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Evaluation of The Period of PURPLE Crying, A Shaken Baby Syndrome Prevention Program

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Evaluation of The Period of PURPLE Crying, A Shaken Baby Syndrome Prevention Program Laura Schwab Reese, MA 1,2 Kimberly Kim, MPH 3 Erin O. Heiden, MPH 1,2 Jingzhen Yang, PhD, MPH 4 - PowerPoint PPT Presentation
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Of 211 baseline participants, 47% were first-time mothers and 58% had a college degree or more. Follow-up participants were demographically similar to the baseline sample. Three-quarters (76%) of mothers rated The Period of PURPLE Crying program as very useful. More nurses (92%) perceived mothers as motivated to share program content than mothers who reported intent to share (89%). Only one-quarter (26%) of mothers watched the DVD while in the hospital, but more than half (59%) of mothers had viewed the DVD by two months post-discharge. Over half (55%) of mothers received a perfect score on a knowledge test of normal infant crying and the dangers of shaking an infant. More than half of mothers recalled (52%) or reported trying (59%) at least one soothing technique. However, fewer mothers recalled (38%) or reported trying (27%) at least one coping technique. Evaluation of The Period of PURPLE Crying, A Shaken Baby Syndrome Prevention Program Laura Schwab Reese, MA 1,2 Kimberly Kim, MPH 3 Erin O. Heiden, MPH 1,2 Jingzhen Yang, PhD, MPH 4 1 University of Iowa Injury Prevention Research Center, 2 Department of Community & Behavioral Health, University of Iowa, 3 Planned Parenthood of the Heartland, 4 Department of Social and Behavioral Sciences, Kent State University Results Discussion and Conclusions Shaken Baby Syndrome (SBS) is a leading cause of death in children less than one year old. The estimated annual incidence of SBS is 25-30 cases per 100,000 infants. The Period of PURPLE Crying is an evidence-based SBS prevention program. Study aims: o Evaluate The Period of PURPLE Crying as implemented in five local hospitals. o Measure program impact on mothers’ knowledge about normal infant crying, the dangers of shaking an infant, and techniques to soothe and cope with infant crying. Overall, the Period of PURPLE Crying intervention was successfully implemented and well-received by both mothers and nurses. o Regardless of education, age, and parity, mothers felt it was important to talk about SBS. o With limited time and resources, nurses were able to implement the program. The successful implementation, combined with results from randomized control trial evaluations, support wide-spread dissemination of the program. Future programs should encourage mothers to share content with Introduction Materials and Methods A post-test only design. Prior to discharge, all mothers who gave birth between March 15 – August 15, 2011 in five participating hospitals received the Period of PURPLE Crying education session from a trained nurse and were given a booklet and DVD to take home. Mothers and nurses completed a survey following the intervention. Phone interviews were conducted with enrolled mothers two months after discharge. Process Measures: mother/nurse agreement on five evaluation domains o Attitude towards the education session o Normal infant crying o Dangers of shaking an infant o Soothing and copying techniques o Motivation to share Table 1. Characteristics of mothers who received The Period of PURPLE Crying education Baseline Follow-up n (%) n (%) All 211 68 Mother’s age a ≤ 25 53 (25.6) 12 (18.5) 26-30 91 (43.9) 28 (43.1) 31-35 48 (23.2) 17 (26.2) >35 15 (7.3) 8 (12.3) Education High school or less 53 (25.1) 10 (14.7) Some college 36 (17.1) 13 (19.1) College degree 81 (38.4) 35 (51.5) Graduate studies 41 (19.4) 10 (14.7) Parity a First child 97 (46.9) 32 (47.1) Not first child 110 (53.1) 36 (52.9) Watched DVD Watched in hospital 53 (26.4) 9 (13.2) Did not watch in hospital 148 (73.6) 59 (86.7) Watched before, during, or after the hospital n/a 40 (58.8) Did not watch video n/a 28 (41.2) a Sums not equal to sample size due to missing numbers. 56% 20% 15% 9% 10 9 8 7 or less 55% 21% 24% Figure 2. Mother’s Knowledge (Percent correct of 10 items) All correc t Missed 1 item Attitudes Normal Crying Dangers Soothing Sharing 0% 20% 40% 60% 80% 100% 84% 81% 84% 80% 70% 13% 14% 11% 12% 14% Figure 3. Consistency between mother and nurse survey answers for five evaluation domainsa Exact Match Close Match a For each domain, consistency was assessed by matched ratings of “mostly agree” or “strongly agree” Table 2. Survey Questions by Evaluation Domain Program Domain Mother Survey Item(s) Nurse Survey Item Attitudes •I felt comfortable talking with the nurse about the Period of PURPLE Crying. •I understand how to prevent shaken baby syndrome. •I felt confident educating this mother about the Period of PURPLE Crying. Normal Crying •The nurse taught me about normal infant crying. •This mother seemed to understand what I told her about normal infant crying. Dangers •The nurse taught me about the dangers of shaking an infant. • This mother seemed to understand the dangers of shaking an infant. Soothing •The nurse taught me ways to help soothe my infant’s crying. •The nurse taught me ways to cope when I am feeling frustrated or overwhelmed by my infant’s crying. •I plan to try the soothing and coping techniques that the nurse explained. •I taught this mother ways to soothe her baby’s crying and/or cope with her own frustration. •I plan to talk to my child’s other caretakers about the •This mother seemed motivated to tell her child’s other Figure 1. Mother’s rating of the usefulness of the Period of PURPLE Crying (Scaled 1 to 10 with 1 as “Not Useful” and 10 as “Very Useful”)
Transcript

Of 211 baseline participants, 47% were first-time mothers and 58% had a college degree or more. Follow-up participants were demographically similar to the baseline sample.

Three-quarters (76%) of mothers rated The Period of PURPLE Crying program as very useful.

More nurses (92%) perceived mothers as motivated to share program content than mothers who reported intent to share (89%).

Only one-quarter (26%) of mothers watched the DVD while in the hospital, but more than half (59%) of mothers had viewed the DVD by two months post-discharge.

Over half (55%) of mothers received a perfect score on a knowledge test of normal infant crying and the dangers of shaking an infant.

More than half of mothers recalled (52%) or reported trying (59%) at least one soothing technique. However, fewer mothers recalled (38%) or reported trying (27%) at least one coping technique.

Evaluation of The Period of PURPLE Crying,A Shaken Baby Syndrome Prevention ProgramLaura Schwab Reese, MA1,2 Kimberly Kim, MPH3 Erin O. Heiden, MPH1,2 Jingzhen Yang, PhD, MPH4

1University of Iowa Injury Prevention Research Center, 2Department of Community & Behavioral Health, University of Iowa, 3Planned Parenthood of the Heartland, 4Department of Social and Behavioral Sciences, Kent State University

Results

Discussion and Conclusions

Shaken Baby Syndrome (SBS) is a leading cause of death in children less than one year old.

The estimated annual incidence of SBS is 25-30 cases per 100,000 infants.

The Period of PURPLE Crying is an evidence-based SBS prevention program.

Study aims:o Evaluate The Period of PURPLE Crying as

implemented in five local hospitals.o Measure program impact on mothers’

knowledge about normal infant crying, the dangers of shaking an infant, and techniques to soothe and cope with infant crying.

Overall, the Period of PURPLE Crying intervention was successfully implemented and well-received by both mothers and nurses. o Regardless of education, age, and parity,

mothers felt it was important to talk about SBS.

o With limited time and resources, nurses were able to implement the program.

The successful implementation, combined with results from randomized control trial evaluations, support wide-spread dissemination of the program.

Future programs should encourage mothers to share content with their child’s other caregivers.

Introduction

Materials and Methods A post-test only design. Prior to discharge, all mothers who gave birth

between March 15 – August 15, 2011 in five participating hospitals received the Period of PURPLE Crying education session from a trained nurse and were given a booklet and DVD to take home.

Mothers and nurses completed a survey following the intervention. Phone interviews were conducted with enrolled mothers two months after discharge.

Process Measures: mother/nurse agreement on five evaluation domainso Attitude towards the education sessiono Normal infant cryingo Dangers of shaking an infanto Soothing and copying techniqueso Motivation to share information

Outcome Measures: mothers’ o Knowledge of normal infant crying and

dangers of shaking an infanto Techniques to soothe and cope with infant

crying

Table 1. Characteristics of mothers who received The Period of PURPLE Crying education

Baseline Follow-upn (%) n (%)

All 211 68Mother’s agea

≤ 25 53 (25.6) 12 (18.5)26-30 91 (43.9) 28 (43.1)31-35 48 (23.2) 17 (26.2)>35 15 (7.3) 8 (12.3)

EducationHigh school or less 53 (25.1) 10 (14.7)Some college 36 (17.1) 13 (19.1)College degree 81 (38.4) 35 (51.5)Graduate studies 41 (19.4) 10 (14.7)

Paritya

First child 97 (46.9) 32 (47.1)Not first child 110 (53.1) 36 (52.9)

Watched DVDWatched in hospital 53 (26.4) 9 (13.2)Did not watch in hospital 148 (73.6) 59 (86.7)Watched before, during, or after the hospital n/a 40 (58.8)

Did not watch video n/a 28 (41.2)a Sums not equal to sample size due to missing numbers.

56%20%

15%

9%10

9

8

7 or less

55%21%

24%

Figure 2. Mother’s Knowledge (Percent correct of 10 items)

All cor-rect

Missed 1 item

Missed 2+ items

Attitudes Normal Crying Dangers Soothing Sharing0%

20%

40%

60%

80%

100%

84% 81% 84% 80% 70%

13% 14% 11% 12%14%

Figure 3. Consistency between mother and nurse survey answers for five evaluation domainsa Exact Match Close Match

aFor each domain, consistency was assessed by matched ratings of “mostly agree” or “strongly agree”

Table 2. Survey Questions by Evaluation DomainProgram Domain Mother Survey Item(s) Nurse Survey Item

Attitudes•I felt comfortable talking with the nurse about the Period of PURPLE Crying.•I understand how to prevent shaken baby syndrome.

•I felt confident educating this mother about the Period of PURPLE Crying.

Normal Crying •The nurse taught me about normal infant crying. •This mother seemed to understand what I told her about normal infant crying.

Dangers •The nurse taught me about the dangers of shaking an infant. • This mother seemed to understand the dangers of shaking an infant.

Soothing

•The nurse taught me ways to help soothe my infant’s crying.•The nurse taught me ways to cope when I am feeling frustrated or overwhelmed by my infant’s crying.•I plan to try the soothing and coping techniques that the nurse explained.

•I taught this mother ways to soothe her baby’s crying and/or cope with her own frustration.

Sharing •I plan to talk to my child’s other caretakers about the Period of PURPLE Crying and the dangers of shaking an infant.

•This mother seemed motivated to tell her child’s other caretakers about the Period of PURPLE Crying and the danger of shaking an infant.

Figure 1. Mother’s rating of the usefulness of the Period of PURPLE Crying

(Scaled 1 to 10 with 1 as “Not Useful” and 10 as “Very Useful”)

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