Evaluating a No Hit Zone program and provider interventions at an urban academic pediatric practice

Abstract

BackgroundVery few analyses of the effectiveness of No Hit Zone (NHZ) programs have been done to date. Prior research has demonstrated the negative impacts of corporal punishment (CP) as well as the positive role healthcare providers can play in providing information on disciplinary techniques. The Children’s Hospital of The King’s Daughters (CHKD) set up a NHZ program to address these needs. ObjectivesTo determine the effect of a fully-implemented No Hit Zone program and provider intervention on caregiver beliefs around discipline.To determine how effectively the program was implemented. Participants and settingThose surveyed were 244 parents or guardians of children between the ages of 18 months and 5 years at the General Academic Pediatrics (GAP) clinic at CHKD. MethodsParticipants were approached in their individual exam rooms. Once consent was obtained, participants were given a survey with questions investigating demographics, discipline use, NHZ awareness, and intervention effectiveness. ResultsAnalyses revealed about half of all participants reported having previously used corporal punishment to discipline their child at least once. Only 30% of participants reported having heard about the NHZ. Among those who had, self-reported viewpoint change about discipline style use had been significantly affected by the NHZ education and discussion with their pediatrician (p < 0.001). ConclusionsProvider interventions and establishment of a NHZ was found to be significantly associated with self-reported changes in attitudes about the use of discipline by caregivers. Areas of improvement include the dissemination of NHZ materials and applying the education interventions with more families.