St James-Roberts, I., Garratt, R., Powell, C. et al. (7 more authors) (2019) A support package for parents of excessively crying infants : development and feasibility study. Health Technology Assessment, 23 (56). pp. 1-144. ISSN 1366-5278
Abstract
Background
Around 20% of 1- to 4-month-old infants cry for long periods without an apparent reason. Traditionally, this was attributed to gastrointestinal disorder (‘colic’), but evidence shows that just 5% of infants cry a lot because of organic disturbances; in most cases, the crying is attributable to normal developmental processes. This has led to a focus on the impact of the crying on parents. Parental vulnerabilities influence how parents evaluate and respond to the crying and predict adverse outcomes. By developing evidence-based services that support parents, this study was designed to take the first steps towards national health services that enhance the coping and well-being of parents whose babies excessively cry. Related aims were to improve these infants’ outcomes and how NHS money is spent.
Objectives
To develop a novel intervention package to support parents of excessively crying infants and to examine the feasibility of delivering and evaluating it in the NHS.
Design
Stage 1 of this study aimed to (1) complete a literature review to identify example support materials, (2) obtain parents’ guidance on the support needed when a baby cries excessively, together with their evaluation of the example materials, and (3) develop a support package based on the results. Stage 2 aimed to (1) recruit 60 parents whose babies were currently excessively crying, (2) assess parents’ and NHS professionals’ willingness to complete a study of the support package, (3) measure the use and evaluation of the package components, (4) estimate the package component costs and (5) provide evidence on the feasibility and methods for a large-scale trial.
Setting
Primary health care.
Participants
Stage 1: 20 parents of previously excessively crying infants and 55 health visitors (HVs) or specialist community public health nurses (SCPHNs). Stage 2: 57 parents of currently excessively crying infants and 124 HVs/SCPHNs.
Interventions
The support package included a website, a printed booklet and a programme of cognitive–behavioural therapy-based sessions delivered to parents by a qualified practitioner.
Main outcome measures
(1) Demographic data, (2) figures for parents’ use of the package components and continuation in the study, (3) parents’ and HVs’/SCPHNs’ ratings of the package components and suitability for NHS use, (4) questionnaire measures of parental well-being and infant health and (5) costs.
Results
Most parents (95%) accessed the website or printed materials and half (51%) attended the practitioner sessions. All 52 parents and 85% of HVs/SCPHNs providing data would support the inclusion of the package in the NHS. It was associated with reduced parental frustration, anxiety, depression, reported infant crying and contacts with health professionals and increased knowledge about crying. Methods for a full trial and figures for the cost of excessive infant crying for the NHS and each package element were identified.
Limitations
No control group was included. Most of the recruited parents were white, well educated and in stable relationships.
Conclusions
Parents and HVs/SCPHNs recognise the need for NHS provisions that support parents of excessively crying babies and consider the materials developed to meet that need. A full-scale randomised controlled trial is feasible and desirable.
Trial registration
Current Controlled Trials ISRCTN84975637.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Queen’s Printer and Controller of HMSO 2019. This work was produced by St James-Roberts et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK. |
Keywords: | crying; humans; infant; infant behaviour; parents |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 21 Oct 2019 15:01 |
Last Modified: | 23 Oct 2019 16:35 |
Status: | Published |
Publisher: | National Institute for Health Research |
Refereed: | Yes |
Identification Number: | 10.3310/hta23560 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:152410 |