Enhancing Safe Sleep Practices of Urban Low-Income Mothers

加强城市低收入母亲的安全睡眠习惯

基本信息

批准号：
8543206
负责人：
Andrea C Gielen
金额：
$ 62.3万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-01 至 2018-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8543206
关键词：
Academy Address Affect African American American Attention Attitude Back Back to Sleep Behavior Therapy Belief Caregivers Caring Centers for Disease Control and Prevention (U.S.)Cessation of life Characteristics Child Child Care Childhood Clinic Communication Continuing Education Control Groups Counseling Coupled Data Death Rate Education Educational Intervention Effectiveness Emotional Environment Exposure to Family Funding Goals Guide prevention Health Educators Health Knowledge, Attitudes, Practice Health education Home environment Infant Infant Mortality Intervention Intervention Trial Knowledge Life Low income Maternal and Child Health Methods Mothers NIH Program Announcements National Institute of Child Health and Human Development Newborn Infant Parenting behavior Parents Participant Patient Education Patients Pattern Pediatrics Physicians Population Positioning Attribute Primary Health Care Randomized Controlled Trials Reporting Research Research Personnel Resources Risk Factors Safety Services Site Sleep Sudden infant death syndrome Time United States United States Public Health Service Visit Work aged allied health education base behavior change clinical care clinical research site environmental intervention experience high risk infant death injury prevention innovation literacy pediatrician prenatal prevent primary care setting programs public health relevance racial and ethnic disparities response safety net skills standard care standard of care success supine sleep theories trial comparing

项目摘要

DESCRIPTION (provided by applicant): Every year in the United States, more than 4,500 infants die suddenly of no immediately obvious cause. Half of these Sudden Unexpected Infant Deaths (SUID) are due to Sudden Infant Death Syndrome (SIDS), the leading cause of SUID and of all deaths among infants aged 1-12 months. While the American Academy of Pediatrics' (AAP) Back to Sleep campaign has led to increased supine sleeping and coincided with a dramatic reduction in SIDS since 1994, staggering racial and ethnic disparities have persisted. Child death reviews of SUID have been beneficial in identifying important risk factors to guide prevention efforts. The ultimate goal of this proposed work is to prevent otherwise healthy infants from dying by providing innovative, theory-driven education coupled with easy access to a portable crib, when necessary. The specific aims of the study are: 1) To evaluate the impact of safe sleep interventions (physician counseling + enhanced health education + crib distribution) on parents' knowledge, beliefs, intentions, skills and practices related to creating and maintaining a safe sleep environment for their infants during the first four months of life; 2) To describe the characteristics of physician anticipatory guidance about safe sleep and identify physician, patient and parent characteristics associated with coverage of the topic at the well-child visits; and 3) To evaluate the dissemination of the B'more for Healthy Babies (BHB)'s safe sleep campaign messages and services among our study participants. This 41/2 year study will take place in the Johns Hopkins Harriet Lane Clinic. Methods will include a 3- group randomized controlled trial comparing the safe sleep intervention delivered at the 2-week well-child visit to standard of care and attention matched control groups. Data to be collected include: 1) baseline assessments of parents' safe sleep-related knowledge (including exposure to the BHB campaign), beliefs, intentions, skills and practices; 2) audio-recording of physician-parent and health educator-parent interactions and parent-reported assessments of the encounters; and 3) home observations of infant sleep-related practices and environments when the infant is 3-4 weeks and 2-3 months old. Results of this work will advance the application of theory-driven educational and environmental interventions addressing the injury prevention needs of high-risk families. Results will have widespread utility for disseminating effective safe sleep behavior change programs to pediatric clinical care settings serving similar high-risk families.

描述（由申请人提供）：在美国，每年有超过 4,500 名婴儿无明显原因突然死亡。这些婴儿意外猝死 (SUID) 中有一半是由婴儿猝死综合症 (SIDS) 造成的，这是造成 SUID 和 1-12 个月婴儿所有死亡的主要原因。自 1994 年以来，虽然美国儿科学会 (AAP) 的“重返睡眠”运动提高了仰卧睡眠率，同时婴儿猝死综合症 (SIDS) 也大幅减少，但令人震惊的种族和民族差异仍然持续存在。 SUID 儿童死亡审查有助于确定重要的风险因素以指导预防工作。这项拟议工作的最终目标是通过提供创新的、理论驱动的教育，并在必要时方便地使用便携式婴儿床，防止原本健康的婴儿死亡。该研究的具体目的是： 1) 评估安全睡眠干预措施（医生咨询+加强健康教育+婴儿床分配）对家长与创造和维持安全睡眠环境相关的知识、信念、意图、技能和实践的影响婴儿出生后头四个月； 2) 描述医生关于安全睡眠的预期指导的特征，并确定与健康儿童就诊时主题报道相关的医生、患者和家长的特征； 3) 评估 B'more for Healthy Babies (BHB) 安全睡眠运动信息和服务在研究参与者中的传播情况。这项为期 41/2 年的研究将在约翰·霍普金斯大学 Harriet Lane 诊所进行。方法将包括一项 3 组随机对照试验，将为期 2 周的健康儿童访视时提供的安全睡眠干预措施与护理标准和注意力匹配的对照组进行比较。需要收集的数据包括： 1) 对家长安全睡眠相关知识（包括接触 BHB 活动）、信念、意图、技能和实践的基线评估； 2) 医生与家长以及健康教育者与家长互动的录音以及家长报告的遭遇评估； 3）当婴儿3-4周和2-3个月大时，对婴儿睡眠相关的做法和环境进行家庭观察。这项工作的结果将推动理论驱动的教育和环境干预措施的应用，以满足高风险家庭的伤害预防需求。结果将具有广泛的实用性，可用于向为类似高风险家庭提供服务的儿科临床护理机构传播有效的安全睡眠行为改变计划。