Is office-based counseling about media use, timeouts, and firearm storage effective? Results from a cluster-randomized, controlled trial

Journal Name: 
Pediatrics
Authors: 
Barkin,S.L.
Finch,S.A.
Ip,E.H.
Scheindlin,B.
Craig,J.A.
Steffes,J.
Weiley,V.
Slora,E.
Altman D.G.
Wasserman,R.C.
Abstract: 
OBJECTIVE: The objective of this study was to determine whether patients' families' violence-prevention behaviors would be affected by their primary care practitioner's use of a violence-prevention clinical intervention during the routine well-child examination. METHODS: In this cluster-randomized, controlled trial (2002-2006), 137 Pediatric Research in Office Settings practices were randomly assigned and initiated patient recruitment for either an office-based violence-prevention intervention or a control group (educational handout on literacy promotion provided). Primary caregivers of children who were aged 2 to 11 years and presented for a well-child visit were surveyed at baseline and 1 and 6 months. Practitioners were trained to (1) review a parent previsit summary regarding patient-family behavior and parental concern about media use, discipline strategies, and children's exposure to firearms, (2) counsel using brief principles of motivational interviewing, (3) identify and provide local agency resources for anger and behavior management when indicated, and (4) instruct patient-families on use of tangible tools (minute timers to monitor media time/timeouts and firearm cable locks to store firearms more safely where children live or play). Main outcomes were change over time in self-reported media use
7
2008
Volume: 
122
Pages: 
e15-e25
Keywords: 
Aged, analysis, Child, Child Behavior, Child Rearing, Child,Preschool, clinical, Counseling, Domestic Violence, electronic, Family, Female, Firearms, Humans, intervention, Male, Mass Media, medical, Methods, patient, Patients, Pediatrics, Physician's Role, prevention & control, primary care, Research, Research Support, review, support, tools, Universities