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Primary Care Parenting Intervention and Its Effects on the Use of Physical Punishment Among Low-Income Parents of Toddlers

Canfield, Caitlin F. PhD*; Weisleder, Adriana PhD*; Cates, Carolyn B. PhD*; Huberman, Harris S. MD; Dreyer, Benard P. MD; Legano, Lori A. MD; Johnson, Samantha Berkule PhD§; Seery, Anne PhD*; Mendelsohn, Alan L. MD*

Journal of Developmental & Behavioral Pediatrics: October 2015 - Volume 36 - Issue 8 - p 586–593
doi: 10.1097/DBP.0000000000000206
Original Articles

Objectives: As part of a large randomized controlled trial, the authors assessed the impact of 2 early primary care parenting interventions—the Video Interaction Project (VIP) and Building Blocks (BB)—on the use of physical punishment among low-income parents of toddlers. They also determined whether the impact was mediated through increases in responsive parenting and decreases in maternal psychosocial risk.

Methods: Four hundred thirty-eight mother–child dyads (161 VIP, 113 BB, 164 Control) were assessed when the children were 14 and/or 24 months old. Mothers were asked about their use of physical punishment and their responsive parenting behaviors, depressive symptoms, and parenting stress.

Results: The VIP was associated with lower physical punishment scores at 24 months, as compared to BB and controls. In addition, fewer VIP parents reported ever using physical punishment as a disciplinary strategy. Significant indirect effects were found for both responsive parenting and maternal psychosocial risk, indicating that the VIP affects these behaviors and risk factors, and that this is an important pathway through which the VIP affects the parents' use of physical punishment.

Conclusion: The results support the efficacy of the VIP and the role of pediatric primary care, in reducing the use of physical punishment among low-income families by enhancing parent–child relationships. In this way, the findings support the potential of the VIP to improve developmental outcomes for at-risk children.

*Division of Developmental Behavioral Pediatrics, Department of Pediatrics, NYU School of Medicine, Bellevue Hospital Center, New York, NY;

Department of Pediatrics, SUNY Downstate Medical Center, New York, NY;

Department of Pediatrics, NYU School of Medicine, New York, NY;

§Department of Psychology, Marymount Manhattan College, New York, NY.

Address for reprints: Caitlin F. Canfield, PhD, Department of Pediatrics, NYU School of Medicine, 550 First Avenue, New York, NY 10016; e-mail:

Supported by NIH grants to A. L. Mendelsohn (PI): 5R01 HD047740 01–04; 2R01 HD047740 05–08; 3R01 HD047740–08S1. Additional funding was provided by the Tiger Foundation, Marks Family Foundation, Rhodebeck Charitable Trust, New York Community Trust, Children of Bellevue, Inc, KiDS of NYU Foundation, Inc and the NY City Council.

Disclosure: The authors declare no conflict of interest.

Received March , 2015

Accepted July , 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.