Reach Out and Read and Save the Children are partnering on a federal grant from the U.S. Department of Education, with the goal of creating a culture of literacy to support low-income children and families in 30 economically-disadvantaged and underserved communities in rural and remote areas of Arizona, Kentucky, South Carolina and Colorado. The expected impact of Building Child Centered Communities in Rural America project is to create an environment where children can learn and develop in supportive, healthy, literacy rich environments with active and sustained support from their families, caregivers and community. To achieve this impact, we initiated a comprehensive project that delivers direct interventions to at-risk children during the critical early childhood and school-age years and also builds a network of family and community supports. Activities are grouped into three specific areas of impact: School Support, Family Engagement and Community Engagement. Through this project, Reach Out and Read fulfills its mission of leveraging the existing health care infrastructure to promote early literacy and language development among families living in 16 rural counties. In year one of the two-year grant (October 1, 2015-September 30, 2016), 127 medical professionals in 39 clinics gave books to children and developmentally-appropriate anticipatory guidance to parents in more than 30,000 well-child visits. As a result, children in these rural communities went home from their check-ups with a brand new book to add to their home library; likewise, parents took home their provider’s encouragement, along with information, about the importance of daily reading aloud, singing, talking, and playing to their children’s healthy development. Reach Out and Read medical professionals also presented early childhood development information and guidance at 31 of Save the Children’s regularly-scheduled Parent-Child Group Meetings in these rural communities, educating parents and community members about early brain development and the importance of activities such as reading, singing, rhyming, and playing to fostering language acquisition and literacy development. Their participation was universally well-received, and providers themselves expressed enthusiasm about this additional opportunity to contribute to creating a culture of literacy in their communities. During the grant period, our medical providers distributed over 63,000 books at community events co-hosted with Save the Children, and during routine well-child visits at local medical practices and clinics.