Multilingual Parents’ Experiences of an Early Language and Literacy Intervention: A Qualitative Study Using the Behaviour Change Wheel

Abstract

Introduction

Early language development is shaped by both biological and environmental factors. Parent-mediated interventions promoting shared reading and interaction can enhance the home language environment and children’s language skills. To achieve this, interventions need to facilitate behaviour change in the home environment. The intervention Språkstart Halland supports early language development through gift packs and guidance from library staff, delivered during home visits at 6 and 11 months and via preschools at age 3. This study aims to (1) explore experiences of Språkstart Halland among parents with a first language other than Swedish and (2) based on these results explore the intervention’s potential to promote behaviour change using the Behaviour Change Wheel framework.

Methods

Semi-structured interviews were conducted with fifteen parents; interpreters were used as needed. Data were analysed using qualitative content analysis. In a second step, the resulting categories were further interpreted using the Behaviour Change Wheel (BCW) framework.

Results

Three main categories were identified: (1) “Greater opportunities for language learning in various languages through increased knowledge and accessible tools and strategies”; (2) “Valued support beyond expectations – the social context is instrumental”; and (3) “Seeking ways to be a parent in a new socio-cultural context.” The BCW analysis indicated that the intervention addressed all components defined in the framework to influence behaviour: motivation, capability, and opportunity.

Conclusion

The intervention has potential to enhance language-stimulating activities in multilingual homes.

Introduction

It is known that several early life factors in children’s environments influence their language and literacy development, in interplay with biological factors [1]. While multilingual language development per se is not considered to constitute an etiological factor for language difficulties [2], it does add an additional layer of complexity to the interplay of early life factors influencing language development [3]. Whether children are learning one or several languages, their language development is influenced by the quantity and quality of their language input [4], and expressive language skill is influenced by the amount of language use [5]. Environmental factors influencing these aspects can be indirectly shaped by broader contextual conditions, such as government policies, cultural belief systems, and societal attitudes towards the value and status of a language [6]. In the case of multilingual children whose first language (L1) is not the dominant one in their society (hereafter referred to as a non-majority language), several interacting risk factors for children’s language development are often present. This situation is commonly linked to immigrant status [5], and it might be accompanied by constraints such as limited income and lower parental education, as well as reduced social support [1]. Such constraints have been associated with less rich language input, which in turn has been linked to differences in children’s language skills [7, 8]. In this context, multilingual language development is sometimes treated in educational contexts as an indicator of risk. This reflects a complex interplay of factors, rather than a causal association between multilingualism and language difficulties [2, 9].

Children’s school readiness can be supported by emergent literacy skills including oral language development, phonological and print awareness [10]. The home learning environment (HLE) plays a central role in the development of early language and literacy skills. Tamis-LeMonda et al. [11] offered a useful conceptualization of the early HLE, proposing three core components: (1) participation in literacy activities (such as shared reading, storytelling, songs and rhymes), (2) the quality of caregiver engagement (including language exposure and responsive parenting), and (3) access to learning materials (including books and developmentally supportive toys). While there is no universally agreed-upon set of defining elements of the HLE, a substantial body of research has demonstrated associations between these components and children’s early language and literacy outcomes in both monolingual and multilingual children [12–20].

Based on this body of evidence, well-established early interventions globally aim to strengthen the HLE, thereby supporting children’s early language and literacy development. These interventions commonly centre on shared reading, providing books and guidance for interactive reading [e.g., [21–23]]. To varying degrees, interventions also include everyday interactional practices, such as talking about objects and events in daily routines, singing nursery rhymes, and engaging in play [e.g., [24]]. These initiatives provide knowledge to inform parents’ beliefs about early shared reading and language stimulation, while also promoting positive attitudes towards reading [21]. Parents from diverse linguistic and cultural backgrounds reported that book gifting, combined with guidance on shared reading and interaction, enhanced their early language and literacy practices [25]. However, the extent to which families with a non-majority language benefit from early language and literacy interventions that provide books in the majority language has not yet been fully established [26].

The literature provides broad support for the positive effects of parent-mediated early language and literacy interventions on the literacy activities component of the HLE, as conceptualized by Tamis-LeMonda et al. [11]. Evaluations report increased frequency of shared reading [e.g., [26]] and more positive attitudes towards the activity [e.g., [25, 27]]. Studies also indicate that early language and literacy interventions enhance caregiver engagement, reflecting the second HLE component, for example, through more interactive reading styles and increased parental responsiveness [28, 29]. The access to learning materials, identified as the third HLE component [11], is directly addressed in many early language and literacy interventions through the distribution of age-appropriate books and related materials [30].

Numerous studies have also reported that early language and literacy interventions are associated with positive outcomes in children’s language and literacy skills [26, 28, 31]. However, some studies have reported limited or no effects [e.g., [32]]. In addition, concerns have been raised about possible publication bias, meaning that studies with statistically significant findings may be overrepresented in the literature [26]. Evidence suggests that intervention outcomes are influenced by how interventions are implemented. In a study examining intervention implementation in a health-care context, book gifting alone did not significantly affect literacy activities in the home. In contrast, the delivery of a greater number of intervention components, including anticipatory guidance and modelling, was associated with both increased quantity and improved quality of shared reading, such as the use of specific shared reading strategies [33]. Early language and literacy interventions often comprise multiple interacting components and are shaped by contextual influences, such as their integration with local services, including child health services, early childhood education settings, and other community services. These features are characteristic of a complex intervention [34, 35]. In such interventions, it is important to identify the underlying mechanisms of change, that is, the causal links between intervention components and outcomes, within a given context [34]. While outcomes of early language and literacy interventions are well studied, intervention content and implementation are often insufficiently specified [36–38] and the processes and mechanisms underlying the targeted outcomes are seldom explicitly defined.

Parent-mediated early language and literacy interventions most often aim to modify parental behaviours in order to influence the HLE [26, 28]. Therefore, applying a behaviour change framework can support understanding of the processes through which parents’ behaviours, and thereby the HLE, are influenced. The Behaviour Change Wheel (BCW) framework is a comprehensive approach to designing and evaluating behaviour change interventions [39]. It has previously been shown to be useful for characterizing components of parent-mediated interventions in speech and language pathology [38]. At its core is a model of behaviour: the COM-B model. This model describes an individual’s behaviour (B) as a function of their capability, opportunity, and motivation (COM) (see online suppl. Fig. S1; for all online suppl. material, see https://doi.org/10.1159/000552090). Each COM-B component (capability, opportunity, and motivation) consists of two sub-components. Capability includes physical and psychological capability, opportunity comprises physical and social opportunity, and motivation encompasses reflective and automatic motivation [40]. According to the BCW framework, an intervention can influence behaviour by affecting one or more of the three COM-B components. This is achieved through the use of different intervention functions, which are broad strategies for promoting behaviour change, such as education and training [39]. The BCW outlines a total of nine intervention functions [39]. For definitions and examples, see online supplementary Table S1.

This study focuses on a Swedish parent-mediated early language and literacy intervention called Språkstart Halland¹, which provides language-stimulating gift packs and guidance at the ages of 6 months, 11 months, and 3 years. Centred on home visits, the intervention combines language-stimulating resources with guidance and modelling to foster shared activities such as talking, play, singing, and reading. Compared to similar interventions, Språkstart Halland can be considered relatively comprehensive in scope. The intervention therefore serves as a suitable case for exploring the processes through which an early language and literacy intervention may influence the HLE. Analysing an intervention with a relatively broad and multifaceted design may generate insights that are analytically relevant for similar early language and literacy interventions.

Parents’ experiences of Språkstart Halland have previously been explored in a focus group study conducted in Swedish [41]. Inclusion criteria in that study required sufficient Swedish language skills to participate in group discussions, which led to the exclusion of parents with very limited Swedish skills. Moreover, it was noted during the focus groups that the setting created barriers to full participation for parents with limited Swedish skills. This likely constrained the depth and diversity of perspectives captured within this sub-group. Hence, the present study broadens the scope of this work. Individual interviews were selected to enable interpreter support, which was not feasible in a focus group format. This approach allows for exploration of how families with a non-majority language background may benefit from early language and literacy interventions providing books in the majority language, contributing to an area that has been identified as underexplored in previous research [26].

Accordingly, the aims of the present study were to (1) explore experiences of Språkstart Halland among parents with a first language other than Swedish and based on these findings (2) explore the intervention’s potential to promote the HLE using the Behaviour Change Wheel framework [40]. The research questions were “What are the experiences of Språkstart Halland among parents with a first language other than Swedish?” and “How can the intervention processes be understood as influencing the home learning environment when interpreted through the Behaviour Change Wheel framework?”.

Methods

To gain a deeper understanding of parents’ experiences of the intervention, we chose to perform semi-structured interviews [42]. The use of individual interviews made it possible to use an interpreter as required. Interview data were first analysed using qualitative content analysis [43], primarily following an inductive approach with the aim of describing parents’ experiences. In a second step, the categories from the content analysis were further interpreted using the BCW framework [39]. This provided a structured, theory-informed approach to exploring how different parts of the intervention may support behaviour change. It should be noted, however, that the second part of the analysis represents an interpretative application of the BCW framework, rather than the use of a standardized analytical procedure, and should therefore be considered exploratory.

Intervention

Språkstart Halland is an early language and literacy intervention implemented in parts of the Swedish region of Halland. It targets all children in the relevant age groups. When children are 6 and 11 months old, library staff called “language starters” visit families at home (if families so prefer, they may come to the library instead). Families receive age-appropriate gift packs including books, toys, leaflets with songs and rhymes accompanied by video clips on the intervention’s Website, and written guidance on language development and language stimulation. The written guidance is available in 16 languages, but the books have either text in Swedish or no text. During the visits, the language starter demonstrates how to use the materials interactively, modelling the use of body language, sounds, gestures, and facial expressions to engage toddlers in the intervention activities: “talking, playing, singing, and reading” [44]. Families are encouraged to use their L1 and to participate in library activities. Occasionally, an interpreter is used or other language support provided. When the children are 3 years old, further gift packs are distributed through pre-schools, with additional information shared, for example, at pre-school parents’ meetings. Those few parents whose children do not attend pre-school receive the gift pack from the language starter through individual arrangements. In the municipality where the study was conducted, the intervention normally reaches over 90 percent of the target population (about 80–100 children per year) for the first visit, with high participation rates for the subsequent visits as well. During the COVID-19 pandemic, visits were more often held at the library or sometimes outdoors, and the participation rate dropped to 58 percent (Ehde Andersson M., 2025, personal communication).

Participants

Participants (n = 15, representing 14 families) were recruited through purposive sampling, aiming for demographic variation (see Table 1). Recruitment was conducted by the language starter, who had had previous contact with all participants. The language starter provided brief information about the study. For parents who expressed interest in participating, contact details were forwarded to the first author (H.D.), who then provided both written and oral information about the study, including an opportunity to ask questions. Language support was provided if needed. Participants gave their written informed consent prior to taking part in the research. The study was approved by the Swedish Ethical Review Authority (Ref. No. 2021-06771-02). All participants lived in a small rural industrial municipality with many foreign-born residents. Inclusion criteria included having an L1 other than Swedish and having participated in at least one intervention visit. The participants were between 24 and 42 years old (M = 31). The time they had spent in Sweden ranged from 3 to 18 years. Their knowledge of the Swedish language varied; it was not formally assessed. Information about their language backgrounds is given in Table 2. Two families had received only the first visit, seven had received the first and second ones, and one had also received the third gift pack. Home and library visits were fairly equally distributed. The time elapsed since the most recent visit ranged from about 1 month to 3 years, with a median of 1 year.

Table 1.

Demographic information about participants

Demographic variables	Number of participants (n = 15)
Parent
Mother	11
Father	4
Highest level of education
Less than upper-secondary school	3
Upper-secondary school	4
University/higher education	8
Employment status
Employed	5
Employed and on parental leave	2
On parental leave	2
Student	3
Job-seeker	1
Student and job-seeker	1
Housewife	1
Number of children in the home
1 child	6
2 children	3
3 children	4
4 children	1
5 children	1

Table 2.

Participants’ language backgrounds

Languages spoken in the home	Number of participants (n = 15)
Albanian	2
Albanian and Swedish	1
Arabic	4
Arabic and Kurdish	1
Arabic and Swedish	1
Azerbaijani	1
Finnish, English, and Swedish	1
Polish	1
Somali	2
Spanish	1

The two participants who reported speaking Albanian in the home represented the same family.

Data Collection

Data were gathered through individual interviews. In one interview, both parents participated. Participants completed a brief background-information questionnaire. The interviews followed a semi-structured interview guide with open-ended questions (see online suppl. Material S1), which had been developed within a previous study [41]. All participants were offered to have a qualified interpreter present during their interview, and four of them accepted this offer. The remaining interviews were held in Swedish, without an interpreter. The interviews, which were performed at the public library or occasionally in participants’ homes, were audio-recorded. Interview time ranged from 25 to 85 min with a mean of about 50 min. When the 11th interview had been performed, a comprehensive review of the data collected so far was conducted during a brief reflective intermission. Since the most recent interviews were found to have provided new insights, data collection continued. Two additional interviews, involving a total of three participants, were carried out, followed by a second reflective intermission, and then one more interview was performed. At this point, after the 14th interview, it was determined that the capacity to acquire further novel information of relevance for the analysis had been saturated. Hence, data collection ended.

Data Analysis

The first author transcribed the audio-recorded interviews verbatim, starting after the first interview and continuing alongside data collection. The interview material was reviewed several times to obtain an overview. The analysis was conducted using qualitative content analysis [43]. An inductive approach was primarily applied, complemented by deductive elements [45]. The software NVivo 14 [46] was used to aid the analysis. Transcripts were segmented into meaning units, which were condensed [43] and then abstracted into codes [47]. This was followed by an organizing phase initially guided by deductive principles. Categories identified in the analysis of a previous study [41] were used to facilitate the initial sorting of data by content [45]. The analysis then continued inductively through re-grouping of content based on similarity, re-categorizing and abstracting [45, 47]. Categorization and subcategorization were discussed by all co-authors until consensus was reached. The analysis involved a dynamic and iterative process where steps were revisited and the analysis was continuously refined. Eventually, an overarching theme running through the entire material was identified. One example of the analytic process, from quote to final categories and overarching theme, is given in Table 3.

Table 3.

Example of the analytic process in content analysis

Quote	Condensation	Code	Subcategory	Category	Overarching theme
Adrian: “Well, this is one reason why we, you know, why we’ve used books, why we’ve been singing, why we’ve, you know, got her going in that way, instead of, well, playing with toys and so on. Trying instead to get her into books and singing and so on. And just like my wife says, she’s a very social girl, she really wants to, she’s curious and so on. So that’s what it’s meant.”	It has helped us to get her going with books and singing rather than just playing. She is a social and curious girl who really wants this	It has helped us to lead the child into language-stimulating activities; the child really wants this	1.2. New materials and approaches created increased opportunities for language-stimulating activities	1. Greater opportunities for language learning in various languages through increased knowledge and accessible tools and strategies	Meaningful, personal support addressing an essential issue – engaging guidance that stimulates the family’s language learning

After completing the qualitative content analysis, the content of each category was compared with the definitions of the nine BCW intervention functions [39] (see definitions in online suppl. Table S1). Identified intervention functions were documented, and the ways in which they were manifested in the current material were described with reference to the content analysis. In cases where overlap occurred and content could be mapped onto multiple intervention functions, an inclusive approach was adopted, whereby all relevant functions were documented. This reflects the multifaceted nature of intervention processes, where a single component may simultaneously serve several functions, consistent with the BCW framework [39]. For each identified intervention function, its potential influence on the COM-B components (opportunity, capability, and motivation) was further analysed based on the links outlined in the BCW framework [39]. These links were then contextualized and described with reference to the present material. Relations between the content analysis categories, intervention functions, and associated COM-B components were discussed among all co-authors to enhance transparency and credibility.

Findings

This section is divided into two parts: an initial presentation of the qualitative content analysis, followed by an interpretation guided by the Behaviour Change Wheel framework. Table 4 summarizes the results of the content analysis and provides an overview of the Behaviour Change Wheel intervention functions identified within each subcategory.

Table 4.

Overview of the content analysis findings and associated BCW intervention functions

Qualitative content analysis		BCW analysis
overarching theme: meaningful, personal support addressing an essential issue – engaging guidance that stimulates the family’s language learning		intervention functions
categories	subcategories	edu.	pers.	train.	env. re.	mod.
1. Greater opportunities for language learning in various languages through increased knowledge and accessible tools and strategies	1.1. Supported parents’ understanding – encouraged early engagement in language-stimulating activities	X	X	​	X	​
	1.2. Increased opportunities for language-stimulating activities through new materials and approaches	X	X	X	X	X
	1.3. Increased language-learning activities for child and parent – in various languages	​	​	​	X	​
2. Valued support beyond expectations – the social context is instrumental	2.1. A positive experience – a supportive relationship and multifaceted support	​	X	​	X	​
	2.2. Participation in social contexts enhances language learning and integration	​	​	​	X	​
3. Seeking ways to be a parent in a new socio-cultural context	3.1. Parents noticed cultural differences and embraced new approaches	X	​	​	X	​
	3.2. Addressing parents’ ongoing concerns to support multilingual language development	X	​	​	X	​

This table presents the results of the qualitative content analysis, including the overarching theme, three main categories, and seven subcategories. It illustrates the five intervention functions identified through the BCW analysis: education (edu.), persuasion (pers.), training (train.), environmental restructuring (env. re.), and modelling (mod.) [39] and indicates which intervention functions were identified for each subcategory.

Findings from the Content Analysis

The analysis yielded one overarching theme, three main categories (1–3), and seven subcategories (1.1–3.2). In the presentation below, pseudonyms are used for the parents, their children, and the language starter. The illustrative quotations given from the parents’ interviews have been translated into English by the authors.

Overarching Theme

An overarching theme was found to run through the entire material: meaningful, personal support addressing an essential issue – engaging guidance that stimulates the family’s language learning. Multilingual language development was regarded as essential, but parents noted that it could be challenging to navigate how best to support their child in this process. They considered that receiving personal guidance and support from a person they trusted both as a professional and as a person, along with being given relevant materials, had enabled and inspired them to increase the amount of language-learning activities in the family.

Category 1: Greater Opportunities for Language Learning in Various Languages through Increased Knowledge and Accessible Tools and Strategies

This category describes how parents experienced that the intervention provided valuable knowledge, resources, and inspiration that facilitated increased language-stimulating activities in the home. The materials in easy-to-read Swedish were accessible and supported language learning in the family.

Subcategory 1.1: Supported Parents’ Understanding – Encouraged Early Engagement in Language-Stimulating Activities. Parents stated that the intervention gave them knowledge and helped them discover the benefits and importance of early language-stimulating strategies. They learnt, for example, that reading benefits a child’s vocabulary and language development and that children learn words from everyday conversations even at 6 months of age. Yasmin expressed: “When I met, Jennie [the language starter, author’s comment], her name is, she said that even when they’re this really young, they listen. Even if you think maybe they don’t, they do, they just gather up all the words you say.” One parent even described the insight that they could influence their child’s language learning at such a young age as a profound epiphany. Samir explained: “The biggest difference they made was that they advised us to start teaching the children when they were young, when they were two years old, one year old, they can be taught, but I thought after five years.” Parents noted that, because of this insight, their younger children had better conditions than their older ones since they had previously adopted a wait-and-see approach despite their older child’s notable language difficulties. These accounts illustrate that the intervention helped parents realize that they could support their child’s early language development. Parents also declared that the intervention equipped them to take on the responsibility that this entails and enabled them to become increasingly self-efficacious in the task. It was appreciated that the intervention brought attention to the family’s routines so as to raise awareness regarding this. Many parents described having received a push in the right direction to start language stimulation earlier. They expressed gratefulness for understanding its benefits and for receiving this information effortlessly during a busy time. Some parents stated that they were already familiar with the strategies but still found the intervention to be a helpful reminder to start early. Further, some parents appreciated receiving individually tailored advice based on their current situation, while occasional accounts from other parents did not indicate that they had gained any new insights regarding knowledge, strategies, or habits.

Subcategory 1.2: Increased Opportunities for Language-Stimulating Activities through New Materials and Approaches. The intervention was said to have provided materials and strategies that had helped parents get started with language-stimulating activities. Parents explained how they were reminded, encouraged, or taught how to, for example, read with a young child. Some had tried before but felt uncertain. Yasmin said: “I didn’t really know how to, and I thought maybe he doesn’t listen to me, or, I felt like he doesn’t pay attention to what I’m reading.” It was stated that the child enjoyed being read to more and paid more attention when parents read with engagement, a varied tone of voice, gestures, and body language. Parents shared how the language starter had served as a model by showing engagement in reading, singing, playing, and talking about things and actions nearby, supported by gestures and body language. Elisa stated: “I think all the time about what Jennie did with Lisa, and I try to do the same thing.” Benefits for the child’s learning were noted, although at times the child did not seem interested and turned to other activities. Parents experienced closeness to the child in the shared activities. Louisa stated: “I think it’s much better that parents can have very good contact with their children. If you can communicate, you can read your child’s reactions.” It was also claimed that the activities helped to calm the child down. Some parents noted that they had similar strategies in their home culture, such as storytelling and nursery rhymes, with the only difference being the language.

The books included in the gift pack were found to represent a good selection of enjoyable, age-appropriate literature that subsequently inspired families to buy or borrow more books. Many families already had literature and toys, but they were not always characterized as suitable for the child’s current age. Other parents stated that the entire concept of children’s books was new to them. The intervention was said to help parents discover the benefits of children’s literature and of the accompanying toys and activities. Specific opinions regarding the materials received differed. However, many parents expressed a wish for audio-recordings accompanying the books, to facilitate pronunciation. They also requested additional materials similar to those received to extend learning opportunities. In addition, there were occasional requests relating to, for example, materials translated into a specific L1, materials with naturalistic pictures, and additional materials including Key Word Signs. Regarding the latter, however, it was noted that the use of different signs across languages caused confusion when parents looked for further information.

Subcategory 1.3: Increased Language-Learning Activities for Child and Parent – in Various Languages. Parents said that the amount of language-stimulating activities had increased after the intervention in terms of shared reading, playing, singing, talking, and learning in everyday activities. Parents described actively making room for language-stimulating activities in everyday life, for example, striving to read more regularly. Further, children showed that they enjoyed the activities and took the initiative in using the materials with parents or siblings, or on their own. The children had discovered shared reading as an enjoyable activity that could be requested from the parent, as recounted by Nadia: “sometimes when I’m at home, cooking or doing something in the kitchen or in my room, he comes to me and gets the book and says, ‘mummy, please read to me’.” However, some parents stated that such activities would have been carried out even without the intervention. Barriers to shared language-stimulating activities mentioned by parents included lack of time, parental stress and tiredness, and children’s short interest span or lack of interest in the activities.

Materials and strategies such as descriptive talk, shared play, and interactive reading were used in both L1 and L2. Parents described using L1 in shared reading to talk about the pictures or translate the text. They recounted actively noticing whether the child understood and supplementing with visual support and translation between languages when needed. Parents also reported increased language-stimulating activities in Swedish after the intervention, driven by greater awareness of the child’s Swedish-language skills. Children and parents learnt Swedish together through the visits and shared activities. The books contained simple, useful vocabulary that parents found they could read, sometimes with the help of older siblings. Some parents found it beneficial to practise their own language skills with the child. Others stated that they refrained from reading in Swedish, fearing that they might teach the child incorrectly. In such cases, songs were preferred as the correct pronunciation could be heard. Finally, parents stated that activities after the intervention were mainly initiated by the parent who had been present at the intervention, even if information was shared between caregivers.

Category 2: Valued Support beyond Expectations – the Social Context Is Instrumental

This category describes how parents appreciated that the intervention was given to support children’s language development. The interaction with the language starter was described as enjoyable and supportive, with perceived benefits for language learning. Parents also highlighted the importance of the social context for language learning and integration.

Subcategory 2.1: A Positive Experience – A Supportive Relationship and Multifaceted Support. The intervention was characterized as interesting and enjoyable. Parents felt pleased to see their child happy during the playful activities. They appreciated how the language starter devoted time to the child and family, acknowledged their early language-stimulation habits, and engaged with them on a more personal level. Parents described feeling encouraged and affirmed, also regarding their own process for learning Swedish. Anna noted: “She said that I had learnt Swedish well since the last time we met […] She was so pleasantly surprised. When you hear just a little something positive, it makes a big difference.” The language starter’s ability to facilitate ease of conversation despite language disparities created a supportive environment that enabled openness – professional skill created a sense of trustworthiness.

Parents stated that they valued that the intervention was offered to support children’s language development. They appreciated being given a gift, and they reflected upon the importance of ensuring that all children have access to books and toys as not all families have the means or habits to purchase such materials or borrow books from the library. Some parents perceived the intervention as a big surprise since they had not heard of it and knew of nothing similar from their home country. Some had felt hesitant before the initial visit, and they suggested that the information provided before the intervention could be improved, for example, through co-operation with the child health-care services. Overall, parents expressed satisfaction and wanted the intervention to continue. However, those who were familiar with the strategies involved placed greater emphasis on the potential value of the intervention to those less well informed.

Subcategory 2.2: Participation in Social Contexts Enhances Language Learning and Integration. Parents noted that the intervention visits provided an opportunity for their child to meet someone who spoke Swedish, pointing out that this could make the child start learning the Swedish language. Nadia said: “I think it’s important. It helps people. Especially people who speak another language. Because I think it’s a first way to help the child get started with another language. So that they get integrated.”

Various social contexts were deemed to help support language development. The invitation to the library, with its rich resources to support the child’s language development, was valued. The personal invitation made parents feel welcome, even with a child who might not stay calm, as well as confident that they would receive good advice. They reported borrowing books in both Swedish and their L1, for themselves as well as for their children. Taking part in group activities organized at the library, such as baby cafés, was described as an opportunity to get to know other families, which would enhance integration. However, some parents said that they had visited the library even before, while others expressed an intention to visit but had not yet done so. Participation in various social situations featuring the different languages was recognized as important for language learning as language practices vary according to context.

Category 3: Seeking Ways to Be a Parent in a New Socio-Cultural Context

This category describes parents’ efforts to support their child’s multilingual language development and cultural adaptation. The guidance provided by the intervention was valued and deemed to address an essential issue.

Subcategory 3.1: Parents Noticed Cultural Differences and Embraced New Approaches. Parents mentioned that many things had been unknown to them when they had arrived in their new country. They described how they sought to understand what was most beneficial for their child and were willing to adopt new cultural practices, for both educational and cultural reasons. Hence, they valued guidance from a reliable and culturally knowledgeable source such as library staff. Leyla stated: “The intervention has been of great importance to me, because when we arrived we didn’t know what it was like in Sweden. So it’s very good that the intervention has this kind of development, so we can have rhymes and books and so on, for the children’s language.” Experiences regarding cultural differences varied, and the following examples are by no means exhaustive. Several parents noted that reading for pleasure and shared reading with children was more common and more accessible in Sweden. Explicitly teaching children language before they started school was less common in some home cultures. However, some parents mentioned that the teaching of letters typically started earlier in their home countries. Parents generally described how they adopted new habits in addition to their existing ones. One parent recounted still engaging in oral storytelling, a customary practice in that parent’s home country. However, since arriving in Sweden, the children had discovered the enjoyment of TV and occasionally spent hours using resources that the parent described as recommended for the fostering of development. Shared reading was another practice adopted. It is clear that the intricate process of acquiring new cultural habits and integrating them into existing practices can involve considerable challenges, and the intervention seems to have supported this process.

Subcategory 3.2: Addressing Parents’ Ongoing Concerns to Support Multilingual Language Development. Many parents expressed that they appreciated the intervention because it addressed their ongoing concerns regarding their child’s multilingual language development. Parents highlighted the value to the child of learning both L1 and L2 as well as the value of sharing a common language to enhance communication. Some children seemed to acquire several languages easily. However, others struggled, which made parents question their approaches. Teaching the child Swedish was characterized as a challenge, given that parents did not fully master it themselves. They had been given advice by the child health-care services and their child’s pre-school, and they highlighted the latter as a trusted resource for learning Swedish and for evaluation of the child’s Swedish-language skills. Parents also sought advice from the Internet, social media, family, and friends. The guidance given by the language starter regarding this complex issue was appreciated, including her calming advice on children’s ability to learn several languages simultaneously. Elisa expressed: “It was something I was wondering very much about. Because, Lisa, the language, from the beginning I thought, what language will she learn first? Albanian or Swedish? And I asked, I grabbed the opportunity and asked Jennie, and her answer was reassuring to me, that she can learn two languages simultaneously, or several languages.”

Behaviour Change Wheel

Five out of the nine BCW intervention functions [39] were identified in the parents’ narratives: education, persuasion, training, environmental restructuring, and modelling. Table 4 presents the intervention functions identified within each subcategory of the content analysis. Table 5 provides a summative description of the identified intervention functions as applied in the context of Språkstart Halland. In the following, the identification of each intervention function is described with reference to the subcategories of the content analysis. Links between the intervention functions and the COM-B components, as outlined in the BCW framework, are explored (for an overview, see online supplementary Table S2). Examples of how these links are realized in the present context are provided.

Table 5.

Description of BCW intervention functions identified for Språkstart Halland

Intervention function	Description of intervention function identified for Språkstart Halland
Education	- Information about language development and language-stimulating strategies communicated by the language starter and provided in brief written text
	- Opportunity to learn about local children’s culture from materials, demonstration and interaction
	- Information regarding multilingual language development and recommended strategies
Persuasion	- Conveying to parents that they play an active and meaningful role in supporting their child’s early language development
	- Sharing positive affect during the targeted activities in the intervention visit
	- Affirming and encouraging parents’ efforts
Training	Guidance on early language-stimulating strategies
Environmental restructuring	Physical context
	- Provision of language-stimulating materials well adapted to the age group
	Social context
	- The social situation of the intervention visit, which created opportunities for mutual exchange and learning
	- The invitation to engage with the library’s services, including social activities
	- New social routines introduced in the families
Modelling	- The language starter modelling the activities during the visit

Based on Michie et al. [39]. The table details the BCW intervention functions that were identified for Språkstart Halland. Based on the content analysis performed in the present study, relevant descriptions of these intervention functions are provided.

Education, defined as “increasing knowledge or understanding” [39], was identified in subcategories 1.1, 1.2, 3.1, and 3.2. Subcategories 1.1 and 1.2 include descriptions of how increased knowledge about language-stimulating strategies, conveyed either verbally or through guidance (modelling) during the visits, influenced parents’ psychological capability – that is, their understanding of how their child’s language development could be supported. Subcategory 3.1 describes how the intervention enhanced parents’ knowledge and understanding of local children’s culture. In subcategory 3.2, parents describe how the intervention supported their knowledge regarding the child’s multilingual language development and associated supportive strategies. The increased knowledge was interpreted as supporting reflective motivation [39].

Persuasion, defined as “using communication to induce positive or negative feelings or stimulate action,” was identified in subcategories 1.1, 1.2, and 2.1. Subcategory 1.1 describes how the communicated intervention content highlighted parents’ potential to support their child’s early language development, which appeared to enhance parents’ sense of agency, affecting both automatic and reflective motivation [39]. Subcategory 1.2 describes how parents received guidance and inspiration for carrying out the targeted activities, for example, through modelling. The language starters’ engaged manner, including the use of varied tone of voice, gestures, and body language, was described as inspiring parents to engage in the activities. Subcategory 2.1 describes how parents felt encouraged and affirmed in their efforts. The positive experience of the targeted activities during the visit was described as inducing positive feelings towards engaging in the activities. These aspects were interpreted as fostering automatic motivation. Encouragement and social support may also influence reflective motivation [39].

Training, defined as “imparting skills” [39], was identified in subcategory 1.2. It pertains to how parents found that the guidance they received helped enhance their skills (psychological capability). Elisa said: “When I read to her in the beginning, I just read ‘bla bla bla’, and that was not very interesting to Lisa. But when Jennie started reading to her, I started doing the same thing as Jennie did with her, and it worked!”. Parents further described increased confidence in carrying out the activities as their skills developed and that children’s positive reactions became more frequent when introduced strategies were used. These experiences were interpreted as influencing parents’ automatic motivation [39].

Environmental restructuring, defined as “changing the physical or social context” [39], was identified in all subcategories. Subcategory 1.1 describes how parents gained knowledge and subcategory 1.2 how they learnt strategies during the interaction with the language starter, which suggests that the intervention created social opportunity for learning. Subcategory 1.2 also describes how the gifted materials supported learning during the intervention, creating physical opportunity. Subcategory 1.3 describes how new social routines were created as activities were shared between family members after the intervention, using the gifted materials. This implies that social and physical opportunities were created in the home environment. Subcategory 2.1 details positive social experiences as well as opportunities for social support and encouragement. Subcategory 2.2 addresses the social context created during the meeting and the invitation to other social activities, creating social opportunity. Subcategories 3.1 and 3.2 detail learning about local children’s culture and multilingual language development in interaction with the language starter. Thus, social opportunities were created both during the meeting with the language starter, through the invitation to associated activities, and in the family after the intervention.

Modelling, defined as “providing an example for people to aspire to or imitate”, was identified in subcategory 1.2. This subcategory details parents’ positive experiences of how the language starter modelled the targeted activities, which enabled imitative learning. Engaging with an inspiring model can trigger automatic motivation to imitate [40]. The opportunity to observe and learn from a skilled practitioner within a supportive relational context was interpreted as creating social opportunity. Acts of modelling were also interpreted as contributing to the intervention functions of education, training, and persuasion [39].

Behaviour was not objectively observed in the present study. Subcategory 1.3, however, includes parents’ self-reported descriptions of positive changes in their language-stimulating behaviours.

In sum, the intervention functions identified were found to target all components of the COM-B system: capability, opportunity, and motivation [39]. Hence, there is a potential for the intervention to positively influence parents’ interaction with their children and the language-stimulating activities they engage in with them.

Discussion

Experiences among Parents with a First Language Other Than Swedish

This study extends the scope of a previous study exploring parents’ experiences of Språkstart Halland [41] by expanding opportunities for participation among parents with a first language other than Swedish. A substantial part of the findings in the present study is consistent with those previously reported [41], thereby strengthening the credibility of these findings within this subgroup. Both studies similarly indicate that parents perceived the intervention as supportive in providing knowledge, tools, and inspiration for early language-stimulating practices. Compared with the previous focus group study, the present study brings forward aspects that were not previously highlighted. Instances were identified where the intervention message diverged considerably from parents’ previous views and practices. Examples included a complete lack of prior experience with children’s books and shared reading (subcategory 1.2), as well as beliefs that teaching of language-related skills should begin closer to school entry (subcategory 1.1). These examples illustrate contexts in which the intervention may contribute to more substantial shifts in parental approaches.

The present study further highlights the intervention’s potential to support majority language (Swedish) learning and integration, both through interactions with the language starter during intervention visits and through invitations to related activities at the library (subcategory 2.2). These contexts may provide opportunities for both increased quantity and quality of majority language input [4]. Since exposure to all relevant languages is important for multilingual language development [3], access to a wide range of social contexts in which these languages are used is important for language learning. Contexts supporting integration may be additionally valuable as positive cultural exchange can support psycho-social well-being among families with migration backgrounds [48].

Richer descriptions were provided of how the gifted materials were used across languages, illustrating the intervention’s potential to support the development of both L1 and L2. Similar benefits have been reported for interventions in which families received books in both their L1 and L2 [25]. The present study suggests that providing books in the majority language, when accompanied by written information in families’ L1, may positively contribute to multilingual families’ HLE. For interventions targeting a multicultural audience, the importance of culturally responsive intervention content has previously been highlighted regarding both materials [49] and strategies [6, 50]. As the inclusion criteria for the present study was based solely on language skills, the participant group represents a range of cultural backgrounds, including those both more similar to and more different from the Swedish context. Parents in the study were not directly asked about the intervention’s cultural fit. However, materials and strategies were recognized as useful and appreciated by parents from varying backgrounds, with only minor suggestions for improvement. Misunderstandings of current recommendations regarding children’s screen time occurred, suggesting that clearer guidance may be needed for some parents on this matter [51]. Parents in the present study highlighted the recognition of strategies such as storytelling and nursery rhymes across cultures, which may indicate that these strategies are generally accessible to families regardless of language and cultural background. Talk and play activities that incorporate responsive communication strategies have been shown to be effective in promoting children’s language development [52, 53]. Previous research has also shown that, for parents with less education, such activities can be even more effective in promoting children’s language development than activities emphasizing the use of books and print/code awareness [52]. As lower levels of parental education are frequently reported among families with a non-majority L1 [1], these strategies may be particularly valuable for this population, in addition to shared reading.

Occasional requests for translated books were reported. The availability of books in parents’ L1 may provide additional benefits since parents tend to engage more and experience more positive feelings while reading in their L1 [54]. In addition, materials with auditory supplements, as requested by parents, could be beneficial in providing a high-quality language model for L2 in home literacy activities, as well as potentially supporting aspects of parents’ L2 reading development [55].

It was noted that the intervention may increase parents’ awareness of children’s learning of the majority language. Given the benefits of promoting the development of both L1 and L2 [6, 56] and the benefits of language and literacy activities in L1 for L2 development [3], it remains important that the intervention’s intended message – encouraging parents to support their child’s L1 as a foundation for overall language development – is effectively communicated. Acknowledging and reinforcing the value of the L1 may therefore also be important [6].

Interpretation of the BCW Analysis

The BCW analysis indicates that the intervention comprises multiple interacting components and is shaped by contextual influences, consistent with definitions of a complex intervention [34, 35]. It is therefore relevant to explore its potential mechanisms of change. The identification of processes that may underpin mechanisms of change can be informed by theory [39, 57]. Given the nature of the study design, causal effects cannot be established. Instead, the following discussion explores how parents’ reported experiences can be theoretically understood in terms of processes influencing the COM-B components of capability, opportunity, and motivation. It also considers how these influences may support behaviour change in the targeted practices, representing a step towards a theoretically informed description of potential mechanisms of change.

Several processes were identified as influencing capability. As parents described learning and applying new approaches, supported by the intervention functions of education and training, they reported an increased sense of competence in supporting their child’s early language development. Perceived competence has been identified as an important factor for engagement and persistence in behaviour change as individuals are more likely to continue behaviours that they feel capable of performing effectively [58]. The modelling of language-stimulating activities was described as enriching parents’ understanding of how such activities could be enacted in practice, thereby facilitating learning. The value of modelling has previously been demonstrated, with studies showing associations between guidance incorporating modelling and increased use of the taught shared reading strategies among parents [33].

Further aspects supporting capability were those that enhanced parents’ knowledge. Parents entered the intervention with varying levels of prior knowledge and experience, which shaped how the information provided was perceived. For parents with less prior experience, the intervention was described as particularly influential, contributing to changes in beliefs about early language development, including perceptions of its importance and of parents’ opportunities to support it. Such beliefs are known to be associated with parental engagement in language-stimulating activities [59, 60]. Changes in beliefs appeared to strengthen parents’ autonomy, which may further enhance parents’ engagement in and identification with the practices and messages communicated [58]. The processes influencing capability appear to contribute to both parents’ engagement in literacy activities and to the quality of caregiver engagement, as described in the HLE conceptualization proposed by Tamis-LeMonda et al. [11].

Opportunity appeared to be influenced by several processes. Parents’ accounts indicated that the intervention created rich social opportunities. By being delivered either in the home environment or in family-specific sessions at the library, the intervention appeared to create opportunities for participants to develop personal, trusting relationships with the language starter. A positive relationship between a learner and an instructor, characterized by good emotional quality and a positive connection, has been shown to contribute to supportive learning contexts [61]. The meeting with the language starter, as well as potential engagement in related library activities, also seemed to foster a sense of relatedness, reflected in feelings of social connectedness and belonging. Within self-determination theory, relatedness is considered central to supporting individuals in “taking in” and integrating new practices as personally meaningful [58]. Access to social contexts at the library may provide opportunities for shared literacy activities [11], as well as social contexts in which these practices are valued. This may be influential as behaviour may be influenced by both immediate social interactions and broader cultural norms [39]. Accordingly, these processes appeared to foster caregiver engagement and participation in literacy activities across both home and library contexts [11].

The provision of age-appropriate language-stimulating materials, supporting physical opportunity, addressed access to learning materials within the HLE conceptualization [11]. This aspect is important as access to relevant learning materials has been associated with both the quality of the HLE and children’s subsequent language and literacy development [62–64].

Motivation appeared to be influenced by several processes. Parents described how both they and their children found the intervention sessions enjoyable. As the language starter modelled the targeted activities, positive affect appeared to be conveyed through their engagement in the interaction, which may have contributed to positive experiences during the sessions. Positive emotional experiences have been shown to facilitate engagement in behaviours and reinforce continued engagement over time [65]. In addition, positive feedback from the child, expressed through signs of enjoyment, may reinforce parents’ engagement in shared reading and other language-stimulating activities [66]. Shared positive affect during the activities may also foster parents’ positive attitudes towards early literacy activities. Such attitudes may be further supported by positive reinforcement from the language starter during the interactions, as well as increased understanding of the importance of early language-stimulating activities. Positive parental attitudes towards early literacy activities has been associated with the development of children’s language skills. The association has been shown to be mediated by the HLE [67]. The language starters’ engaged play and shared reading were also described as fostering imitation, consistent with modelling as an intervention function [39]. Parents’ experiences of emotional closeness with their child during these activities may further support continued engagement. These processes may facilitate engagement in literacy activities, a central aspect of the HLE [11].

In sum, the intervention appeared to address all aspects of the HLE as defined by Tamis-LeMonda et al. [11]. Since the present study aimed to explore parents’ experiences of the intervention, no objective measures of the HLE were included. However, according to parents’ self-reports, the intervention appeared to have contributed to the HLE in the participating families in a range of ways across different family contexts. In families where skills and knowledge were already present, motivational and relational aspects may still have been influential in meaningful ways. Together, these findings suggest that the intervention may influence behaviour through interacting changes in capability, opportunity, and motivation.

Implications of the BCW Analysis

The application of the BCW framework in the present study has enhanced understanding of the processes underpinning the Språkstart Halland intervention, generating insights that may inform the analysis of similar early language and literacy interventions. This represents a step towards articulating the intervention’s mechanisms of change and contributing to the development of a program theory [34]. The BCW-informed analysis indicates that multiple components of the intervention interact in ways that appear to influence the HLE [39]. Articulating and theoretically grounding these processes may contribute to understanding how intervention components can be modified while maintaining the intervention’s core function, facilitating adaptation to different contexts [34].

Knowledge and practical know-how may represent key processes through which parents’ capability to engage in language-stimulating activities is supported. This may enhance parental autonomy by enabling parents to apply these strategies independently in everyday interactions and by strengthening parents’ sense of being able to make a difference in their child’s development [58].

Supportive social contexts may represent important conditions through which positive relationships and a sense of relatedness can develop, processes that may support learning [61] and facilitate engagement in early language-stimulating activities [58]. Access to relevant materials may represent an additional enabling condition that support participation in such activities within everyday contexts.

Key processes that appeared to support motivation included positive emotional experiences associated with the activities, as well as strengthened or reinforced beliefs about the importance of early language-stimulating activities. Enjoyment shared by parents and children potentially reflects a bidirectional process [29] in which positive emotional responses from both parties may reinforce continued participation over time.

The present study explores experiences of an early language and literacy intervention in a multilingual population, in which Swedish language proficiency varied considerably. As such, the study does not specifically capture experiences of participants who do not share a common language with the intervention staff. However, the analysis suggests that even when the educational component cannot be fully conveyed due to language differences, other intervention functions may still have the potential to influence language-stimulating behaviours.

Strengths and Limitations

The trustworthiness of qualitative studies can be evaluated through the criteria of credibility, transferability, dependability, and confirmability [68]. The credibility of the present study can be affected by the participant sample and by methodological aspects related to data collection and analysis [69]. To reach participants with limited Swedish skills, language starters were used as gatekeepers [70]. This may have affected the selection of participants as it is generally easier to recruit individuals with whom there is an existing rapport. Parents who were approached, and who chose to participate in the study, may have had more positive experiences with the intervention, better relations to the staff, and greater engagement in early language stimulation. This might cause opposing views to be under-represented. It is also possible that the lack of negative accounts reflects a social desirability bias, where participants may have felt inclined to present favourable views in the interview context [71].

Further, the reach of the intervention decreased during the COVID-19 pandemic, particularly among parents with a first language other than Swedish. The authors acknowledge that this may have affected the sample available for the present study.

The use of interpreters ensured the inclusion of participants with limited L2 mastery, which strengthens credibility. However, the use of interpreters can also challenge credibility [72, 73]. It is important that the personal and professional qualities of the interpreter should be suitable for both the informant and the task [73]. In one of the interviews, the interpreter’s educational background (basic level) and gender (male, for a female participant) were not ideal, which may have affected credibility of that particular interview. However, the interview still generated valuable data and was included in the analysis. These circumstances were not deemed to have significantly influenced the overall findings. Eleven out of the 15 participants opted to conduct the interview in Swedish without interpreter support. In these cases, the individual interview format still allowed for the rephrasing of questions and clarification to enhance mutual understanding, an approach that has been recommended over the use of interpreters to strengthen credibility in cases of milder language barriers [72].

Several aspects could have affected the narratives that participants shared regarding their experiences of the intervention, influencing credibility. Isolation due to COVID-19 may have affected how the intervention was perceived. However, not all participants received the intervention during pandemic restrictions. The mode of delivery (home versus library visit) may affect the experience of the intervention. The study sample represents all aspects relevant to the general intervention context, thereby strengthening credibility. For some participants, the time gap between the intervention and the interview may have affected recall, which may undermine the credibility of the findings. However, most participants had received their most recent visit within a year prior to the interview. In addition, this variation ensured representativeness over time.

During data collection, several reflective intermissions ensured that the data were sufficient, strengthening credibility. Iterative analysis, including revisiting transcripts even in the final stages, ensured that the final categories represented the raw data accurately, which also strengthened credibility. Collaboration among multiple researchers with diverse profiles in terms of knowledge, pre-understanding, and experience further strengthened both credibility and dependability. Dependability and confirmability are strengthened by the fact that the present study triangulates previous findings [41]. Confirmability is further ensured by the provision of representative quotes. The experiences shared by the parents who participated in the interviews are transferrable to similar contexts.

Future Directions

The findings highlight potential areas for further improvement of the intervention. For example, to better support family literacy in L2, additional audio materials would be beneficial. When relevant, discussions could also include screen time, framed in relation to opportunities for language-rich interactions, with guidance provided in line with current recommendations. The information provided before the intervention could also be enhanced. To support L1 development, ensuring that the intervention’s existing message – encouraging parents to support their child’s L1 as a foundation for overall language development – is effectively communicated, while explicitly acknowledging the value of the L1, may be beneficial. Providing books in families’ L1 may offer additional benefits.

Future studies could describe the intervention method in greater detail, for instance, by applying the Behaviour Change Technique Taxonomy [39, 74], which has been shown to be suitable for classifying parent-mediated interventions that promote child language development [38]. Such studies should strive to include objective measures. The impact of the intervention on children’s home language environment and language skills could also be further examined.

Conclusion

Parents with a first language other than Swedish reported that Språkstart Halland promoted early language-stimulating activities as well as the learning of Swedish for the entire family. The intervention facilitated participation in social contexts and created pathways into environments, such as group activities at the library, that enhanced language learning and integration. The application of the Behaviour Change Wheel provided a structured approach to understanding the processes underpinning the Språkstart Halland intervention and suggested that the intervention has the potential to promote increased language-stimulating activities in the home. This theory-informed analysis may inform the design and analysis of similar early language and literacy interventions and contribute to the understanding of mechanisms of change [34].

Statement of Ethics

The study was approved by the Swedish Ethical Review Authority, Uppsala (Ref. No. 2021-06771-02). Written informed consent was obtained from all participants to participate in the study.

Conflict of Interest Statement

The authors have no conflicts of interest to declare. The funder was not involved in the study design, data collection, analysis, interpretation, or the decision to publish.

Funding Sources

The study was supported by Region Halland, Sweden.

Author Contributions

H.D.: conceptualization, methodology, formal analysis, investigation, writing – original draft, project administration, and writing – review and editing. I.H.: conceptualization, methodology, formal analysis, and writing – review and editing. C.P.: conceptualization, methodology, and writing – review and editing. E.C.: conceptualization, methodology, formal analysis, writing – review and editing, and supervision. All authors have contributed significantly to the manuscript, have read and approved the final version of the manuscript, and agree to be accountable for all aspects of the work.

Funding Statement

The study was supported by Region Halland, Sweden.

Data Availability Statement

The data that support the findings of this study are not publicly available as they contain information that could compromise the privacy of research participants. Making them publicly available would be inconsistent with the informed consent obtained from participants. Further enquiries can be directed to the corresponding author.