Preventing Shaken Baby Syndrome: A comparison of two parent education programs

Abstract

Shaken Baby Syndrome (SBS) is a severe form of child maltreatment and the leading cause of death among infants who are victims of abuse. When an infant is forcefully shaken, he/she typically sustains a unique constellation of injuries that result in high rates of morbidity and mortality. There are approximately 1,300 reported cases of SBS per year in the United States, but research suggests that the true incidence may be as much as 150 times higher than reported rates. The detection and diagnoses of SBS is often difficult, making efforts toward preventing this form of child maltreatment all the more important.

Parent education programs are the most prominent type of SBS prevention activity. There are two evidence-based primary prevention SBS parent education models: the Dias model and The Period of PURPLE Crying. This study evaluated the effectiveness of the Dias model and PURPLE model as secondary prevention strategies through an alternative treatment experimental design. The study took place within an intensive home visiting program for first time mothers who screened as being at-risk for child maltreatment. The study used framing theory as the conceptual basis for understanding the differential framing effects of the two models. The models were evaluated for effectiveness across four dependent variables: crying knowledge, SBS knowledge, behavioral responses to infant crying, and sharing information with other caregivers.

A total of 126 mothers were enrolled in the study; 92 completed both pre-test and post-test. Outcome data suggest significant improvements in crying knowledge, behavioral responses to infant crying, and sharing information with other caregivers among subjects in the PURPLE model group; subjects in the Dias model group showed no significant improvement on these variables. An unanticipated finding was that both groups showed a high baseline knowledge of SBS.

In this first attempt at comparing these two parent education models within a secondary risk group, findings indicate a likelihood that the PURPLE model is the more effective SBS prevention strategy for this population. The study findings show a differential framing effect between the parent education models, making a contribution to the existing literature on framing theory and frame analysis.