title: Training pediatric residents to provide parent education: a randomized controlled trial.
abstract: OBJECTIVE
  We evaluated the effect of Primary Care Positive Parenting Program (Triple P) training on pediatric residents and the families they serve to test 2 hypotheses: first, training would significantly improve resident skill in identifying and addressing discrete parenting and child behavior problems; and second, parents would report an improvement in their sense of self-efficacy, use of positive discipline strategies, and their child's behavior.
  
  
  METHODS
  Study participants included pediatric residents from 3 community clinics of a pediatric residency program, as well as English-speaking parents of children aged 18 months to 12 years without a diagnosed behavior disorder cared for by study residents. Residents were randomized to receive Primary Care Triple P training either at the beginning or end of the study period. The measured resident outcomes were self-assessed confidence and skills in giving parenting advice. The measured family outcomes were parent sense of self-efficacy, child externalizing behavior, and discipline strategies.
  
  
  RESULTS
  Primary Care Triple P training had a positive, significant, and persistent impact on residents' parenting consultation skills (mean increase on Parent Consultation Skills Checklist 48.11, 95% confidence interval [CI] 40.07, 57.36). Parents visiting intervention-trained residents demonstrated improved disciplinary practices compared to parents visiting control residents (mean change in Child Discipline Survey 0.322, 95% CI 0.02, 0.71), with stronger differential effects for parents with lower baseline skills (mean Child Discipline Survey change 0.822, 95% CI 0.48, 1.83). No differences were found for child behavior or parenting sense of confidence.
  
  
  CONCLUSIONS
  Training residents in Primary Care Triple P can have a positive impact on consultation skills and parent disciplinary practices. This finding adds strength to the call for increased residency training in behavioral pediatrics.
authors: Seattle Children's Research Institute. Electronic address: erin.mccormick@seattlechildrens.org.
authors: Erin
authors: E
authors: McCormick
authors: University of Washington.
authors: Suzanne E U
authors: SE
authors: Kerns
authors: Seattle Children's Hospital and University of Washington.
authors: Heather
authors: H
authors: McPhillips
authors: Seattle Children's Research Institute.
authors: Jeffrey
authors: J
authors: Wright
authors: University of Washington.
authors: Dimitri A
authors: DA
authors: Christakis
authors: University of Washington.
authors: Frederick P
authors: FP
authors: Rivara
mesh_terms: D002648:Child; D002649:Child Abuse / Q000517:prevention & control; D002652:Child Behavior; D002675:Child, Preschool; D004505:Education, Nonprofessional / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting; D010290:Parents / Q000193:education* / Q000523:psychology; D010372:Pediatrics / Q000193:education*; D011368:Professional-Family Relations; D012044:Regression Analysis; D020377:Self Efficacy; D014861:Washington
keywords: Triple P; child; graduate medical education; parenting; pediatric resident; primary care