Evaluation of a Multisite Safe Infant Sleep Education and Crib Distribution Program

Abstract

Rates of sleep-related infant deaths have plateaued in the past few decades despite ongoing infant sleep practice recommendations to reduce risk of sleep-related infant deaths by the American Academy of Pediatrics. The state department of public health trained facilitators at 28 sites across the state to facilitate a group safe sleep educational program. A prospective, matched pre- and post-test cohort design with follow-up was used to evaluate changes in self-reported knowledge, intentions, and practices. The final sample included 615 matched pre- and post-test surveys, and 66 matched follow-up surveys. The proportion of correct responses on all knowledge and intended practice items increased significantly from pre- to post-test. When asked where their babies would have slept if they had not received the portable crib, 66.1% of participants planned to use a recommended sleep location (e.g., crib or bassinet). At post-test, 62.3% planned to change something about their infant’s sleep based on what they learned. At follow-up, knowledge was maintained for all but two items and practices and for half of practice items. The results suggest that participating in the education program was associated with increased knowledge and intended adherence, but that these changes were not maintained at follow-up. These results are in line with the research literature that finds a difference in intentions and actual practices after the baby is born.

Practices and Awareness Regarding an Infant’s Sleep Environment among Japanese Caregivers: A Cross-Sectional Survey

“…First of all, educating precaregivers by experts during the pregnancy period before they prepare for their infant's SE is important. Participating in an education program about infant SSE could increase knowledge and intended adherence, but these changes may not be maintained after the baby is born [46]. Therefore, promoting caregivers' awareness of infant SSE via a continuous and repetitive approach from pregnancy to the parental period can be important.…”

The provision of the baby box was associated with safe sleep practices in a low-resource community: a randomized control trial in Ecuador

“…Published accounts of prenatal safe infant sleep education in the US demonstrated an increase in knowledge and intended adherence particularly when receiving advice from a healthcare provider, but often does not translate into sustained safe sleep practice after the infant is born [ 15 , 16 ]. Researchers suggest that reinforcing caregiver knowledge and addressing barriers to safe sleep after the infant is born may assist families to maintain safe sleep practice over time [ 16 ]. More research is needed to prevent sleep related infant deaths in many contexts and to better understand interventions that promote behavior change and the uptake of sustained safe sleep practices.…”