Sit Down and Play: A Preventive Primary Care-Based Program To Enhance Parenting Practices.

The primary care office offers an ideal setting to encourage parenting behaviors that promote early childhood development. We conducted a pilot study to establish feasibility and acceptability of Sit Down and Play (SDP), a brief primary care-based program to facilitate positive parenting behaviors through take-home play activities. A prospective 1-month study was conducted in an urban primary care clinic. SDP was administered to 30 caregivers of 6-12 month old children while they waited for their well-child appointment. Caregivers completed baseline and 4-week follow-up surveys. Open-ended interview questions regarding acceptability and usefulness of SDP were administered and analyzed using content analysis. Parenting practices related to child development were measured with standardized measures and changes analyzed using paired t-test and linear mixed effects models. Most caregivers were mothers (90%) and non-white (97%); the majority of children received Medicaid (87%). There were significant increases in parental reports of practices related to child development (p<0.001), including families who reported low incomes (i.e. <$25,000) and received a high-school education or less (p=0.001). Four main themes emerged from the open-ended interview data: 1) importance of play, 2) noticing a change in their child, 3) reinforcing existing positive parenting behaviors, and 4) satisfaction with the program. This preliminary study suggests that SDP is a feasible and potentially beneficial program that can be delivered during pediatric well-child visits. Further studies are needed to determine the effectiveness of SDP on parenting behaviors and developmental outcomes.