Promoting Kindergarten Readiness in Primary Care: Perspectives of Children's Primary Care Providers.

Background and objective: Children's healthcare providers have important roles in kindergarten readiness. We sought to understand children's primary care providers' (PCP) current approaches to fostering kindergarten readiness for their patients, perceptions of barriers, and ideas for improvement.

Methods: Children's PCPs were recruited and interviewed between June and August 2021. Interviews were audio recorded, transcribed, and iteratively analyzed to identify and refine emerging themes.

Results: Eleven PCPs were interviewed from eleven unique practices across rural and urban settings in North Carolina. Key themes included (1) Integrating kindergarten readiness in the primary care clinic, (2) Partnering with communities to improve kindergarten readiness, and (3) Promoting equity to improve kindergarten readiness. Within the clinic, PCPs valued extended care teams and dedicated assessment tools. PCPs reported wanting greater collaboration with schools and community organizations and more transparent assessment and referral processes. PCPs identified inequities within existing systems and called for more culturally inclusive, equitable kindergarten readiness promotion. Recommendations included removing cultural and language bias from assessments, improving racial/ethnic concordance, and advocating for supportive systems-level policies.

Conclusions: Children's PCPs identified many current and future opportunities to partner with families and communities to optimize children's school readiness throughout early childhood. Many school readiness promoting activities recommended by PCPs in this study could be supported through quality measures that track and provide financing for these specific actions.