Period of PURPLE Crying


Categories associated with best practice:

  • Individual
  • PP-icon1
  • Young Adult (ages 19-24) icon
  • Adult (ages 25-64) icon
  • Canada
  • Health Care Setting
  • Injury Prevention

Determinants of Health: Education, literacy and life-long learning, Healthy child development


Objective: The Period of PURPLE Crying® program aims to educate parents about a period in infants’ lives where they are more likely to cry as a behavioural response to distress. The program provides parents with tools to address frustrations parents may experience during this time, and the dangers of shaking a baby in response to a parent’s frustration or anger. The program also addresses the importance of sharing the thoughts and feelings parents have in response to their infant’s crying to care providers in order to prevent shaking.

Population/Setting: Participants were recruited from hospitals in the Greater Vancouver Area, British Columbia. Included were mothers who had an uneventful pregnancy, a healthy singleton infant (>37 weeks’ gestation), access to a DVD player, and who were fluent in English. Research assistants or discharge nurses recruited mothers at 6 hospitals.
Methods: A randomized controlled trial in which 1279 mothers received materials from the Period of PURPLE Crying program or control materials during a home visit by a nurse by 2 weeks after the birth of their child. At 5 weeks, the mothers completed a diary to record their behaviour and their infants’ behaviour. Two months after giving birth, the mothers completed a telephone survey to assess their knowledge and behaviour.
Key Results: The receipt of the Period of PURPLE Crying materials led to higher maternal scores for knowledge about infant crying and for some behaviours considered to be important for the prevention of shaking.

Primary Source Document

R Barr, M Barr, T Fujiwara, J Conway, N Catherine, R Brant, Do educational materials change knowledge and behaviour about crying and shaken baby syndrome? A randomized controlled trial Canadian Medical Association Journal, 180(7), 727-33.

Contact information of developer(s) and/or implementer(s)

Dr. Ronald G. Barr
Centre for Community Child Health Research
4480 Oak St., L408, Vancouver BC V6H 3V4
Fax 604 875-3589

Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
Increase positive behaviour related to the prevention of shaken baby syndrome.
  • Individual level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Increase knowledge related to the prevention of shaken baby syndrome
  • Individual level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.

Health Issue(s) that is/are addressed by the Intervention

Health Promotion

    Risk Reduction

    • Prevent injury

    Specific Activities of the Intervention

    • Educational health information offered
    • Information sessions offered about a risk factor or condition

    Priority/Target Population for Intervention Delivery

    Life Stage

    • Young adult (age 19-24 years)
    • Adults (age 25-64 years)


    Educational Settings

      Community Setting

      • Health care setting




      Implementation History

      • Multiple implementations - Different settings/populations/providers - The intervention showed significant adaptability as it has been implemented in different settings or with different populations or by different provider(s). This can include multiple implementations during the same time period. Each implementation of the intervention must have been substantially the same and must have demonstrated positive results for the primary objectives of the intervention.

      Expertise Required for Implementation within the Context of the Intervention

      • Requires specialized skills that are easily available within the context - The intervention requires the participation of personnel with advanced skills (e.g. medical doctors, epidemiologists, social workers) but that are easily available within the intervention context.

      Are there supports available for implementation


      Are there resources and/or products associated with the interventions

      Yes. The Period of PURPLE Crying materials - an 11-page booklet and a DVD.