170 Impact of a universal infant abuse education programme in reducing physical abuse hospitalization rates among children in British Columbia, Canada

<h3>Background</h3> The Period of PURPLE Crying Program® (PURPLE) is an evaluated universal parent education infant abuse prevention programme delivered to all parents/caregivers of newborns in British Columbia (B.C.). Education and materials focus on: increasing parent/caregiver awareness on early increased infant crying and coping strategies to counter frustration and anger arising from inconsolable crying; improving awareness around the dangers of shaking infants; and, reducing the incidence of abusive head trauma. <h3>Objective</h3> To determine if the PURPLE programme impacted the rate of physical abuse hospitalization cases for children less than or equal to 24 months old in B.C. since implementation in 2009, in alignment with published results indicating reduction in crying complaints presenting to emergency departments and a reduction in hospital admission for abusive head trauma. <h3>Programme Description</h3> PURPLE emphasizes that crying is a normal and healthy way for infants to communicate, and provides parents with tools and strategies for responding to crying in a positive and supportive way. Before discharge from maternity hospitals and at-home births, trained maternity nurses and midwives deliver PURPLE education. Trained public health and primary care nurses engage parents in conversation about infant crying and reinforce PURPLE key messages during well baby check-ups, first immunization, and appointments up to four months of age. Trained community service providers reinforce messages during interactions with families and capture those that may not be aware of PURPLE, bridging the health and social service systems. <h3>Outcomes and Learnings</h3> A reduction was observed in physical abuse hospitalization rates among children less than or equal to 24 months of age following the implementation of PURPLE. <h3>Implications</h3> The programme emphasizes the importance of partnership between patients, families, and care providers, and empowering patients to make informed decisions about infant care. Infant crying, soothing and coping information for new parents and caregivers can be accessed and adapted for use in their practice by jurisdictions that do not deliver PURPLE universally. <h3>Conclusions</h3> Health and community providers role in engaging parents in conversations about PURPLE messages over multiple timepoints using a structured universal education program resulted in a decrease in physical abuse hospitalization rates since implementation.