Background: Child maltreatment is a serious health concern in the United States (U.S.) affecting as many as one in four children throughout their lifetime (Finkelhor, Turner, Ormond, & Hamby, 2013). In 2013, a reported 678, 932 victims of child maltreatment were reported to Child Protective Services (CPS), and of those cases 1,520 were fatal (CDC, 2015a). Out of all the various types of child maltreatment, Shaken Baby Syndrome (SBS) is the leading cause of child abuse deaths in the U.S. (CDC, n.d.). While current research has focused on validating the effectiveness of educational interventions, very few studies have analyzed the efficacy of individualized, patient-centered action plans. Such data would be beneficial to assess the usefulness of action plans in preparing caregivers for coping with an inconsolable infant at home. Purpose: To enhance caregiver knowledge about SBS and to provide parents with the skills and resources necessary to cope effectively and efficiently at home when unable to console their infant. Methods: This study utilized a quasi-experimental pre-test/post-test design. Participants were recruited from the Franciscan Women’s Health Associates located at St. Joseph Medical Center in Tacoma, Washington and were members of the Centering prenatal groups. The entirety of the study was completed during these groups including the pre-test, intervention, action plan, and post-test. Data was analyzed through the utilization of descriptive statistics as well as a paired t test. Results: Overall, results revealed that participant (n=26) knowledge significantly improved after the educational intervention (p=0.000) with a mean score of 87.56% on the pre-test and a mean score of 95.38% on the post-test. In addition, a majority of participants (57.5%) found both the action plan and the education to be extremely useful. Discussion: The results of this study were consistent with current evidence indicating that education on SBS, the dangers of shaking, and healthy coping mechanisms significantly impacts caregiver knowledge. In addition, a majority of participants viewed the action plans favorably identifying that they would be beneficial if they felt frustrated. Future research is warranted to gather more information on the long-term outcomes of educational interventions as well as individualized action plans.

This quantitative research is on the efficacy of Minnesota Statute 144.574 enacted in 2005 in response to the growing awareness of behavior leading to inflicted Traumatic Brain Injuries (iTBI) in infants and children. The model for this research is grounded in the Theory of Reasoned Action wherein the education of new parents which graphically explains the physiologic changes to the structural architecture of the brain post-trauma, paired with their signature on a social contract (SC), demonstrated a reduction in incidence. Because the enacted statute does not include the signing of a SC, nor does it require face-to-face education as in the model, Statute 144.574 cannot claim to be completely grounded in medical science. The result is that neither legislators nor the medical and public health community know whether the statute is effective in lowering incidence. This research was designed to explore the difference in the incidence pre-and post-enactment, in rural vs. urban communities, the proportion of incidence and ethnicity, and an ordinal shift in the distribution of severity. All births in Minnesota from 1998 through 2017 were included. Cases defined using International Classification of Disease were extracted from secondary data from the brain and spinal cord injury, hospital discharge, and vital statistics databases. A Z-test was employed to compare the incidence in a control cohort of infants and children born prior to enactment to the incidence of same in an interventional cohort born post-enactment. Results suggest the statute has not resulted in lowering incidence, have uncovered an unanticipated statistically significant increase in rural vs. urban incidence, yet point to a trend in favor of less severe iTBI. These results represent a positive social change which is grounded in the society's imperative and social justice of protecting children by informing public health officials, caregivers, and legislators of the need for meaningful reform and strengthening of programs leading to lowering the incidence of iTBI in children in Minnesota.