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Souto AM, Marmitt LP, de Mola CL, Cesar JA. Knowledge about sudden infant death syndrome prevention among postpartum women in Southern Brazil, 2019: a cross-sectional survey. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2024; 33:e2023622. [PMID: 38232242 PMCID: PMC10804915 DOI: 10.1590/s2237-96222024v33e2023622.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/06/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE To assess knowledge on sudden infant death syndrome (SIDS) prevention among postpartum women who received prenatal care in public and private services in Rio Grande, Rio Grande do Sul, Brazil, in 2019. METHODS A cross-sectional study was conducted with postpartum women who gave birth in that municipality in 2019; the outcome was the indication of incorrect sleeping position (side/supine position) to prevent SIDS; the chi-square test was used to compare proportions between those who underwent prenatal care in public and private services. RESULTS Among all 2,195 postpartum women, 67.7% (95%CI 65.7;69.6) were unaware of the position that prevents SIDS, 71.6% were public care service users; 77.8% of them feared choking/suffocation; 1.9% were informed about SIDS during prenatal care; doctors/nurses (70.5%) and grandmothers (65.1%) were influential regarding the baby's sleeping position. CONCLUSION Most postpartum women were unaware of the sleeping position that prevents SIDS, especially those receiving care in the public sector; in general, this subject is not discussed in prenatal care. MAIN RESULTS Two out of three mothers believed the newborn should sleep in the side or prone position, which does not prevent but rather facilitates sudden infant death syndrome (SIDS); lack of knowledge was significantly greater when prenatal care took place in public services. IMPLICATIONS FOR SERVICES SIDS should be addressed in prenatal care. Guidance from a doctor/nurse during consultations can be essential for mothers to change their mind and adopt a safe sleeping position (supine position) for their child. PERSPECTIVES SIDS prevention campaigns are relevant in the context of prenatal care, as is conducting research that aims to evaluate potential impacts of interventions on the correct sleeping position for babies.
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Affiliation(s)
- Anelise Medeiros Souto
- Universidade Federal do Rio Grande, Programa de Pós-Graduação em
Saúde Pública, Rio Grande, RS, Brazil
| | - Luana Patrícia Marmitt
- Universidade do Oeste de Santa Catarina, Programa de Pós-Graduação
em Biociências e Saúde, Joaçaba, SC, Brazil
| | - Christian Loret de Mola
- Universidade Federal do Rio Grande, Programa de Pós-Graduação em
Saúde Pública, Rio Grande, RS, Brazil
| | - Juraci Almeida Cesar
- Universidade Federal do Rio Grande, Programa de Pós-Graduação em
Saúde Pública, Rio Grande, RS, Brazil
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Dorjulus B, Prieto C, Elger RS, Oredein I, Chandran V, Yusuf B, Wilson R, Thomas N, Marshall J. An evaluation of factors associated with safe infant sleep practices among perinatal home visiting participants in Florida, United States. J Child Health Care 2023; 27:78-90. [PMID: 34517738 DOI: 10.1177/13674935211044871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sleep-related deaths are a leading cause of infant mortality in Florida. The American Academy of Pediatrics recommends placing infants to sleep on their back, alone, and without soft bedding. Compliance with these guidelines varies among parents. This evaluation examined the rates of safe infant sleep practices and associated factors among 1985 participants enrolled in Florida Maternal, Infant, and Early Childhood Home Visiting (FL MIECHV) programs during 2017-2019. Participant- and program-level variables were examined in relation to three sleep practices: infant position, bedding, and bed-sharing at 2-3 months to determine which factors were associated with high rates of safe sleep outcomes. Analyses included univariate descriptive statistics, bivariate statistics, and multivariable logistic regression. Most caregivers (70%) reported always placing their babies to sleep on their back, alone, and without soft bedding. Factors such as primary language, race, education, housing situation, and year the Safe Baby™ curriculum implemented were significantly associated with safe infant sleep practices. Bearing this in mind, FL MIECHV can tailor safe sleep education, messaging, and strategies to support participants at highest risk. Recent adoption of the Safe Baby™ curriculum, and associated staff training, was an important factor influencing parents' infant sleep practices.
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Affiliation(s)
- Barbara Dorjulus
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Concha Prieto
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Rafaella S Elger
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | | | - Vidya Chandran
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Bola Yusuf
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Roneé Wilson
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Nicholas Thomas
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
| | - Jennifer Marshall
- College of Public Health, 7831University of South Florida, Tampa, FL, USA
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3
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Infant Care Practices, Caregiver Awareness of Safe Sleep Advice and Barriers to Implementation: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137712. [PMID: 35805369 PMCID: PMC9265757 DOI: 10.3390/ijerph19137712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
Modifiable infant sleep and care practices are recognised as the most important factors parents and health practitioners can influence to reduce the risk of sleep-related infant mortality. Understanding caregiver awareness of, and perceptions relating to, public health messages and identifying trends in contemporary infant care practices are essential to appropriately inform and refine future infant safe sleep advice. This scoping review sought to examine the extent and nature of empirical literature concerning infant caregiver engagement with, and implementation of, safe sleep risk-reduction advice relating to Sudden Unexpected Deaths in Infancy (SUDI). Databases including PubMed, CINAHL, Scopus, Medline, EMBASE and Ovid were searched for relevant peer reviewed publications with publication dates set between January 2000–May 2021. A total of 137 articles met eligibility criteria. Review results map current infant sleeping and care practices that families adopt, primary infant caregivers’ awareness of safe infant sleep advice and the challenges that families encounter implementing safe sleep recommendations when caring for their infant. Findings demonstrate a need for ongoing monitoring of infant sleep practices and family engagement with safe sleep advice so that potential disparities and population groups at greater risk can be identified, with focused support strategies applied.
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Understanding the barriers and facilitators to safe infant sleep for mothers of preterm infants. J Perinatol 2021; 41:1992-1999. [PMID: 33288866 PMCID: PMC8855739 DOI: 10.1038/s41372-020-00896-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/30/2020] [Accepted: 11/20/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To identify barriers and facilitators to adherence to safe sleep practices (SSP) among mothers of preterm infants using qualitative methodology. DESIGN We conducted 23 in-depth interviews in English or Spanish with mothers of preterm infants who were recently discharged from four hospitals, utilizing a grounded-theory approach and framework of the Theory of Planned Behavior (attitudes, perceived control, social norms). RESULTS For attitudes, mothers' fear about their infants' vulnerable preterm state related to suffocation, apnea of prematurity, and reflux influenced infant sleep practices. For social norms, education received in the NICU and advice from other health care providers, family, friends, and media impacted their choices. For perceived control, mothers adapted infant sleep practices to meet their own needs and address the perceived safety and comfort of infants. CONCLUSION Factors identified that influence maternal decision-making about infant sleep practices can inform interventions to address sudden unexpected infant death reduction in preterm infants.
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Lewis CC, Lyon AR, McBain SA, Landes SJ. Testing and Exploring the Limits of Traditional Notions of Fidelity and Adaptation in Implementation of Preventive Interventions. J Prim Prev 2020; 40:137-141. [PMID: 30684091 DOI: 10.1007/s10935-019-00539-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This commentary reflects on key challenges raised across the articles of this special issue, notably the tension between fidelity and adaptation, the importance of articulating core components and principles of evidence-based programs, the need for pragmatic measures, and the challenges associated with articulating and testing mechanisms of implementation strategies. These challenges are amplified in the context of prevention research where task shifting, or revising professional roles, is especially common. Synergies with work emerging from the Society for Implementation Research Collaboration are highlighted throughout.
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Affiliation(s)
- Cara C Lewis
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA. .,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA, 98195, USA.
| | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Sacha A McBain
- VISN 16 South Central Mental Illness Research Education and Clinical Center (MIRECC), Central Arkansas VA Health Care System, 2200 Fort Roots Drive, North Little Rock, AR, 72114, USA.,Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, USA
| | - Sara J Landes
- VISN 16 South Central Mental Illness Research Education and Clinical Center (MIRECC), Central Arkansas VA Health Care System, 2200 Fort Roots Drive, North Little Rock, AR, 72114, USA.,Department of Psychiatry, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR, 72205, USA
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Vilvens HL, Vaughn LM, Southworth H, Denny SA, Gittelman MA. Personalising Safe Sleep Messaging for Infant Caregivers in the United States. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:891-902. [PMID: 31847057 DOI: 10.1111/hsc.12920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 10/26/2019] [Accepted: 11/25/2019] [Indexed: 06/10/2023]
Abstract
The purpose of our study was to better understand why parents/caregivers might not practice safe sleep behaviours. In autumn 2016, we conducted 'pulse' interviews with 124 parents/caregivers of children under the age of one year at a variety of local community events, festivals and meetings in cities with high infant mortality rates around the Midwestern US state of Ohio. Through an inductive approach, pulse interviews were analysed using thematic coding and an iterative process which followed for further clarification of themes (Qualitative Research in Psychology, 2006, 3, 77; BMC Medical Research Methodology, 2013, 13, 117). The six major themes of underlying reasons why parents/caregivers might not practice safe sleep behaviours that were identified in our coding process included the following: (a) culture and family tradition, (b) knowledge about safe sleep practices, (c) resource access, (d) stressed out parents, (f) lack of support and (g) fear for safety of baby. Using the descriptive findings from the pulse interviews, qualitative themes and key informant validation feedback, we developed four diverse fictional characters or personas of parents/caregivers who are most likely to practice unsafe sleep behaviours. These personas are characteristic scenarios which imitate parent and caregiver experiences with unsafe sleep behaviours. The personas are currently being used to influence development of health promotion and education programs personalised for parents/caregivers of infants less than one year to encourage safe sleep practices.
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Affiliation(s)
| | - Lisa M Vaughn
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | | | | | - Michael A Gittelman
- Division of Emergency Medicine, Cincinnati Children's Hospital, Cincinnati, OH
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Middlemiss W, Brownstein NC, Nelson SP, Manchiraju S, Leddy M, Steliotes N, Grzywacz JG. Crafting effective messages to enhance safe infant sleep. J Am Assoc Nurse Pract 2020; 33:441-450. [PMID: 32039958 DOI: 10.1097/jxx.0000000000000365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/01/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Health care professionals are continually challenged by the need to provide health information in a way that successfully changes health practices. Research has documented this as a concern in relation to safe infant sleep health campaigns. Often, caregivers' knowledge of recommended practices is not associated with a change in infant sleep choices. PURPOSE Health campaigns, including most safe infant sleep efforts, often share specific risk factors and steps for avoiding risk, that is, in a verbatim format. Research has shown that caregivers' behavior may be more likely to change when presented with messages based on their general understanding of risk, that is, gist-based format. This research examines caregivers' responses as related to verbatim- and gist-based safe sleep information. METHODS Five hundred forty-one caregivers of infants were shown 12 images depicting infants in safe or unsafe sleep spaces. Images varied across three commercially available spaces, infant race, and presence/absence of one policy-based risk factor. RESULTS Differences in caregivers' discernment of safe and unsafe sleep images paralleled reported differences in knowledge of safe sleep recommendations. Discernment of safe/unsafe images was greater for White than Black caregivers, as well as for females in comparison with male caregivers. Gist-based considerations, such as familiarity with the sleeper depicted or infant race, were also associated with caregivers' discernment of safe/unsafe images. IMPLICATIONS FOR PRACTICE Attending to both gist- and verbatim-based knowledge regarding safe infant sleep campaign information may help to effectively facilitate caregivers' ability to always create safe sleep spaces for their infants.
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Affiliation(s)
- Wendy Middlemiss
- Department of Educational Psychology, University of North Texas, Denton, Texas
| | - Naomi C Brownstein
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida
| | - Scott P Nelson
- College of Medicine, Florida State University, Tallahassee, Florida
| | - Srikant Manchiraju
- The Jim Moran School of Entrepreneurship, Florida State University, Tallahassee, Florida
| | - Miranda Leddy
- Department of Educational Psychology, University of North Texas, Denton, Texas
| | - Nicole Steliotes
- Department of Nutrition, Food, and Exercise Science, Florida State University, Tallahassee, Florida
| | - Joseph G Grzywacz
- Department of Family and Child Sciences, Florida State University, Tallahassee, Florida
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Stiffler D, Matemachani SM, Crane L. Considerations in Safe to Sleep® messaging: Learning from African-American mothers. J SPEC PEDIATR NURS 2020; 25:e12277. [PMID: 31742922 PMCID: PMC6980322 DOI: 10.1111/jspn.12277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/19/2019] [Accepted: 10/11/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to identify why African-American mothers do not tend to follow the Safe to Sleep® recommendations and to begin to identify a way to frame the Safe to Sleep® message so that African-American mothers might be more likely to follow these recommendations. DESIGN We recruited African-American mothers with infants over the age of 6 months to participate in two focus groups facilitated by a community engagement manager experienced in focus group facilitation. We used ethnography to find shared patterns of behavior and beliefs in African-American women related to safe sleep. RESULTS We identified 14 concepts and formulated them into three categories: it's just easier; can't fight culture and grandma; and Effectively teaching mother. From these we were able to identify the shared value of multifaceted learning. PRACTICE IMPLICATIONS African-American mothers say that they are generally aware of the Safe to Sleep® recommendations, even though the majority of mothers do not follow them. The reasons they give for not following them are that they are not comfortable doing so, they feel they are unable to do so, or find it unnecessary. Many of the mothers attempted to follow the Safe to Sleep® recommendations but abandoned the effort due to the stress of their crying infant. Trying to follow the Safe to Sleep® recommendations were stressful for the mothers, even though there was concern expressed by some that their infant could indeed suffocate or die from sudden infant death syndrome. The mothers gave suggestions on how they would change the message or the delivery of the message.
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Affiliation(s)
| | | | - Lisa Crane
- Goodwill of Central and Southern Indiana, Nurse-Family Partnership, Indianapolis, Indiana
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Gemble A, Hubert C, Borsa-Dorion A, Dessaint C, Albuisson E, Hascoet JM. Knowledge assessment of sudden infant death syndrome risk factors in expectant mothers: A prospective monocentric descriptive study. Arch Pediatr 2019; 27:33-38. [PMID: 31784291 DOI: 10.1016/j.arcped.2019.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 07/24/2019] [Accepted: 10/20/2019] [Indexed: 11/17/2022]
Abstract
In France, approximately 500 deaths per year are related to sudden infant death syndrome (SIDS). After a 75% reduction of SIDS-related deaths in the 1990s, thanks to large prevention campaigns directing parents to put their infants to sleep on their back, the number of SIDS-related deaths remains stable. However, we estimate that 100-200 infant deaths per year in France could be prevented with better education on the risk factors for SIDS. In this prospective, descriptive monocentric study, we aimed to evaluate the level of expectant women's knowledge about SIDS. Questionnaires were distributed during a midwife consultation. A score on sleeping conditions, environmental and protective factors was determined with coefficients attributed according to their relevance to SIDS. Of 296 questionnaires distributed, 202 were completed and included in the analysis from March 1 to September 21, 2018. Scores were distributed from 2 to 46/50. The average score was 28.6/50. Information was principally obtained from media and not health professionals. When the information was delivered by a caregiver, in particular by a paediatrician, we observed better knowledge among these women. This study shows that it is important for health professionals to take the time to inform future mothers about the risk factors for SIDS, especially the least informed population groups such as young mothers and those from lower socioeconomic status, in order to reduce the number of avoidable infant deaths.
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Affiliation(s)
- A Gemble
- Department of Neonatology, University Hospital of Nancy, 54000 Nancy, France.
| | - C Hubert
- Department of Neonatology, University Hospital of Nancy, 54000 Nancy, France
| | - A Borsa-Dorion
- Pediatric Emergency Department, University Hospital of Nancy, 54000 Nancy, France
| | - C Dessaint
- Obstetrics and Fetal Medicine Department, University Hospital of Nancy, 54000 Nancy, France
| | - E Albuisson
- Unit of Methodology, Data Management and Statistics (UMDS), University Hospital of Nancy, 54000 Nancy, France
| | - J-M Hascoet
- Department of Neonatology, University Hospital of Nancy, 54000 Nancy, France
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Moon RY, Carlin RF, Cornwell B, Mathews A, Oden RP, Cheng YI, Fu LY, Wang J. Implications of Mothers' Social Networks for Risky Infant Sleep Practices. J Pediatr 2019; 212:151-158.e2. [PMID: 31201032 PMCID: PMC6707860 DOI: 10.1016/j.jpeds.2019.05.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/18/2019] [Accepted: 05/10/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the structure of networks in a cohort of mothers and to analyze associations of social network characteristics and norms with infant sleep practices. STUDY DESIGN We recruited a prospective cohort of mothers with infants <6 months of age from January 2015 to December 2016. Mothers completed a survey about their personal social networks and infant care practices. Latent class analysis identified unobserved network types. Binary statistics and path analysis were performed. RESULTS Overall, 402 mothers were surveyed. Latent class analysis identified 2 a priori unknown social network types: "exclusive" (restricted) and "expansive." Mothers who were black, younger, unmarried, less educated, and of lower socioeconomic status were more likely to have exclusive networks than expansive networks. Mothers with exclusive networks were more likely to be exposed to the norm of soft bedding (P = .002). Exposure to norms of non-supine infant placement, bedsharing, and soft bedding use within one's network was associated with engaging in these practices (P < .0001 for each). First-time mothers were more likely to pay attention to a non-supine norm and place infants in a non-supine position. Black mothers and first-time mothers were more likely to pay attention to the norm and use soft bedding. CONCLUSIONS Both the type of networks mothers have and the norms regarding infant sleep practices that circulate within these networks differed by race. Network norms were strongly associated with infant sleep practices and may partially explain the racial disparity therein.
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Affiliation(s)
- Rachel Y. Moon
- Department of Pediatrics, University of Virginia. Charlottesville, VA
| | - Rebecca F. Carlin
- Goldberg Center for Community Pediatric Health, Children’s National Health System, Washington, DC,Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC
| | | | - Anita Mathews
- Goldberg Center for Community Pediatric Health, Children’s National Health System, Washington, DC
| | - Rosalind P. Oden
- Goldberg Center for Community Pediatric Health, Children’s National Health System, Washington, DC
| | - Yao I. Cheng
- Center for Translational Science, Children’s National Health System, Washington, DC
| | - Linda Y. Fu
- Goldberg Center for Community Pediatric Health, Children’s National Health System, Washington, DC,Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Jichuan Wang
- Center for Translational Science, Children’s National Health System, Washington, DC,Department of Epidemiology and Biostatistics, George Washington University, Washington DC
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Chesser AK, Ahlers-Schmidt CR, Schunn C. Grandparent Knowledge of Infant Safe Sleep. Glob Pediatr Health 2019; 6:2333794X19852008. [PMID: 31211184 PMCID: PMC6545637 DOI: 10.1177/2333794x19852008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/18/2019] [Accepted: 04/19/2019] [Indexed: 11/17/2022] Open
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Cesar JA, Marmitt LP, Carpena MX, Pereira FG, Neto JDM, Neumann NA, Acevedo JD. Maternal Knowledge and Unsafe Baby Sleep Position: A Cross-Sectional Survey in Southern Brazil. Matern Child Health J 2019; 23:183-190. [PMID: 30105515 DOI: 10.1007/s10995-018-2613-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective to evaluate women's knowledge about the best baby sleeping position and to identify factors associated with a greater probability of putting infants to sleep in an unsafe position, in Rio Grande, Southern Brazil. Method This is a cross-sectional population-based study that included all women who bore children in 2013 in this municipality. A single, standardized questionnaire was given within 48 h after delivery in the only two local maternity hospitals. The outcome was that women reported the lateral and the ventral decubitus as the best sleeping positions for babies. A Chi square test was used for proportions and Poisson regression was used with robust variance adjustment in the multivariate analysis. The prevalence ratio was the measure of effect used. Results We included 2624 women in this study. Of these, 82.1% (95% CI 80.6-83.6) stated that the baby should sleep in the lateral or ventral decubitus positions. 76.4% reported having acquired this knowledge from their mothers and 34.7% were willing to adopt the correct (supine) sleeping position for their child if recommended by doctors. The adjusted analysis showed that the lower the schooling of the mothers and the greater the number of people per bedroom and number of children, the greater the probability of women choosing an unsafe baby sleeping position. Conclusions for Practice This study showed that the percentage of women who are unaware of the correct baby sleeping position is very high, that doctors should be convinced to recommend the supine baby sleeping position, and that campaigns on this subject should also include grandparents as a priority intervention group.
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Affiliation(s)
- Juraci A Cesar
- Programa de Pós-graduação em Saúde Pública, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, 96200-400, Brazil
| | - Luana P Marmitt
- Programa de Pós-graduação em Ciências da Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, 96200-400, Brazil.
| | - Marina X Carpena
- Programa de Pós-graduação em Saúde Pública, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, 96200-400, Brazil
| | - Franciele G Pereira
- Programa de Pós-graduação em Saúde Pública, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, 96200-400, Brazil
| | - Jose D Macedo Neto
- Programa de Pós-graduação em Saúde Pública, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, 96200-400, Brazil
| | - Nelson A Neumann
- Coordenação Nacional da Pastoral da Criança, Curitiba, Paraná, 80810-900, Brazil
| | - Jayshlyn D Acevedo
- Divisão de População & Saúde, Faculdade de Medicina da Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, 96200-400, Brazil
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Lagon E, Moon RY, Colvin JD. Characteristics of Infant Deaths during Sleep While Under Nonparental Supervision. J Pediatr 2018; 197:57-62.e36. [PMID: 29622341 DOI: 10.1016/j.jpeds.2018.01.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/18/2017] [Accepted: 01/18/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To compare risk factors for infant sleep-related deaths under the supervision of parents and nonparents. STUDY DESIGN We conducted a secondary analysis of sleep-related infant deaths from 2004 to 2014 in the National Center for Fatality Review and Prevention Child Death Review Case Reporting System. The main exposure was supervisor at time of death. Primary outcomes included sleep position, location, and objects in the environment. Risk factors for parental vs nonparental supervisor were compared using χ2 and multivariable logistic regression models. Risk factors associated with different nonparental supervisors were analyzed using χ2. RESULTS Of the 10 490 deaths, 1375 (13.1%) occurred under nonparental supervision. Infants who died under nonparental supervision had higher adjusted odds of dying outside the home (OR 12.87, 95% CI 11.31-14.65), being placed prone (OR 1.61, 95% CI 1.39-1.86) or on their side (OR 1.35, 95% CI 1.12-1.62), or being found prone (OR 1.74, 95% CI 1.50-2.02). Among infants who died under nonparental supervision, those supervised by relatives or friends were more often placed on an adult bed or couch for sleep and bed sharing (P < .0001), and to have objects in the sleep environment (P = .01). CONCLUSIONS Infants who died of sleep-related causes under nonparental supervision were more likely to have been placed nonsupine. Among nonparental supervisors, relatives and friends were more likely to use unsafe sleep environments, such as locations other than a crib or bassinet and bed sharing. Pediatricians should educate parents that all caregivers must always follow safe sleep practices.
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Affiliation(s)
- Elena Lagon
- University of Virginia School of Medicine, Charlottesville, VA
| | - Rachel Y Moon
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA
| | - Jeffrey D Colvin
- Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, MO
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Gollenberg A, Fendley K. Is it Time for a Sudden Infant Death Syndrome (SIDS) Awareness Campaign? Community Stakeholders' Perceptions of SIDS. ACTA ACUST UNITED AC 2017; 24:53-64. [PMID: 29249897 DOI: 10.1080/13575279.2016.1259155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background Sudden infant death syndrome (SIDS) remains a leading cause of infant death in the United States and in Virginia, the SIDS rate is higher than the national average. We sought to gauge the perceptions among community-identified stakeholders as to community resource needs to reduce SIDS. Methods We used snowball sampling to identify important community stakeholders to be interviewed as key informants. A semi-structured interview lasting 45 min-2 hours was delivered to determine resource needs to reduce SIDS, and whether high-risk community members were aware of SIDS risk factors among stakeholders representing a variety of disciplines. Interviews were conducted in two geographic areas with higher than average rates of infant mortality, an urban district, Winchester City, VA and a rural district, Page County, VA. Results A total of 74 interviews were completed with stakeholders in healthcare, health departments, social services, law enforcement, education/childcare, faith-based institutions, non-profit agencies and non-affiliated community members. The majority of respondents perceive that high-risk community members are not aware of factors that can lead to SIDS (50%). Participants suggested that more "education" is needed to further reduce the rates of SIDS in their communities (73%). Respondents detailed that more pervasive, strategic, and multi-channeled education is necessary to reduce cases of SIDS. Conclusion Community leaders perceive that high-risk community members are not fully aware of risk factors that can lead to SIDS. Maternal/child health stakeholders in these Virginia locales suggested more community-based education as a potential solution to SIDS.
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Affiliation(s)
- Audra Gollenberg
- Associate Professor of Public Health, Shenandoah University, College of Arts & Sciences, Public Health Program, Winchester, VA 22601
| | - Kim Fendley
- Associate Professor of Sociology, Shenandoah University, College of Arts & Sciences, Sociology Program, Winchester, VA 22601
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Austin JE, Nashban CJ, Doering JJ, Davies WH. Prevention Messages in Parent-Infant Bed-Sharing: Message Source, Credibility, and Effectiveness. Glob Pediatr Health 2017; 4:2333794X17743403. [PMID: 29201949 PMCID: PMC5700781 DOI: 10.1177/2333794x17743403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/20/2017] [Indexed: 11/15/2022] Open
Abstract
Objective. Despite educational outreach, bed-sharing prevalence is rising. Mothers’ and fathers’ bed-sharing practices, prevention message source, perceived source credibility, and the effectiveness of the prevention message were evaluated. Methods. Data were collected from 678 community parents via an online survey. Results were analyzed using descriptive statistics and phi tests. Results. Bed-sharing reasons focused on comfort and ease. Mothers were more likely to receive prevention messages from individual professionals or organizations, whereas fathers were more likely to hear prevention messages from spouses/coparents and grandfathers. Physicians were the most common source, and physicians and grandmothers were rated as the most credible and effective. Conclusions. Prevention message source varies between mothers and fathers, highlighting the need for continued research with fathers. Grandmothers and physicians are effective and credible sources of prevention messages. Although less frequent, prevention messages from grandmothers were most effective. There was no evidence of effective messages from educational campaigns.
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Affiliation(s)
- Jillian E Austin
- University of Wisconsin-Milwaukee, WI, USA.,Nemours Children's Specialty Care, Jacksonville, FL, USA
| | - Chad J Nashban
- Wisconsin School of Professional Psychology, Milwaukee, WI, USA
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Abstract
BACKGROUND More than 95% of higher-order multiples are born preterm and more than 90% are low birth weight, making this group of infants especially vulnerable to sudden infant death syndrome (SIDS). Emerging evidence suggests that families with twins face challenges adhering to the American Academy of Pediatrics (AAP) recommendations to reduce SIDS risks. Adherence to the AAP recommendations in families with higher-order multiples has not been described. PURPOSE This study describes SIDS risk reduction infant care practices for higher-order multiples during the first year of life. METHODS Mothers caring for higher-order multiple-birth infants were recruited from an online support group. An online survey was used to assess infant care practices when the infants were first brought home from the hospital as well as at the time of the survey. RESULTS Ten mothers of triplets and 4 mothers of quadruplets responded. Less than 80% of the mothers practiced "back to sleep" immediately postdischarge. Supine sleep positioning decreased over time, particularly during daytime naps. Only 50% of the infants shared the parents' bedroom and approximately 30% bed-shared with their siblings. Sleep-time pacifier use was low. IMPLICATIONS FOR PRACTICE Safe sleep education must include specific questions regarding home sleeping arrangements, encouragement of breast milk feedings, supine positioning, and pacifier use at every sleep for higher-order multiple infants well before discharge in order for parents to plan a safe sleep environment at home. IMPLICATIONS FOR RESEARCH Prospective studies to identify barriers and facilitators can inform future strategies supporting adherence to safe sleep practices for higher-order multiple infants.
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Colson ER, Geller NL, Heeren T, Corwin MJ. Factors Associated With Choice of Infant Sleep Position. Pediatrics 2017; 140:peds.2017-0596. [PMID: 28827382 PMCID: PMC5574721 DOI: 10.1542/peds.2017-0596] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The American Academy of Pediatrics recommends infants be placed supine for sleep. Our objectives in this study were to, in a nationally representative sample, examine (1) prevalence of maternal intention regarding infant sleeping position and of actual practice and (2) factors associated with their choices. METHODS We recruited mothers from 32 US hospitals, oversampling African American and Hispanic mothers, in a nationally representative sample of mothers of infants aged 2 to 6 months. Survey questions assessed choice of usual infant sleeping position, all sleeping positions, intention for sleep position, as well as actual practice. Multivariable logistic regression analyses controlled for demographic, receipt of doctor advice, and theory of planned behavior variables (attitudes, subjective norms, and perceived control). RESULTS Of the 3297 mothers, 77.3% reported they usually placed their infants in the supine position for sleep, but fewer than half reported that they exclusively did so. Only 43.7% of mothers reported that they both intended to and then actually placed their infants exclusively supine. African American mothers and those who did not complete high school were more likely to intend to use the prone position. Theory of planned behavior factors (attitudes, subjective norms, and perceived control) and doctor advice were associated with maternal choice. CONCLUSIONS Not all mothers place their infants exclusively supine for sleep. Many mothers intend to place their infants supine yet often do not do so in actual practice. Factors potentially amenable to intervention including attitudes, subjective norms, and doctor advice are associated with intention and practice.
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Affiliation(s)
- Eve R. Colson
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | | | - Timothy Heeren
- Department of Biostatistics, School of Public Health, Boston University, Boston, Massachusetts
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