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Evaluation of a Crib Distribution and Safe Sleep Educational Program to Reduce Risk of Sleep-Related Infant Death

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Abstract

To increase access to safe infant sleep surfaces and reduce risk of sleep-related infant deaths, the Georgia Department of Public Health implemented a portable crib distribution and safe sleep educational program. The aim of this evaluation was to compare parental knowledge and practices related to infant sleep before and after receipt of the safe sleep educational program and crib. A prospective, matched pre- and post-test cohort design with a follow-up survey was utilized to evaluate changes in knowledge and practices. Female participants were recruited through the county health department and met the following criteria: (1) between 32 and 40 weeks pregnant or within 3 months postpartum, and (2) demonstrated financial need. Participants completed a survey prior to the start of a group educational program and upon program completion. For those who agreed, a follow-up phone survey was conducted approximately 10 weeks after program completion or after the infant’s birth. McNemar’s Chi square tests were conducted to detect significant differences between specific items on pre-test, post-test, and follow-up surveys, and paired sample t tests were conducted to compare differences in knowledge and practice scores. A total of 132 participants completed matched pre- and post-test surveys and 76 completed follow-up surveys. Knowledge of recommendations regarding position, surface, environment, smoking, breastfeeding, and pacifier use increased significantly between pre- and post-test, with most participants maintaining knowledge at follow-up. The proportion of recommended practices also increased significantly. A group-based safe sleep educational program can be effective in reducing risky infant sleep practices.

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References

  1. Centers for Disease Control and Prevention. (2016). About sudden unexpected infant death and sudden infant death syndrome. Retrieved from http://www.cdc.gov/sids/.

  2. Moon, R. Y. & American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. (2016). SIDS and other sleep-related infant deaths: Evidence base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics, 138(5), e20162940. https://doi.org/10.1542/peds.2016-2940.

    Article  PubMed  Google Scholar 

  3. El-Sayed, A. M., Finkton, D. W., Packzkowski, M., Keyes, K. M., & Galea, S. (2015). Socioeconomic position, health behaviors, and racial disparities in cause-specific infant mortality in Michigan, USA. Preventive Medicine, 76, 8–13. https://doi.org/10.1016/j.ypmed.2015.03.021.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Malloy, M. H., & Eschbach, K. (2007). Association of poverty with sudden infant death syndrome in metropolitan counties of the United States in the years 1990 and 2000. Southern Medical Journal, 100(11), 1107–1113. https://doi.org/10.1097/SMJ.0b013e318158b9de.

    Article  PubMed  Google Scholar 

  5. Salm Ward, T. C., & Doering, J. J. (2014). Application of a socio-ecological model to mother-infant bedsharing. Health Education & Behavior, 41(6), 577–589.

    Article  Google Scholar 

  6. Moon, R. Y. & American Academy of Pediatrics Taskforce on Sudden Infant Death Syndrome. (2011). SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleeping environment. Pediatrics, 128(5), 1030–1039. https://doi.org/10.1542/peds.2011-2284.

    Article  PubMed  Google Scholar 

  7. Moon, R. Y., Hauck, F. R., & Colson, E. R. (2016). Safe infant sleep interventions: What is the evidence for successful behavior change? Current Pediatric Reviews, 12, 67–75. https://doi.org/10.2174/1573396311666151026220906.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Salm Ward, T. C., & Balfour, G. (2016). Infant safe sleep interventions, 1990–2015: A review. Journal of Community Health, 41(1), 180–196. https://doi.org/10.1007/s10900-015-0060-y.

    Article  PubMed  Google Scholar 

  9. Ahlers-Schmidt, C. R., Schunn, C., Dempsy, M., & Blackon, S. (2014). Evaluation of community baby showers to promote safe sleep. Kansas Journal of Medicine, 7, 1–5.

    Google Scholar 

  10. Ahlers-Schmidt, C. R., Schunn, C., Lopez, V., Blackmon, S., Dempsey, M., & Sollo, N. (2016). A comparison of community and clinic baby showers to promote safe sleep for populations at high risk for infant mortality. Global Pediatric Health, 3, 2333794 × 15622305. https://doi.org/10.1177/2333794X15622305.

    Article  Google Scholar 

  11. Carlins, E. M., & Collins, K. S. (2007). Cribs for kids: Risk and reduction of sudden infant death syndrome and accidental suffocation. Health & Social Work, 32(3), 225–229.

    Article  Google Scholar 

  12. Hauck, F. R., Tanabe, K. O., McMurry, T., & Moon, R. Y. (2015). Evaluation of bedtime basics for babies: A national crib distribution program to reduce the risk of sleep-related sudden infant deaths. Journal of Community Health, 40(3), 457–463. https://doi.org/10.1007/s10900-014-9957-0.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Georgia Department of Public Health. (2013). Reducing infant mortality in Georgia 2013 annual report. Atlanta, GA: Department of Public Health. Retrieved from: https://dph.georgia.gov/sites/dph.georgia.gov/files/MCH/RIM_Ga_2013report.pdf.

  14. National Institute of Child Health and Human Development. (2015). Safe to sleep® public education campaign. Retrieved from http://www.nichd.nih.gov/sts/.

  15. Hochbaum, G. M. (1958). Public participation in medical screening programs: A sociopsychological study. (No. 572). Washington, D.C.: U.S. Department of Health and Human Services, United States Public Health Service.

    Google Scholar 

  16. Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education & Behavior, 11(1), 1–47. https://doi.org/10.1177/109019818401100101.

    Article  CAS  Google Scholar 

  17. Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education & Behavior, 2, 328–335. https://doi.org/10.1177/109019817400200403.

    Article  Google Scholar 

  18. Colson, E. R., McCabe, L. K., Fox, K., et al. (2005). Barriers to following the back-to-sleep recommendations: Insights from focus groups with inner-city caregivers. Ambulatory Pediatrics, 5(6), 349–354.

    Article  PubMed  Google Scholar 

  19. Moon, R. Y., & Omron, R. (2002). Determinants of infant sleep position in an urban population. Clinical Pediatrics, 41, 569–573.

    Article  PubMed  Google Scholar 

  20. Oden, R. P., Joyner, B. L., Ajao, T. I., & Moon, R. Y. (2010). Factors influencing African-American mothers’ decisions about sleep position: A qualitative study. Journal of the National Medical Association, 102(10), 875–880. https://doi.org/10.1016/S0027-9684(15)30705-7.

    Article  Google Scholar 

  21. Von Kohorn, I., Corwin, M. J., Rybin, D. V., Heerin, T. C., Lister, G., & Colson, E. R. (2010). Influence of prior advice and beliefs of mothers on infant sleep position. Archives of Pediatric and Adolescent Medicine, 164(4), 363–369. https://doi.org/10.1001/archpediatrics.2010.26.

    Article  Google Scholar 

  22. Smith, L. A., Geller, N. L., Kellams, A. L., et al. (2016). Infant sleep location and breastfeeding practices in the United States: 2011–2014. Academic Pediatrics, 16(6), 540–549. https://doi.org/10.1016/j.acap.2016.01.021.

    Article  PubMed  Google Scholar 

  23. McNemar, Q. (1947). Note on the sampling error of the difference between correlated proportions or percentages. Psychometrika, 12(2), 153–157. https://doi.org/10.1007/BF02295996.

    Article  PubMed  CAS  Google Scholar 

  24. Warner, R. M. (2008). Applied statistics: From bivariate through multivariate techniques. Los Angeles: SAGE Publications.

    Google Scholar 

  25. Georgia Department of Public Health. (2016). Breastfeeding initiation and duration. Atlanta, GA: Georgia Department of Public Health. Retrieved from: https://dph.georgia.gov/sites/dph.georgia.gov/files/related_files/site_page/GA%20PRAMS_Breastfeeding_ProviderBased_FactSheet.pdf.

  26. Gaydos, L. M., Blake, S. C., Gazmararian, J. A., Woodruff, W., Thompson, W. W., & Dalmida, S. G. (2015). Revisiting safe sleep recommendations for African-American infants: Why current counseling is insufficient. Maternal & Child Health Journal, 19(3), 496–503. https://doi.org/10.1007/s10995-014-1530-z.

    Article  Google Scholar 

  27. Hackett, M., & Simons, H. (2013). Parental adherence to infant sleep safety recommendations. Journal of Community Medicine & Health Education, 3(4), 219–225. https://doi.org/10.4172/2161-0711.1000219.

    Article  Google Scholar 

  28. Salm Ward, T. C. (2015). Reasons for mother-infant bed-sharing: A systematic narrative synthesis of the literature and implications for future research. Maternal & Child Health Journal, 19(3), 675–690. https://doi.org/10.1007/s10995-014-1557-1.

    Article  Google Scholar 

  29. Colson, E. R., Willinger, M., Rybin, D., et al. (2013). Trends and factors associated with infant bed sharing, 1993–2010: The National Infant Sleep Position Study. JAMA Pediatrics, 167(11), 1032–1037. https://doi.org/10.1001/jamapediatrics.2013.2560.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Robida, D., & Moon, R. Y. (2012). Factors influencing infant sleep position: Decisions do not differ by SES in African-American families. Archives of Disease in Childhood, 97(10), 900–905. https://doi.org/10.1136/archdischild-2011-301360.

    Article  PubMed  Google Scholar 

  31. Moon, R. Y., Mathews, A., Joyner, B. L., Oden, R. P., He, J., & McCarter, R. (2017). Health messaging and African-American infant sleep location: A randomized controlled trial. Journal of Community Health, 42(1), 1–9. https://doi.org/10.1007/s10900-016-0227-1.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Whiteside-Mansell, L., Nabaweesi, R., Caballero, A. R., Mullins, S. H., Miller, B. K., & Aitken, M. E. (2017). Assessment of safe sleep: Validation of the parent newborn sleep safety survey. Journal of Pediatric Nursing, 35, 30–35. https://doi.org/10.1016/j.pedn.2017.02.033.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors wish to acknowledge funding for this project by the 1998 Society and the Georgia Department of Public Health. The authors also wish to acknowledge the assistance and support of the Fulton County Health Department, specifically, Trina Dennis; the Georgia Safe Infant Sleep Coalition; and Lauren Polatty, MPH. We would also like to thank the participants who completed surveys as well as the staff who helped with program implementation and data collection.

Funding

Funding for this project was provided by the 1998 Society and the Georgia Department of Public Health.

Author information

Authors and Affiliations

  1. Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E Hartford Ave, Milwaukee, WI, 53211, USA

    Trina C. Salm Ward

  2. Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA, USA

    Marcie M. McClellan

  3. Georgia Department of Public Health, Atlanta, GA, USA

    Terri J. Miller & Shannon Brown

Authors
  1. Trina C. Salm Ward
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  2. Marcie M. McClellan
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  3. Terri J. Miller
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  4. Shannon Brown
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Corresponding author

Correspondence to Trina C. Salm Ward.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the University of Georgia and the DPH Institutional Review Boards.

Additional information

Shannon Brown—Formerly Public Health Associate in the Centers for Disease Control and Prevention (2015–2017).

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Salm Ward, T.C., McClellan, M.M., Miller, T.J. et al. Evaluation of a Crib Distribution and Safe Sleep Educational Program to Reduce Risk of Sleep-Related Infant Death. J Community Health 43, 848–855 (2018). https://doi.org/10.1007/s10900-018-0493-1

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  • DOI: https://doi.org/10.1007/s10900-018-0493-1

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