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.
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机译：目的：目的是确定初级保健干预措施是否可以帮助护理人员发展适当的纪律方法。患者和方法：在儿科初级保健诊所进行了一项随机对照试验。将1-3岁的英语或西班牙语的连续看护人按分流方式随机分配（1：1比率）。干预小组的成员（n = 130）被指示（即是必需的）在Play Nicely教育计划中查看他们选择的至少4种应对儿童侵略的策略;讲西班牙语的看护者查看了西班牙语版。干预时间为5至10分钟。对照组（n = 129）接受标准护理。诊所访问结束时，259名护理人员中有258名（99.6％）同意参加简短的个人访谈。关键指标是看护人的管教计划是否得到帮助，被定义为可以在将来对孩子的管教方式进行适当改变的看护人。结果：总体而言，干预组中的看护人患病的可能性要高12倍。与对照组的看护人相比，已经帮助开发了纪律方法（83％vs 7％; P <.001）。在该组中，干预组讲西班牙语的护理人员（n = 59）与对照组相比，得到帮助的可能性是8倍（91％比12％; P <.001）。干预组中的照护者比对照组中的照护者更有可能报告他们计划减少打屁股（9％vs 0％; P <.001）。结论：简短，必要的初级保健干预有助于英语和讲西班牙语的护理人员会制定适当的纪律方法。这些发现对预防暴力，预防虐待儿童以及如何将有关儿童侵略和纪律方面的咨询纳入对儿童的看护具有重要意义。
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