Abstract
To investigate, by using qualitative methods, beliefs among African-American and American Indian families about infant safe sleep practices, barriers to acceptance of prevention recommendations, and more effective messaging strategies. Seventy-three mothers and supporters participated in focus groups. Participants discussed infant sleep practices and effectiveness of safe sleep messages. Data were coded, and themes were developed and revised in an iterative manner as patterns became more apparent. Themes included reasons for and influences on sleep decisions, and concerns about safe sleep recommendations. Parental sleep decisions seemed to be driven by perceptions of what would make their infant most comfortable and safe, and what would be most convenient. Parents were aware of safe sleep recommendations but unaware of the rationale. Because they generally did not believe that their infants were at risk for a sleep-related death, day-to-day decisions seemed to focus on what was most effective in getting their infant to sleep. There appeared to be no distinctions in opinions among African-American and American Indian families. African-American and American Indian families seemed to have similar concerns about infant comfort and safety, and their perceptions about what would be most effective in achieving these goals appeared to be important influences on their sleep practices. Adherence with safe sleep recommendations may be enhanced if health care providers and educational materials discussed rationale underlying recommendations and addressed common parental concerns. It may be beneficial to target educational interventions towards fathers, as they may be untapped sources in implementing safe sleep practices.
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References
Ajao, T. I., Oden, R. P., Joyner, B. L., & Moon, R. Y. (2011). Decisions of black parents about infant bedding and sleep surfaces: a qualitative study. Pediatrics, 128(3), 494–502.
Beebe, M. (2012). Summary of 2010 infant death statistics. Lansing, MI: Vital Records and Health Data Development Section, Michigan Department of Community Health.
Johnson, J. C., Soliman, A. S., Tadgerson, D., Copeland, G. E., Seefeld, D. A., Pingatore, N. L., et al. (2009). Tribal linkage and race data quality for American Indians in a state cancer registry. [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t]. American Journal of Preventive Medicine, 36(6), 549–554. doi:10.1016/j.amepre.2009.01.035.
Joyner, B. L., Oden, R., Ajao, T. I., & Moon, R. (2010). Where should my baby sleep? A qualitative study of African-American infant sleep location decisions. Journal of the National Medical Association, 102(10), 881–889.
Krueger, R. A., & Casey, M. A. (2000). Focus groups: A practical guide for applied research (3rd ed.). Thousand Oaks, CA: Sage.
Leavitt, M. O. (2008). U.S. Department of Health and Human Services, Indian Health Service. Regional differences in Indian health, 2002–2003 edition. Washington, DC: Government Printing Office.
Malloy, M. H., & MacDorman, M. (2005). Changes in the classification of sudden unexpected infant deaths: United States, 1992–2001. Pediatrics, 115(5), 1247–1253.
Mathews, T. J., & MacDorman, M. F. (2013). Infant mortality statistics from the 2009 period linked birth/infant death data set. National Vital Statistics Reports, 61(8), 1–69.
Moon, R. Y., American Academy of Pediatrics, Task Force on Sudden Infant Death Syndrome. (2011). SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleeping environment. Pediatrics, 129(5), e1341–e1367.
Moon, R. Y., Oden, R. P., Joyner, B. L., & Ajao, T. I. (2010). Qualitative analysis of beliefs and perceptions about sudden infant death syndrome (SIDS) among African-American mothers: Implications for safe sleep recommendations. The Journal of Pediatrics, 157(1), 92–97 e92. doi:10.1016/j.jpeds.2010.01.027.
Oden, R., Joyner, B. L., Ajao, T. I., & Moon, R. (2010). Factors influencing African-American mothers’ decisions about sleep position: A qualitative study. Journal of the National Medical Association, 102(10), 870–880.
Richards, L., & Morse, J. M. (2007). Readme first for a user’s guide to qualitative methods (2nd ed.). Thousand Oaks, CA: Sage.
Shapiro-Mendoza, C. K., Kimball, M., Tomashek, K. M., Anderson, R. N., & Blanding, S. (2009). US infant mortality trends attributable to accidental suffocation and strangulation in bed from 1984 through 2004: Are rates increasing? Pediatrics, 123(2), 533–539. doi:10.1542/peds.2007-3746.
Wong, C. A., Gachupin, F. C., Holman, R. C., Macdorman, M. F., Cheek, J. E., Holve, S., et al. (2014). American Indian and Alaska Native Infant and Pediatric Mortality, United States, 1999–2009. American Journal of Public Health,. doi:10.2105/AJPH.2013.301598.
Acknowledgments
Funding for this project was provided by the W. K. Kellogg Foundation. Authors also received support from the National Institutes of Health (P20MD000198). We would like to thank the Inter-tribal Council of Michigan Healthy Start Project; Calhoun County Public Health Department (Battle Creek, MI); Strong Beginnings, Spectrum Health (Grand Rapids, MI); and Sew up the Safety Net for Women and Children, Henry Ford Health (Detroit, MI) for their collaboration in identifying and recruiting participants and providing culturally competent facilitators for the focus groups.
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Herman, S., Adkins, M. & Moon, R.Y. Knowledge and Beliefs of African-American and American Indian Parents and Supporters About Infant Safe Sleep. J Community Health 40, 12–19 (2015). https://doi.org/10.1007/s10900-014-9886-y
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DOI: https://doi.org/10.1007/s10900-014-9886-y