Once the packages had been selected, each was reviewed in detail by the team to ensure familiarity with its content. One member of the team then reviewed the packages in further depth to identify a sample of the content that would give an overview of the whole and highlight some of the packages’ key features. Using Microsoft Expression Web (Microsoft Corporation, Redmond, WA, USA), a video capture of the selected elements of each website was created, together with a script to be read out while the video capture was playing. A draft of the videos and scripts was then reviewed by other members of the team for comment and revision. The revised versions were shown to two people who were not part of the study team in order to ensure that they provided a good-enough overview of the websites to enable an informed judgement of them to be made.
Although the study team aimed to ensure that each package was reviewed by parents for the same length of time, the websites contained a considerably varying amount of content. As a result, the video captures were of slightly differing lengths, between approximately 6.5 minutes (Coping with Crying and What Were We Thinking!) and 7.5 minutes (Cry Baby and Period of PURPLE Crying). For one package, What Were We Thinking!, laminated copies of a sample of the accompanying written materials were also circulated to focus group participants, and for another, Cry Baby, some of the downloadable resources were printed off and laminated for viewing.
Once this process was completed, the finished products enabled focus group members to be shown the key features of the websites without the need for an internet connection, and also ensured that all participants were exposed to an identical sample and description of each package. In order to avoid any bias arising from the sequence in which the packages were shown, the order of presentation was varied at each focus group, as shown in . A brief description of the aspects of each package shown to focus group participants is given in the following sections.
Order of presenting the packages
Cry Baby
The package was introduced, and it was explained that although the website gave information and advice about managing early infant crying and sleeping, only materials relevant to crying would be shown on this occasion. Having shown the main menu, a section of the introductory video was then played. After this, an overview of some of the topics was given, highlighting how the website offered information on research into crying: the ‘crying curve’ over the first few months, the idea of unsoothable crying that is not because of a problem with the baby or the parents, and the fact that it is not possible to work out the reason for the crying from how it sounds. A section of the website that offers tips to parents on how to check their baby to ensure that nothing is wrong was then shown. The use of various graphic features to give advice and guidance was highlighted to the group. The presentation then moved only to show some of the website section that gave parents advice on how to cope with the crying once they have done what they can to try and stop it.
The presentation showed the other main part of the website resources, which emphasises the importance of parents looking after themselves as well as their baby. A part of the introduction to this section was shown, together with sample aspects of the sections that have been separately developed for mothers and fathers. The resources section was then briefly reviewed, which lists contacts for other organisations and helplines and provides access to the various checklists that can be downloaded from the website. Finally, a section of a page called Baby Myths was introduced, highlighting how it challenges some of the common beliefs that can cause stress among parents. Copies of the three downloadable checklists were then circulated to the group for viewing.
Coping with Crying
The package was introduced, explaining that it consisted of a film, website, DVD and leaflet, but because all the materials are contained within the website, only the website would be shown to the group. The home page was then displayed, and the three sections, Keeping Calm, Soothing Your Baby and Understanding Your Baby, were pointed out. The presentation then moved to the Understanding Your Baby section, explaining how each page included quotations from parents, tips and advice and ideas for where parents can get further help and support. The content of the page was reviewed briefly, explaining how it focused on giving information about babies’ behaviour and learning how to interpret and respond to it – a section listing the kind of things that might trigger a baby to cry was displayed for a short time for the group to read. Other aspects of the page were mentioned, and then the presentation moved to the second section, Soothing Your Baby.
Part of a video on this page was shown to the group, highlighting how it includes content from parents who have had a crying baby and from a parenting adviser. An overview of the information on the page was given, including noting that sometimes none of the soothing strategies will work and, therefore, the importance of parents looking after their own well-being and staying calm. The presentation then moves to the Keeping Calm section of the website, highlighting how this provides advice on strategies to manage stress and information on the potential negative impact of stress on both parents and the baby. An excerpt from a video of parents sharing their experiences and tips was shown, and attention was drawn to the advice offered on what to do if parents are feeling at risk of losing control with the baby.
Finally, the presenter explained that the website contained a further, much longer video that focused on preventing shaken baby syndrome. The content of this video was described to the group, noting that it includes the story of a parent talking about the disability and eventual death of her baby as a result of her partner shaking him. Partly because of this emotive content the research team made the decision not to show this video to the group but to describe its content instead.
The Period of PURPLE Crying
The package was introduced, explaining that the materials consisted of a website, together with a DVD and leaflet given out by health professionals just before or after birth. Only the website was shown to the group, and it was explained that although this contained information about crying and sleeping, only the crying-related content would be described. The home page was displayed, pointing out its six sections: Introduction, Sleeping, Soothing, Crying, Protecting and For Dads. The introductory page was then shown, including an excerpt from a video from a paediatrician explaining the reason for the term ‘PURPLE Crying’, the key features of the crying and that it is neither the baby’s nor the parents’ fault. An overview of the Crying section of the website was then given, showing the information about the research into crying, the advice about responding to people who may not understand it and a caution about ‘foolproof’ solutions to the crying. A section called Real Life Challenges was then introduced, which contained parents’ experiences of having a crying baby, and an excerpt from one of the written stories was read to the group, which described the difficulties a mother had faced and how the situation had been resolved.
A brief overview of the Soothing section was then given, pointing out that it contained information about common features and principles of soothing, together with soothing methods to try and those to avoid. The presentation then moves to the Protecting Children section, noting that there is a large amount of content and showing one page of it, which offers a set of photographic images giving suggestions on how to deal with frustration, followed by some written information that the group is given a short opportunity to read. The presentation then moves to the For Dads section, showing part of a short role-played video illustrating a father’s experience of his baby’s crying. Information about the rest of this section is then given, highlighting how it encourages dads to get involved in parenting their child, the importance of parents working together and the advice on dealing with particular stresses that fathers might face.
What Were We Thinking!
The What Were We Thinking! programme was introduced, explaining that it was not specifically about babies crying, but was designed for first-time parents in general, and that the materials being shown were part of a programme that also includes workbooks and a day workshop that both parents are expected to attend. The presentation began by showing the home page, which introduced the programme, and playing the beginning of a video, which explained the programme using a humorous approach. An overview of the parents’ section was then given, explaining how it starts by discussing the challenges of becoming a parent and adjusting to the changes in relationships; the presentation then describes the worksheets that take up most of the website. An example of one of the worksheets was then displayed, which asks each parent to describe their baby and then to see when they agree and disagree. A demonstration of how to complete the worksheet was given, and the advice given on each page relating to the topic was then highlighted. Another worksheet was then shown and demonstrated, which asks parents to compare how long and when they think that their baby cries and what strategies they have used to soothe them. The accompanying advice was highlighted, and then the presentation moved to a page giving tips on how to settle your baby and an excerpt from one of the short videos demonstrating techniques was shown.
The presentation then highlighted how some of the worksheets are for parents to think about themselves and their experiences. It noted that these include looking at how it feels to be a parent compared with what they thought it would be like, and a brief overview of a section about the losses and gains since becoming a parent is displayed. A section on sharing the workload was then introduced, and part of a role-played video prompting parents to think about their different work responsibilities was shown. Other worksheets, including negotiating support needs, advice for single parents and dealing with criticism, were mentioned but not shown. The presentation then returned to the home page to highlight a blog in which parents can share their experiences. Copies of a number of worksheets were then circulated around the group for viewing.
