Abstract
BackgroundThe ‘Surviving Crying’ study was designed to develop and provisionally evaluate a support service for parents of excessively crying babies, including its suitability for use in the United Kingdom (UK) National Health Service (NHS). The resulting service includes three materials: a website, a printed booklet, and a Cognitive Behaviour Therapy (CBT) programme delivered to parents by a qualified professional. This study aimed to measure whether parents used the materials and to obtain parents’ and NHS professionals’ evaluations of whether they are fit for purpose. Parents were asked about participating in a randomised controlled trial (RCT) to evaluate the materials fully in health service use.MethodsParticipants were 57 parents with babies they judged to be crying excessively and 96 NHS Health Visitors (HVs). Parental use and parents’ and HVs’ ratings of the Surviving Crying materials were measured.ResultsThirty four parents reported using the website, 24 the printed booklet and 24 the CBT sessions. Parents mostly accessed the website on mobile phones or tablets and use was substantial. All the parents and almost all HVs who provided data judged the materials to be helpful for parents and suitable for NHS use. If offered a waiting list control group, 85% of parents said they would have been willing to take part in a full RCT evaluation of the Surviving Crying package.Discussion and conclusionsThe findings identify the need for materials to support parents of excessively crying babies within national health services in the UK. The Surviving Crying support package appears suitable for this purpose and a full community-level RCT of the package is feasible and likely to be worthwhile. Limitations to the study and barriers to delivery of the services were identified, indicating improvements needed in future research.Trial registrationStudy Registration no. ISRCTN84975637.
Highlights
The ‘Surviving Crying’ study was designed to develop and provisionally evaluate a support service for parents of excessively crying babies, including its suitability for use in the United Kingdom (UK) National Health Service (NHS)
The resulting materials, comprising a website, a printed booklet, and a programme of Cognitive Behaviour Therapy (CBT)based support sessions delivered to parents by a qualified practitioner, have been described [21, 22] and provisional evidence that they are associated with reductions in parental frustration, anxiety and depression has been reported [23]. Since their use in the NHS depends on whether parents and NHS professionals find them suitable, this study aimed to measure parents’ use of the materials and parental and Health Visitors (HVs) evaluations of whether they are fit for purpose
All 52 parents and most (≥85%) HVs giving an opinion judged that the materials should be included in the National Health Service (NHS)
Summary
The ‘Surviving Crying’ study was designed to develop and provisionally evaluate a support service for parents of excessively crying babies, including its suitability for use in the United Kingdom (UK) National Health Service (NHS). As well as its loud and aversive sound, many parents find crying bouts which resist soothing manoeuvres - a Bamber et al BMC Health Services Research (2019) 19:592 feature specific to the first four postnatal months - to be frustrating [13]. The effect on parental emotions and actions depends partly on how parents cope with the crying, which involves parental resources, vulnerabilities and circumstances. Factors such as depression, anxiety and high arousal influence how parents interpret and respond to infant crying [14, 15]. Parental vulnerabilities have been found to increase the likelihood of serious long-term child disturbances [16]
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