and book distributors. These offers can be found at www.myROR.org/books. You can also solicit new book donations from individuals or businesses in your area.

The Reach Out and Read Program Manual, has a chapter devoted to identifying good children's books for use in the program, as well as suggestions for ordering, tracking, and storing your book supply.

Many Reach Out and Read Programs also like to have "gently-used" donated books available in the waiting areas for siblings, for sick visits, or for long waiting periods.

Reach Out and Read recognizes that children and parents often spend a fair amount of time in the waiting room. To take advantage of this time, the Reach Out and Read model recommends using the waiting room to promote the joy of reading aloud and to provide information for parents about how to read to their young children. In many Reach Out and Read waiting rooms:

• Volunteers provide children with positive reading experiences and help parents understand that a picture or storybook is an easy, portable way to keep a young child engaged in almost any situation.
• Volunteers model read-aloud techniques that show parents by example that reading with children is a vigorous, enjoyable process.

Not all clinics have waiting rooms or wait times suitable for volunteer reader programs. However, all Reach Out and Read Programs can develop a waiting room component of the Program. For example, Reach Out and Read Programs can:

• Ask volunteers to collect gently-used books, sort them, and put them out on shelves in the waiting room so children of all ages can read them in the waiting room and take them home if they choose.
• Develop displays of short poems, stories, and laminated posters to display in the waiting area.
• Provide posters and pamphlets about health literacy and family literacy opportunities available in the community.

The staff at the Reach Out and Read National Center are available to provide ongoing technical assistance to our Programs. We like to keep in touch, often through our regular e-newsletter. In addition, if your Program is in a region with a Reach Out and Read Coalition, you will benefit from their assistance and support as well.

If you have further questions, see our Starting a Program brochure, email the Reach Out and Read National Center, or call 617-455-0600.