Abstract
Background
Despite the benefits of play on child development, under-resourced children are less likely to have equal access to or opportunities for play. Prescription for Play (P4P), a social impact program of The LEGO® Group, leverages attendance at 18-to-36-month well-child checks to discuss and promote play and has the potential to effectively increase play in under-resourced families. However, limited work has investigated the feasibility and effectiveness of its implementation. As such, this research evaluated the implementation outcomes of P4P within multiple federally qualified health centers (FQHCs), which serve as important safety-net medical settings for under-resourced families.
Methods
Data were collected from six FQHCs. To understand whether P4P impacts caregiver outcomes, an interrupted time series design was used in which two separate samples of caregivers completed a researcher-designed survey before (n = 180) and after (n = 262) program implementation. A mixed-methods approach was undertaken to evaluate the process of delivering P4P using an implementation fidelity framework, in which staff surveys (n = 27), staff interviews (n = 25), and clinic observations (n = 44) were completed.
Results
Caregivers reported positive views towards play and a strong desire to play with their children before and after P4P implementation, with independent samples t-tests showing no differences between groups on survey constructs (ps > .06). Triangulation of qualitative and quantitative process data showed that P4P can be implemented as designed within varied FQHC settings and is acceptable among clinic staff, with additional implementation facilitators identified.
Conclusion
Although P4P does not appear to influence the positive views of and strong investment in play held by caregivers, this study offers important evidence that P4P can be implemented to fidelity within FQHCs, making it a feasible program to deliver in safety-net settings.