Process Evaluation of an Abusive Head Trauma Prevention Program – Are Those Who Need It Getting It?

Background: Abusive head trauma (AHT) is the leading cause of child abuse death among infants in the United States. Males (biological fathers, parent partners, and other male caregivers) comprise the majority of AHT perpetrators (77%) while mothers comprise 8% of the perpetrator population. The purpose of this study was to describe the reach and audience of an abusive head trauma (AHT) prevention program implemented in a hospital perinatal unit.

Methods: A retrospective medical record review of perinatal patients was conducted in a community birthing hospital between March 1, 2014 and June 30, 2014 to evaluate the Period of PURPLE Crying AHT intervention.

Results: Participants (n=305) were new mothers aged 15 to 46 years (mean=27.2), primarily single (63.3%), who preferred the Spanish language (72.8%), with the father of the baby living at home 57.4% of the time. The vast majority of mothers (97.4%) utilized public insurance.  Among participants, 237 (77.7%) received the Period of PURPLE Crying intervention during their hospital stay according to documentation in the electronic medical record. “Fathers/parent partners” received the intervention in 32.9% of cases.

Discussion: Among this study population, less than a third of fathers and parent partners received the Period of PURPLE Crying intervention. Fathers and parent partners of the mother comprise the majority of AHT perpetrators. There is a need to target AHT interventions to fathers and parent partners in addition to mothers and other family members. Further study is required to determine the best ways to overcome barriers and target fathers and parent partners.