Book Babies, an early-literacy home visiting program, was developed to strengthen literacy promoting practices of families’ and children’s early literacy skills. To determine the efficacy of this program and whether its impacts vary by families’ language status, a team of scholars from the UNC Frank Porter Graham Child Development Institute (FPG) and the HighScope Educational Research Foundation (HighScope), evaluated the program. Their findings were shared in “Book Babies Home Visiting Intervention: Evidence of Effect on Literacy-Promoting Practices and Children’s Early Language,” published online on October 30, 2025, in Child & Youth Care Forum.
 
The FPG team was comprised of FPG Faculty Fellow Iheoma Iruka,PhD, founding director of the Equity Research Action Coalition at FPG and a full professor in the Department of Maternal and Child Health at the UNC Gillings School of Global Public Health; Senior Research Scientist Ximena Franco-Jenkins, PhD, co-director of FPG's National Implementation Research Network (NIRN); and Research Coordinator Adis Liy, MEd.
 
Research has demonstrated that early learning experiences are critical for children’s long-term success, as their brains develop most rapidly in the first three years of life. Therefore, it is imperative to ensure that practices aimed at improving children’s early literacy skills provide equitable experiences for racially and linguistically diverse young children and their families.
 
Book Harvest, a nonprofit agency based in Durham, launched Book Babies in 2013. The program provides home visits, beginning at a child’s birth and continuing through the child’s fifth birthday. During these triannual visits, a trained Book Babies home visitor brings 20 curated, developmentally appropriate books to participating families each year, with the final visit taking place once the child is 5 years old. During each visit, the home visitor collaborates with the parent on a variety of early literacy concepts and strategies for the parent to utilize each day with their child. The program also sends bimonthly text messages with early literacy tips, community gatherings, and support for pre-kindergarten applications and enrollment.
 
To ascertain the effectiveness of these strategies, Book Harvest conducted a two-year evaluation of two Book Babies cohorts—children born in 2013 and 2014—in 2015. While there were positive and significant findings, the evaluation had limitations. Since the families chosen for the study were not randomized, it was unclear whether the books or the full range of Book Babies programming made the difference in parenting practices and child outcomes.
 
To address this, Book Harvest engaged a research team at HighScope and FPG to conduct a randomized control trial (RCT) beginning in 2019. Two questions framed the research: “Do Book Babies parents engage in literacy promoting practices such as reading to their child and pointing to the text while reading more than families in the control groups?” and “Do Book Babies children show higher early literacy than children in the control groups?”
 
Community clinics, nurses from Family Connects, Healthy Steps Specialists, and social workers in pediatric clinics referred families for the study. Participants in the two cohorts of Book Babies families from two different sites—Durham County and Forsyth County—were randomly assigned to three groups. The first group, called Book Babies (BB), received the complete intervention, including the full complement of home visiting services and books.

“Home visiting programs are one way to ensure that children are experiencing responsive, enriching, and language-rich settings, but there are few home visiting interventions focused on early literacy,” said Franco-Jenkins. “The evaluation of Book Babies is essential to determine how programs that center on families' strengths and routines can most effectively build this evidence base and mitigate disparities in language outcomes.”
 

The second group, called Books Only, just received books while the third group, the control group, only received a cash incentive to stay in the study. The intervention consisted of three home visits per year to all groups. Approximately half of the sample in all three groups identify as Black/African American while the other half identify as Hispanic. Less than 10% of the sample identifies as another race.
 
The researchers found evidence that participation in Book Babies impacted literacy promoting practices, such as caregivers’ daily reading to children and pointing to text while reading, establishing a routine, and helping children identify a favorite book. While there was no evidence that Book Babies significantly promoted children’s early language, there was a trend indicating that children who are Spanish-speaking dual language learners in the BB treatment group were likely to show growth in comprehension compared to children in the control groups. The team noted that these analyses were completed before the children finished the Book Babies program suggesting that the effects on children’s early language skills may take longer to become apparent.
 
The limited findings showed that the Book Babies intervention was more beneficial for children’s early language than the control groups. There was an exception for Spanish-speaking children, for whom there was an indication that those in the Book Babies treatment group showed stronger comprehension skills than children in the control groups.
 
The authors note that the study provides important evidence that parents living in poverty can be supported to provide materials, time, and literacy enhancing skills to promote literacy and language for their children. “Home visiting programs are one way to ensure that children are experiencing responsive, enriching, and language-rich settings, but there are few home visiting interventions focused on early literacy,” said Franco-Jenkins. “The evaluation of Book Babies is essential to determine how programs that center on families' strengths and routines can most effectively build this evidence base and mitigate disparities in language outcomes.”

“The Book Babies intervention also shows the importance of ensuring programs are culturally and linguistically responsive to families with young children, which has implications for children’s early language and literacy, but more importantly, ensures children are on track for school and life success,” she said. “Given that this study was prematurely ended due to the COVID-19 pandemic, the findings from this RCT show promise for the future scalability of Book Babies.”

Iruka agrees. “The Book Babies intervention also shows the importance of ensuring programs are culturally and linguistically responsive to families with young children, which has implications for children’s early language and literacy, but more importantly, ensures children are on track for school and life success,” she said. “Given that this study was prematurely ended due to the COVID-19 pandemic, the findings from this RCT show promise for the future scalability of Book Babies.”