Educating Parents About Corporal Punishment and Effective Discipline: Pediatricians' Preparedness, Motivation, and Barriers.

OBJECTIVE: To assess US pediatricians' preparedness, motivation, and barriers related to educating parents about corporal punishment (CP) and effective child discipline. METHODS: A random sample of 1500 pediatricians was drawn from a nationwide database in the United States. A self-administered questionnaire was sent via mail in 2016. The response rate (53%; n = 787) was maximized via repeated survey mailings and use of cash incentives. RESULTS: The majority of respondents were White (69%), female (59%) and were members of the American Academy of Pediatrics (85%). Most pediatricians felt somewhat prepared to advise parents about child discipline, particularly CP, and perceived their colleagues to be slightly less prepared than themselves. Although most (72%) respondents believed it was "extremely/very" likely that parents valued their advice about child discipline, only 36% believed parents were "extremely/very" likely to follow their advice. Most respondents were highly motivated to participate in activities designed to change norms regarding CP. The most common strategy pediatricians identified for improving child behavior was being consistent with rules (71%). Perceived barriers to providing child discipline advice to parents included lack of time (90%), lack of insurance reimbursement (48%), and lack of training and educational resources (47%). CONCLUSIONS: Pediatricians are a key source of professional advice for parents about how to discipline children safely. Given this, along with strong approval and use of CP in the United States and its harm for children, the current findings suggest a strong need for pediatricians to receive additional training on how to advise parents about child discipline along with removal of barriers to providing such advice.

US Pediatricians' Attitudes, Beliefs, and Perceived Injunctive Norms About Spanking.

OBJECTIVE: To assess United States pediatricians' attitudes, beliefs, and perceived professional injunctive norms regarding spanking. METHOD: A self-administered questionnaire was mailed to a nationwide random sample of 1500 pediatricians in the US, drawn from a database maintained by IMS Health. Four survey mailings were conducted and cash incentives of up to $20 were provided. The response rate was 53% (N = 787). RESULTS: Most respondents were members of the American Academy of Pediatrics (85%), had been practicing physicians for 15 years or more (66%), and were white (69%) and female (59%). All US regions were represented. About 3-quarters of pediatricians did not support the use of spanking, and most perceived that their colleagues did not support its use either. Pediatricians who were male, black, and/or sometimes spanked as children had more positive attitudes toward spanking and expected more positive outcomes from spanking than their counterparts. Nearly 80% of pediatricians never or seldom expected positive outcomes from spanking, and a majority (64%) expected negative outcomes some of the time. CONCLUSION: The majority of pediatricians in the US do not support the use of spanking with children and are aware of the empirical evidence linking spanking with increased risk of poor health outcomes for children. Pediatricians are a key, trusted professional source in advising parents about child discipline. These findings suggest that most pediatricians will discourage the use of spanking with children, which over time could reduce its use and associated harms in the population. This is of clinical relevance because, despite strong and consistent evidence of the harms that spanking raises for children, spanking is still broadly accepted and practiced in the US.