EVALUATION OF EFFORTS TO EDUCATE MOTHERS ABOUT CHILD-DEVELOPMENT IN PEDIATRIC OFFICE PRACTICES

The efforts expended by pediatricians in a variety of private practice settings to educate mothers of first-born children about child behavior and development were examined in relation to various outcome measures of mother and child functioning over a timeperiod of one-and-a-half years. Mothers learned more about child development in group settings than in solo practice settings, but differences between medical groups with and without nurse practitioners were not significant. Mothers receiving care from pediatricians who made at least a moderate effort to teach, learned more about child development, described more use of positive contact with their children, and felt they were helped more in their childrearing efforts than did mothers receiving care from pediatricians who made little effort to teach. However, there were no significant differences in measures of the child's developmental status related to physician teaching input, and mothers exposed to higher levels of teaching input reported more behavioral problems with their children. The most important predictor of the child's developmental status at 18 months of age was the amount of positive contact between mother and child at one year. It is suggested that the effects of changing the frequency of well-child visits on the mothers' interaction patterns with their children and on their feelings of being supported by the physician be ascertained before making recommendations about the optimal number of such visits.