@article {396, title = {A brief primary care intervention helps parents develop plans to discipline.}, journal = {Pediatrics}, volume = {125}, year = {2010}, month = {2010 Feb}, pages = {e242-9}, 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.

}, keywords = {Caregivers, Child Behavior, Child Rearing, Child, Preschool, Counseling, Female, Health Education, Humans, Infant, Infant Behavior, Male, Parent-Child Relations, Parenting, Physician{\textquoteright}s Role, Play and Playthings, Primary Health Care, Videotape Recording}, issn = {1098-4275}, doi = {10.1542/peds.2009-0874}, author = {Scholer, Seth J and Hudnut-Beumler, Julia and Dietrich, Mary S} }