Citation

Scholer SJ, Hudnut-Beumler J, Dietrich MS. Pediatrics 2010; 125(2): e242-9.

Affiliation

Department of Pediatrics Vanderbilt University School of Medicine and the Monroe Carell Jr Children's Hospital at Vanderbilt.

Copyright

(Copyright © 2010, American Academy of Pediatrics)

DOI

10.1542/peds.2009-0874

PMID

20083523

Abstract

Objective: The objective was to determine if a primary care intervention can help caregivers develop appropriate methods of discipline. Patients and Methods: A randomized, controlled trial was conducted in a pediatric primary care clinic. Consecutive English- or Spanish-speaking caregivers of 1- to 5-year-old children were randomly assigned (1:1 ratio) at triage. Members of the intervention group (n = 130) were instructed (ie, required) to view at least 4 strategies of their choosing for responding to childhood aggression in the Play Nicely educational program; Spanish-speaking caregivers viewed the Spanish edition. The intervention duration was 5 to 10 minutes. Those in the control group (n = 129) received standard care. At the end of the clinic visit, 258 of 259 caregivers (99.6%) consented to participate in a brief personal interview. The key measure was whether caregivers were helped in their plans to discipline, defined as a caregiver who could verbalize an appropriate change in how they would discipline their child in the future. Results: Overall, caregivers in the intervention group were 12 times more likely to have been helped in developing methods of discipline compared with caregivers in the control group (83% vs 7%; P < .001). Within this group, Spanish-speaking caregivers (n = 59) in the intervention group were 8 times more likely to have been helped compared with those in the control group (91% vs 12%; P < .001). Caregivers in the intervention group were more likely than caregivers in the control group to report that they planned to do less spanking (9% vs 0%; P < .001). Conclusions: A brief, required, primary care intervention helps English- and Spanish-speaking caregivers develop appropriate methods of discipline. The findings have implications for violence prevention, child abuse prevention, and how to incorporate counseling about childhood aggression and discipline into the well-child care visit.

Language: en