Evaluating an Evidence-Based Prevention Program Delivered by Primary-Care Providers and In-Home Nurse Visits: The Period of Purple Crying, an Abusive Head-Trauma Prevention Program
Abstract
Shaken Baby Syndrome (SBS) is an abusive head injury where an infant is submitted to severe, repetitive acceleration-deceleration forces with or without blunt impact to the head (Centers for Disease Control and Prevention, 2012). Thirteen to thirty percent of infants diagnosed with abusive head trauma die as a result of their injuries (Dart, 2009). Fifty to ninety percent of survivors are left with varying degrees of disabilities (Reece, 2008). The purpose of the dissertation was to increase knowledge about SBS and to help prevent future occurrences. A family medicine clinic in rural North Dakota and the Nurse Family Partnership of Cass County, ND, participated in the project. The Period of PURPLE Crying, an SBS prevention campaign, was utilized to educate infant caregivers, as well as the registered nurses and family nurse practitioners delivering the education. The program utilizes a 10-minute DVD and a pamphlet to deliver the education. The acronym PURPLE describes the normal characteristics of infant crying. The education stresses how frustrating infant crying can be. The caregivers learn ways to console an infant, ways for the caregiver to stay calm, and how dangerous it is to shake an infant. The targets of the evaluation were infant caregivers and the healthcare providers implementing the education. Pre-surveys utilizing a Likert scale and four short-listing questions assessed infant caregivers' knowledge and beliefs about SBS. A post-survey utilizing the same questions was then used to assess any changes in knowledge and beliefs about SBS. The infant caregivers also showed an understanding about how dangerous shaking can be. The healthcare providers' knowledge and current practices for educating about SBS were evaluated with a free-response pre-survey. After three months of project implementation, a post-survey assessed what the providers had learned and how they felt about the educational tool, again utilizing free-response questions. The majority of the healthcare providers' feedback was positive in relation to their experience implementing the program. Increased knowledge about normal infant crying patterns among both the infant caregivers and the healthcare providers resulted upon intervention completion. The Period of PURPLE Crying is a sound curriculum to provide SBS prevention education.