When providing parents with anticipatory guidance, less is apparently more.
Parental recall of topics discussed during a well-child visit dwindles as the number of topics increases, Dr. Shari L. Barkin and her associates reported: Parents absorb the information best when physicians limit their discussions to less than nine subjects.
“Limiting the number of topics discussed, rather than attempting to squeeze more informational content into the visit, might lead to increased retention, a necessary starting point for behavior change,” wrote Dr. Barkin of Wake Forest University, Winston-Salem, N.C., and her colleagues (Ambul. Pediatr. 2005;5:372–6).
The investigators examined provider-parent agreement and parental recall of subjects discussed during 861 well-child visits. Most of the parents surveyed were mothers (90%), and most of the mothers (59%) reported at least a high school education.
The most discussed topics were car restraints, nutrition, dental care, and reading aloud. Other topics included exercise, firearms, smoking, and media use. Most providers (454) discussed 5–8 topics; 158 covered 1–4 topics, and 249 did 9–13 topics.
Immediately after the visit, parents and providers filled out surveys about the discussions. There was good agreement (at least 70%) about what was and was not discussed, but overall, parents reported discussing slightly fewer topics than did providers (mean topics 6.33 vs. 6.9, respectively). The best agreement between parents and providers occurred when five to eight topics had been discussed. When there were fewer than five topics, parents reported having discussed more topics than providers reported; in discussions of more than nine topics, parents recalled fewer topics than providers recalled.
Parental recall dwindled with time, the investigators wrote. One month after the visit, parents who heard the fewest subjects recalled discussing more than their providers had reported post visit (mean 5.58 vs. 3.12, respectively).
Parents who heard the most topics recalled fewer topics than their providers had reported post visit (mean 8.63 vs. 10.16, respectively).