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The Impact of Health Messages on Maternal Decisions About Infant Sleep Position: A Randomized Controlled Trial

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Abstract

Sudden infant death syndrome (SIDS) rates in African-Americans are more than twice national rates, and historically, African-American parents are more likely than other groups to place infants prone, even when they are aware of supine sleep recommendations. Prior studies have shown African-Americans have low self-efficacy against SIDS but high self-efficacy against suffocation. This study aimed to determine the impact of a specific health message about suffocation prevention on African-American parental decisions regarding infant sleep position. We conducted a randomized controlled trial of 1194 African-American mothers, who were randomized to receive standard messages about safe sleep practices to reduce the risk of SIDS, or enhanced messages about safe sleep practices to prevent SIDS and suffocation. Mothers were interviewed about knowledge and attitude, self-efficacy and current infant care practices when infants were 2–3 weeks, 2–3 months and 5–6 months old. Analyses of covariance were conducted to estimate the change in knowledge, attitudes and practice in each group, and chi square tests were used to compare sleep position with each variable. Over the first 6 months, the proportion of African-American infants placed supine gradually decreased and was unchanged by enhanced education about SIDS, suffocation risk and sleep safety. While initially high self-efficacy against SIDS and suffocation correlated with supine positioning, by 5–6 months self-efficacy did not correspond to sleep position in either group.

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Acknowledgements

This project was supported by the Maternal and Child Health Bureau, Health Resources Service Administration 1R40MC21511 and the National Institute for Minority Health and Health Disparities P20MD000198.

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Authors and Affiliations

  1. Division of General Pediatrics and Community Health, Children’s National Medical Center, Washington, DC, USA

    Rebecca F. Carlin, Anna Abrams, Anita Mathews, Brandi L. Joyner & Rosalind Oden

  2. Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA

    Rebecca F. Carlin

  3. Center for Translational Science, Children’s National Medical Center, Washington, DC, USA

    Robert McCarter

  4. Department of Epidemiology and Biostatistics, George Washington University, Washington, DC, USA

    Robert McCarter

  5. Department of Pediatrics, University of Virginia, Charlottesville, VA, USA

    Rachel Y. Moon

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  1. Rebecca F. Carlin
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Correspondence to Rachel Y. Moon.

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Carlin, R.F., Abrams, A., Mathews, A. et al. The Impact of Health Messages on Maternal Decisions About Infant Sleep Position: A Randomized Controlled Trial. J Community Health 43, 977–985 (2018). https://doi.org/10.1007/s10900-018-0514-0

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