Abstract
Background: Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The Resident Parenting Questionnaire (RPQ) was developed to assess (a) the relationship between pediatric residents' upbringing and their parenting advice style and (b) factors associated with confidence and resource use when delivering parenting advice.Methods: Three hundred and one pediatric residents from 15 United States residency programs completed the RPQ with upbringing and advice responses categorized using Baumrind's parenting model (authoritative, authoritarian, permissive). Chi-square/Fisher's exact tests, Bowker's test of symmetry, and regression analyses assessed associations between residents' upbringing, parenting advice style/content, and confidence in providing parenting advice.Results: Most participants indicated being raised authoritatively (68%) and giving authoritative parenting advice (83%), but advice differed based on how they perceived their upbringing (p < 0.001). Residents noting authoritative upbringing were more likely to give authoritative advice (85%) while others tended to give advice differing from upbringing (e.g., those perceiving authoritarian upbringing were more likely to give authoritative/permissive). Analyses suggest resident race, acculturation, future plans, and resident level are associated with parenting advice type. Confidence in giving parenting advice decreased significantly as patient age increased and increased with resident level advancement. Residents reported consulting attending physicians for parenting advice guidance more than any other evidence-based resources.Conclusion: Most pediatric residents appear to be aware of appropriate authoritative parenting advice regardless of upbringing, especially as they advance through residency. Residents may benefit from opportunities to reflect upon their upbringing, particularly if raised in authoritarian or permissive styles. Targeted training of residents on evidence-based parenting strategies, particularly for older pediatric patients, appears warranted.
Highlights
For several decades, developmental and behavioral concerns have remained a sizeable portion of the complaints expressed in general pediatric visits
The 2009 American Academy of Pediatrics (AAP) Policy Statement clarifying the need for pediatricians to address mental health in primary care settings more effectively, many pediatric residencies fall short of preparing their residents to address their patients’ behavioral and mental health needs as laid out by the AAP [2]
Compared to Accreditation Council for Graduate Medical Education national demographic information available for U.S pediatric and medicine-pediatric residency programs at that time [26], participants were similar in age and gender make-up, but the sample appears to have a predominance of non-Hispanic Caucasian participants
Summary
Developmental and behavioral concerns have remained a sizeable portion of the complaints expressed in general pediatric visits. Despite a mandatory 1-month block rotation in developmental/behavioral pediatrics being implemented as a requirement during general pediatrics residency in 1997, pediatricians’ comfort level with behavior problems remained unchanged a decade later [1]. Many positive child behavioral and mental health outcomes have been closely associated with balanced, authoritative parenting and discipline practices in numerous studies over the past 5 decades [4,5,6]. Discussing parenting and discipline in pediatric visits provides an opportunity for pediatricians to identify and help address potential behavior problems from a young age, potentially preventing the development of future, more adverse child behavior problems. The Resident Parenting Questionnaire (RPQ) was developed to assess (a) the relationship between pediatric residents’ upbringing and their parenting advice style and (b) factors associated with confidence and resource use when delivering parenting advice
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