title: Outcomes of a universal shared reading intervention by 2 years of age: the Let's Read trial.
abstract: BACKGROUND
  Early shared reading and literacy promotion benefits have stimulated international interest in the development of early-years literacy-promotion programs despite limited evidence of effectiveness at a broader population level.
  
  
  OBJECTIVE
  To determine whether a population-based primary care literacy promotion intervention during the first 2 years of life improves early markers of subsequent literacy by 2 years of age.
  
  
  METHODS
  This cluster randomized controlled trial took place in 5 relatively disadvantaged areas in Melbourne, Australia. Infants attending their maternal and child health centers were recruited at age 1-2 months. The intervention (4-8, 12, and 18 months) comprised maternal and child health nurses modelling shared reading activities to parents, supported by parent information and free books. Outcomes (at 2 years) included expressive vocabulary (MacArthur Bates Communicative Development Inventory), communication (Communication and Symbolic Behavior Scales), and home literacy environment (StimQ-Toddler). We analyzed the outcomes using random-effects (linear regression) models allowing for clustering.
  
  
  RESULTS
  A total of 552 families (87.6%; 324 intervention and 228 control families) of 630 recruited families (66.5% response) were retained to outcome. A total of 97.3% of intervention parents received some (93.7% to all) of the intervention. At 2 years, the trial arms had similar vocabulary (adjusted mean difference: -2.0 [95% confidence interval: -6.2 to 2.2]; P = .36), communication (adjusted mean difference: 0.2 [95% confidence interval: -2.3 to 2.7]; P = .87), and home literacy (adjusted mean difference: -0.4 [95% confidence interval: -1.0 to 0.2]; P = .21).
  
  
  CONCLUSIONS
  This universal literacy-promotion program was not beneficial in relatively disadvantaged communities by the age of 2 years and may be ineffective. Alternative interpretations may relate to program intensity, reach and/or sleeper effects. Definitive outcomes at 4 years are awaited.
authors.affiliation: Murdoch Childrens Research Institute, Victoria, Australia. sharon.goldfeld@rch.org.au
authors.forename: Sharon
authors.initials: S
authors.lastname: Goldfeld
authors.forename: Natasha
authors.initials: N
authors.lastname: Napiza
authors.forename: Jon
authors.initials: J
authors.lastname: Quach
authors.forename: Sheena
authors.initials: S
authors.lastname: Reilly
authors.forename: Obioha C
authors.initials: OC
authors.lastname: Ukoumunne
authors.forename: Melissa
authors.initials: M
authors.lastname: Wake
mesh_terms: D000328:Adult; D001877:Books; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics / Q000379:methods*; D010819:Physician's Role; D011320:Primary Health Care / Q000379:methods*; D011932:Reading; D013663:Teaching / Q000379:methods*; D014739:Victoria