Promoting early literacy in primary care: A qualitative study on health visitors' experiences with the pilot implementation of the 'By Reading They Grow' intervention

INTRODUCTION: Early literacy promotion has been recognized as a universal public health approach for achieving maximal population-level benefits on language, cognitive and social-emotional developmental health of children from diverse ethnic and socioeconomic backgrounds. AIMS: To explore the experiences of health visitors in implementing an early literacy promotion intervention in the context of primary care. METHODS: An interpretive descriptive approach to qualitative research was used by conducting three focus groups, with the following research questions: What was the health visitors' experience of the intervention implementation, how itwas integrated into theirdaily primary care practice and what they think about its sustainability. Discussionswere recorded, transcribed verbatim and submitted to thematic analysis. RESULTS: All health visitors implementing the intervention in 12 primary care settings were invited (n=23) and n=22 agreed to be included in the focus groups. Analysis revealed practitioners’ positive experiences, involving acceptance of the intervention by parents, children and colleagues, while engagement of all followed a pattern of ‘mutual motivation’. Participants appreciated the impact of the intervention on enriching their practice, favoring a holistic approach and enhancing job satisfaction. Several facilitators and barriers were also stated, such as availability of appropriate resources and challenges posed by vulnerable populations. The intervention was described as an interactive and systematic process comprising an integral part of routine primary care practice, and considered its sustainability through community dissemination and networking. CONCLUSION: This exploratory qualitative study provides insights into the experiences and views of primary care practitioners on implementing an early literary promotion initiative, which could inform early childhood interventions promoting optimal developmental health on population level. Clinical trial number : not applicable.