Missed opportunities to support parents' use of healthy discipline

To prevent child abuse, efforts are needed to identify potentially unhealthy parenting behaviors.

To assess the proportion of parents with potentially unhealthy parenting attitudes and behaviors who receive parenting support.

Parents of children ages 6 months to 10 years completed a survey in a pediatric clinic serving low-income families in Nashville Tennessee.

Measures included parents' attitudes toward spanking (Attitudes Toward Spanking (ATS)) and parents' discipline practices (Quick Parenting Assessment (QPA)). Higher ATS and QPA scores indicate increased use of potentially unhealthy parenting. We assessed associations between the ATS and QPA and sociodemographic factors. We performed a blinded chart review to identify parents who received some type of parenting support, either education in clinic or referral to a parenting class.

807 parents completed the survey. 59 % had a low ATS score, 35 % had a medium ATS score, and 5 % had a high ATS score. 54 % had a low QPA score, 24 % had a medium QPA score, and 22 % participants had a high QPA score. Elevated QPA scores were associated with the parent being unmarried and having other children. Overall, 13 % of parents received education about parenting and 2 % were referred to a parenting class. For parents with either elevated ATS scores or QPAs, <20 % received some type of parenting support.

Pediatric health care providers are missing opportunities to support parents in their use of healthy discipline behaviors. The findings have implications for the prevention of child abuse and other health problems.