113 - The Effect of a Brief Parenting Assessment on Parents' Plans to Discipline

Poster Number: 113
Publication Number: 113.212

Jacqueline Antoun, Vanderbilt University School of Medicine, Nashville, TN, United States; Victoria N. Lawson, Vanderbilt University School of Medicine, Nashville, TN, United States; Anna Whitney, Vanderbilt University School of Medicine, Nashville, TN, United States; Kathryn Carlson, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States; Merrill M. Stoppelbein, Vanderbilt University School of Medicine, Nashville, TN, United States; Seth J. Scholer, Vanderbilt University School of Medicine, Nashville, TN, United States

Background: Some parenting behaviors (e.g., spanking) are Adverse Childhood Experiences (ACEs). The Quick Parenting Assessment (QPA) is a 13-item validated parenting assessment tool that takes one minute for parents to complete and 1-2 minutes for health care providers to review with parents. Elevated QPAs ( >2) indicate exposure to unhealthy discipline. It is not clear whether the QPA, if reviewed by health care providers, affects parents’ plans to discipline.

Objective: To determine the effect of a parenting assessment, integrated into the well child visit, on parents' plans to discipline their child at home.

Design/Methods: In an academic pediatric primary care clinic serving a diverse, low-income population, English, Spanish, or Arabic versions of the QPA were administered to parents of children at the 15-month, 30-month, 5-year, and 8-year well-child visits. Healthcare providers were encouraged to review the QPA with parents. After the visit, 374 parents were invited to complete a brief questionnaire. For this study, we focused on 157 parents who reported that their health care provider reviewed the QPA with them. Of note, whether the QPA was reviewed was primarily clinician-dependent. Key measures were QPA scores and parents’ report of whether the QPA review affected their plans to discipline their child at home (Nf154), and, if so, what they planned to do differently. We conducted bivariate analyses to explore for associations between the proportion of parents who planned to change how they discipline and sociodemographic factors.

Results: Overall, 41.6% (64/154) of parents reported that they planned to change how they discipline at home because of the QPA review. Almost one quarter (23%) of QPAs were elevated. Parents were more likely to report a planned change if the QPA score was elevated compared to low risk (86% vs. 33%, p < 0.001) There were no significant associations between parents' plans to discipline and sociodemographic factors (Table). In response to the follow up question about what they planned to do differently, parents’ most common responses were redirection (17.9%), time-out (12.8%), ignoring bad behavior (12.8%), taking away a privilege (5.1%), not yelling or raising their voice (23.1%) and not using physical punishment (7.7%).Conclusion(s): This is the first study to demonstrate that a brief parenting assessment, reviewed with a health care provider, affects parents' plans to discipline their child at home, especially for parents who are using unhealthy strategies. The findings have implications for providing targeted parenting support and mitigating ACEs in pediatric primary care.
Table: Factors associated with parents’ plans to change how they discipline at home