title: Four-year-old outcomes of a universal infant-toddler shared reading intervention: the let's read trial.
abstract: OBJECTIVE
  To determine the emergent literacy and language effects of a low-intensity literacy promotion program (Let's Read) provided via universal well-child services to parents during the first 4 years of their child's life.
  
  
  METHODS
  Population-based, cluster randomized controlled trial performed between March 1, 2006, and December 10, 2010.
  
  
  METHODS
  Maternal and child health centers (clusters) in 5 relatively disadvantaged local government areas in Melbourne, Australia.
  
  
  METHODS
  All parents attending their 4-week well-child appointments in participating centers were invited to take part in the study.
  
  
  METHODS
  The Let's Read program was delivered at 4, 12, 18, and 42 months during universal well-child care visits.
  
  
  METHODS
  Child emergent literacy skills (intrasyllabic, phonemic, and sound/letter knowledge) and language (core, receptive, and expressive), measured at 4 years of age.
  
  
  RESULTS
  A total of 630 parents participated, with 365 children in 32 intervention clusters and 265 children in 33 control clusters; 563 children (89.4%) were retained in the study to 4 years of age. The adjusted mean differences (intervention minus control) for emergent literacy was 0.2 (95% CI, -0.2 to 0.6; P = .29) for intrasyllabic units, 0.05 (95% CI, -0.4 to 0.5; P = .85) for phonemic awareness, and 0.1 (95% CI, -1.5 to 1.6; P = .92) for letter knowledge. For language, the differences were 1.6 (95% CI, -1.1 to 4.3; P = .25) for core, 0.8 (95% CI, -2.0 to 3.7; P = .56) for receptive, and 1.4 (95% CI, -1.4 to 4.2; P = .32) for expressive scores.
  
  
  CONCLUSIONS
  This population-wide primary care literacy promotion and book distribution program provided neither the anticipated benefits to literacy and language nor enhanced uptake of literacy activities at 4 years of age, even when targeted to relatively disadvantaged areas.
  
  
  BACKGROUND
  isrctn.org Identifier: ISRCTN04602902.
authors.affiliation: Royal Children’s Hospital, Murdoch Childrens Research Institute and University of Melbourne, Melbourne, Australia. sharon.goldfeld@rch.org.au
authors.forename: Sharon
authors.initials: S
authors.lastname: Goldfeld
authors.forename: Jon
authors.initials: J
authors.lastname: Quach
authors.forename: Ruth
authors.initials: R
authors.lastname: Nicholls
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: D001877:Books; D002662:Child Health Services; D002675:Child, Preschool; D003467:Cultural Deprivation; D004493:Education; D005260:Female; D006801:Humans; D007223:Infant; D057194:Intention to Treat Analysis; D007804:Language Development; D016014:Linear Models; D008297:Male; D011204:Poverty Areas; D011314:Preventive Health Services; D011932:Reading; D012959:Socioeconomic Factors; D014739:Victoria