Reach Out and Read

Evidence Rating  
Evidence rating: Scientifically Supported

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Health Factors  
Date last updated

The Reach Out and Read program partners with doctors, nurse practitioners, and other medical professionals to incorporate literacy support into regular well-child visits. From the 6-month checkup through age five, medical providers give children developmentally appropriate books and give parents guidance and encouragement on reading with their children. The program focuses on children in low income communities1.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Increased time spent reading

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Improved language skills

What does the research say about effectiveness?

There is strong evidence that Reach Out and Read1 increases the frequency with which participating low income and minority parents read to their children23, 4. Effects have been demonstrated for black and Latino parents5, parents who speak English as a second language67, and parents with less than a high school education3, 6.

Young children of low income or Latino immigrant parents who participate in ROR appear to understand more words than their peers2. ROR participation may also improve spoken vocabulary5 and early literacy skills8 for some children in Spanish-speaking families. ROR can lead parents to keep more books in their homes2. A Toronto-based study of participating children with adolescent parents suggests that ROR is associated with increased time spent reading and reading enjoyment, and reduced maternal depression9. Ongoing ROR visits may lead to stronger program effects5, 108.

A Michigan-based study suggests that giving ROR program presentations to all physicians and residents, posting reading tips in exam rooms, and creating workflow plans for book distribution can increase both physician counseling and book distribution rates11. Researchers suggest that careful book selection can support positive messages with children (e.g., books with depictions of nutritious food)12, and positive parenting content (e.g., children’s books addressing behavioral issues)13.

How could this strategy impact health disparities? This strategy is rated likely to decrease disparities.
Implementation Examples

Reach Out and Read Programs are active in all 50 states, Washington, D.C., Puerto Rico, the U.S. Virgin Islands, the Northern Mariana Islands, and many U.S. military bases overseas1. In total, over 5,000 ROR program sites serve an estimated 4.2 million children annually, distributing over 6 million books a year. As of 2015, 14 states invest state and federal funds in support of local ROR programs14.

Implementation Resources

ROR - Reach Out & Read (ROR). Where great stories begin.


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1 ROR - Reach Out & Read (ROR). Where great stories begin.

2 Needlman 2004 - Needlman R, Silverstein M. Pediatric interventions to support reading aloud: How good is the evidence? Journal of Developmental and Behavioral Pediatrics. 2004;25(5):352–63.

3 Needlman 2005 - Needlman R, Toker KH, Dreyer BP, Klass P, Mendelsohn AL. Effectiveness of a primary care intervention to support reading aloud: A multicenter evaluation. Ambulatory Pediatrics. 2005;5(4):209-15.

4 Yeager Pelatti 2014 - Yeager Pelatti C, Pentimonti JM, Justice LM. Methodological review of the quality of Reach Out and Read: Does it “work”? Clinical Pediatrics. 2014;53(4):343–350.

5 Mendelsohn 2001 - Mendelsohn AL, Mogilner LN, Dreyer BP, et al. The impact of a clinic-based literacy intervention on language development in inner- city preschool children. Pediatrics. 2001;107(1):130-4.

6 Golova 1999 - Golova N, Alario AJ, Vivier PM, Rodriguez M, High PC. Literacy promotion for Hispanic families in a primary care setting: A randomized, controlled trial. Pediatrics. 1999;103(5):993-7.

7 Silverstein 2002 - Silverstein M, Iverson L, Lozano P. An english-language clinic-based literacy program is effective for a multilingual population. Pediatrics. 2002;109(5):e76.

8 Dienar 2012 - Diener ML, Hobson-Rohrer W, Byington CL. Kindergarten readiness and performance of Latino children participating in Reach out and Read. Journal of Community Medicine & Health Education. 2012;2(3):133.

9 Kumar 2016 - Kumar MM, Cowan HR, Erdman L, Kaufman M, Hick KM. Reach Out and Read is feasible and effective for adolescent mothers: A pilot study. Maternal and Child Health Journal. 2016;20(3):630–638.

10 Theriot 2003 - Theriot JA, Franco SM, Sisson BA, et al. The impact of early literacy guidance on language skills of 3-year-olds. Clinical Pediatrics. 2003;42(2):165-72.

11 Thakur 2016 - Thakur K, Sudhanthar S, Sigal Y, Mattarella N. Improving early childhood literacy and school readiness through Reach Out and Read (ROR) program. BMJ Quality Improvement Reports. 2016;5(1):u209772–w4137.

12 England 2015 - England JL, Linchey J, Madsen KA, Patel AI. Reach out and eat: Food and beverages depicted in books for preschoolers. Clinical Pediatrics. 2015;54(13):1257–1264.

13 Bauer 2012 - Bauer NS, Hus AM, Sullivan PD, et al. A pilot study using children’s books to understand caregiver perceptions of parenting practices. Journal of Developmental & Behavioral Pediatrics. 2012;33(5):423–430.

14 NCSL-Goodwin 2015 - Goodwin K, Poppe J, Lipkowitz R. Trends: Three ways to a healthy start. National Conference of State Legislatures (NCSL) State Legislatures Magazine. 2015.