Prescription for Play: Implementing a pediatric play promotion intervention in federally qualified health centers

Prescription for Play (P4P) is a social impact program delivered during 18–36-month well-child checks to promote caregiver-directed play. To understand the impact of P4P on caregiver outcomes and whether it can be feasibly delivered in safety-net settings, this research evaluated P4P’s implementation across six federally qualified health centers (FQHCs). The association of P4P on caregiver outcomes was assessed using an interrupted time series design in which two separate caregiver samples completed surveys before (n = 180) and after (n = 262 ) P4P implementation. Implementation of P4P was further assessed using a mixed methods evaluation of 27 staff surveys, 25 staff interviews, and 44 clinic observations. Caregivers reported positive views towards play and a strong desire to play with their children before and after P4P implementation; independent samples t-tests showed that group differences were not statistically significant for any survey construct. Triangulation of quantitative and qualitative implementation data showed that P4P can be implemented as designed within varied FQHC settings and is acceptable among clinic staff. Although P4P does not appear to influence caregivers’ positive views of and strong investment in play, this study offers important evidence that P4P can be implemented to fidelity within FQHCs, supporting its feasibility for delivery in safety-net settings.