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Robert D. Sege, MD, PhD; Gary Perry, FNP, MPH; Luisa Stigol, MD; Linda Cohen, MD, MPH; John Griffith, PhD; Matthew Cohn; Howard Spivak, MD

Arch Pediatr Adolesc Med. 1997;151(4):392-397.

Abstract
Objective
To determine whether newly developed anticipatory guidance materials designed to teach the use of time-outs and the importance of reductions in childhood television viewing would be recalled by parents and if their use would result in changes in self-reported parental behavior.

Subjects and Setting
A total of 559 parents of children aged 14 months to 6 years recruited at the time of routine child health maintenance visits at 2 managed care pediatric departments in eastern Massachusetts.

Methods
In-person parent interviews were conducted in the waiting room prior to office visits, with follow-up telephone calls 2 to 3 weeks after the visit. Two groups of families were enrolled: a control group who received usual anticipatory guidance and an intervention group who received written materials. Intervention group providers were trained to include study topics during the office visit and to introduce the written materials.

Results
Provider training and the provision of written materials increased the parents' specific recall of anticipatory guidance for at least 2 to 3 weeks following the office visit. This effect was specific to the areas of intervention and did not carry over to other commonly used topics of anticipatory guidance. Among parents who had never used a time-out prior to the office visit, there was a significant increase in the use of time-outs. Parents who received anticipatory guidance regarding the link between exposure to television violence and subsequent violence in children were somewhat more likely to report reductions in weekend television viewing than were parents in the control group, although this change was not statistically significant.

Conclusions
Certain parenting behaviors have been associated with subsequent violence. Brief, inexpensive anticipatory guidance in relevant areas, provided in the context of routine health supervision visits, appears to result in favorable short-term changes in parenting practices.

Arch Pediatr Adolesc Med. 1997;151:392-397

Author Affiliations
From the Tufts University School of Medicine and The Floating Hospital for Children at New England Medical Center (Drs Sege and Spivak), the Harvard Community Health Plan (Ms Perry and Drs Stigol and Cohen), and the New England Medical Center (Dr Griffith and Mr Cohn), Boston, Mass. Deceased.

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