The Latino School Readiness Gap: Engaging Families in Design Thinking for Primary Care Interventions

Objective: Among Latino families with a recent kindergartener, we 1) qualitatively explored school readiness (SR) journeys and 2) used design thinking to understand their preferences, usability, and acceptability of primary care–based SR interventions (checklist, coordinator, coaching, texting, preschool, library referrals, parenting groups, and Reach out and Read). Methods: Focus groups and interviews were completed at 4 Oregon pediatric clinics over 2 sessions: 1) narrative inquiry of SR stories through journey maps and 2) SR intervention assessment through design thinking. Sessions were led by an English/Spanish bilingual-bicultural facilitator, recorded, and transcribed. Iterative team–based coding with inductive analysis was conducted in the source language. Results: Participants (N = 33) were primarily Spanish-speaking (58%) mothers (76%) born in Mexico (64%) with at least a high school degree (69%), with US-born children (55%) who attended preschool (81%). Journey maps revealed a positive educational foundation of teaching values, culture, and language for kindergarten preparation, with strong beliefs that school will teach life skills. Compared to English-speaking parents, Spanish-speaking parents focused more on social-emotional development than specific early literacy or math activities, reporting less confidence in teaching cognitive skills. Parents identified a longitudinal model with SR interventions at multiple points. Themes regarding targeted SR support, hesitancy to request help, and bilingualism were integrated into a prior framework to promote SR (Figure). Conclusions: Participating families encouraged school success in their children before kindergarten and focused on social-emotional, cultural, and linguistic development. Caregivers identified a variety of acceptable and feasible clinic–based SR interventions that build on Latino families’ social strengths.