Sage Journals: Discover world-class research

Abstract

The American Academy of Pediatrics (AAP) published Recommendations for a Safe Infant Sleeping Environment; however, parents still report frequent use of dangerous infant sleep practices. An online computer program was developed and piloted to investigate whether parents could be taught to create safe sleep environments using online training. Computerized safe sleep environments created by parents of children 0 to 23 months were assessed for compliance with the AAP Sleep Recommendations. Using a pre- and posttest design, the present study investigated the effectiveness of online instructions (adapted standard of care) and a computerized behavioral skills training package, which included instructions, modeling, rehearsal, and feedback. Additional pre- and posttests assessed parents’ ability to identify sleep risks in 3 pictures to assess generalization of skills learned. Overall, participants demonstrated significant improvements from pre- to posttest across both treatment conditions on the creation of a safe sleep environment and on the free response identification of risks in 3 sleep environments. Performance did not significantly differ between the treatment groups. Results suggest considerable promise for technology-aided approaches in training parents to create a safe sleep environment.

Implications for Impact Statement

Creating safe infant sleep environments is important and necessary in reducing sudden and unexpected infant deaths. In this online study, caregivers created safer infant sleep environments and identified more sleep environment risks after computer-based training and when using a sleep safety checklist. Providing access to this computer-based training and/or sleep safety checklist can teach caregivers about infant sleep safety and may result in safer infant sleep environments.

Get full access to this article

View all access options for this article.

References

American Academy of Pediatrics, Task Force on Sudden Infant Death Syndrome . (2005). The changing concept of sudden infant death syndrome: Diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics, 116, 1245–1255.

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, 128, 1030–1039.

American Academy of Pediatrics, Task Force on Sudden Infant Death Syndrome . (2016). SIDS and other sleep-related infant deaths: Updated 2016 recommendations for a safe infant sleeping environment. Pediatrics, 138, 1–12.

Ateah

C. A.

Hamelin

K. J.

(2008). Maternal bedsharing practices, experiences, and awareness of risks. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 37, 274–281.

Austin

J. E.

Nashban

C. J.

Doering

J. J.

Davies

W. H.

(2017). Prevention messages in parent-infant bed-sharing: Message source, credibility, and effectiveness. Global Pediatric Health, 4, 1–9. 10.1177/2333794X17743403

Austin

J. E.

Zinke

V. L.

Davies

W. H.

(2016). Influencing perception about children with autism and their parents using disclosure cards. Journal of Autism and Developmental Disorders, 46, 2764–2769. 10.1007/s10803-016-2821-6

Blair

P. S.

Sidebotham

Evason-Coombe

Edmonds

Heckstall-Smith

E. M.

Fleming

(2009). Hazardous cosleeping environments and risk factors amenable to change: Case-control study of SIDS in south west England. British Medical Journal, 339, b3666. 10.1136/bmj.b3666

Centers for Disease Control and Prevention . (2017). Sudden unexpected infant death and sudden infant death syndrome. Retrieved from https://www.cdc.gov/sids/data.htm

Chew

L. D.

Griffin

J. M.

Partin

M. R.

Noorbaloochi

Grill

J. P.

Snyder

. . . Vanryn

(2008). Validation of screening questions for limited health literacy in a large VA outpatient population. Journal of General Internal Medicine, 23, 561–566. 10.1007/s11606-008-0520-5

10.

Chianese

Ploof

Trovato

Chang

J. C.

(2009). Inner-city caregivers’ perspectives on bed sharing with their infants. Academic Pediatrics, 9, 26–32. 10.1016/j.acap.2008.11.005

11.

Chung

Oden

R. P.

Joyner

B. L.

Sims

Moon

R. Y.

(2012). Safe infant sleep recommendations on the Internet: Let’s Google it. The Journal of Pediatrics, 161, 1080–1084.e1. 10.1016/j.jpeds.2012.06.004

12.

Colson

E. R.

McCabe

L. K.

Fox

Levenson

Colton

Lister

Corwin

M. J.

(2005). Barriers to following the back-to-sleep recommendations: Insights from focus groups with inner-city caregivers. Ambulatory Pediatrics, 5, 349–354. 10.1367/A04-220R1.1

13.

CONSORT Transparent Reporting of Trials . (2010). The CONSORT flow diagram. Retrieved from http://www.consort-statement.org/consort-statement/flow-diagram

14.

Defenderfer

E. K.

Davies

W. H.

Raicu

A.-M.

Brei

Klein-Tasman

B. P.

(2017). Childhood toilet fears as an early behavioral indicator of anxiety. Children’s Health Care, 46, 366–378. 10.1080/02739615.2016.1193808

15.

Diaz

J. A.

Griffith

R. A.

J. J.

Reinert

S. E.

Friedmann

P. D.

Moulton

A. W.

(2002). Patients’ use of the internet for medical information. Journal of General Internal Medicine, 17, 180–185.

16.

Eron

N. B.

Dygert

K. M.

Squillace

Webster

N. J.

Andrianos

Crockett

E. G.

Consenstein

(2011). The physician’s role in reducing SIDS. Health Promotion Practice, 12, 370–378. 10.1177/1524839909341033

17.

Gawande

(2009). The checklist manifesto: How to get things right. New York, NY: Metropolitan Books Henry Holt & Co.

18.

Gaydos

L. M.

Blake

S. C.

Gazmararian

J. A.

Woodruff

Thompson

W. W.

Dalmida

S. G.

(2015). Revisiting safe sleep recommendations for African-American infants: Why current counseling is insufficient. Maternal and Child Health Journal, 19, 496–503. 10.1007/s10995-014-1530-z

19.

Halfon

Stevens

G. D.

Larson

Olson

L. M.

(2011). Duration of a well-child visit: Association with content, family-centeredness, and satisfaction. Pediatrics, 128, 657–664. 10.1542/peds.2011-0586

20.

Haun

Noland Dodd

V. J.

Graham-Pole

Rienzo

Donaldson

(2009). Testing a health literacy screening tool: Implications for utilization of a BRIEF health literacy indicator. Federal Practitioner, 26, 24–31.

21.

Kochanek

K. D.

Murphy

S. L.

National Center for Health Statistics . (2015). Deaths: Final data for 2011. National Vital Statistics Reports, 63, 1–120.

22.

Kornacki

L. T.

Ringdahl

J. E.

Sjostrom

Nuernberger

J. E.

(2013). A component analysis of a behavioral skills training package used to teach conversation skills to young adults with autism spectrum and other developmental disorders. Research in Autism Spectrum Disorders, 7, 1370–1376. 10.1016/j.rasd.2013.07.012

23.

Martin

L. R.

Williams

S. L.

Haskard

K. B.

Dimatteo

M. R.

(2005). The challenge of patient adherence. Therapeutics and Clinical Risk Management, 1, 189–199.

24.

McKenna

J. J.

McDade

(2005). Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding. Paediatric Respiratory Reviews, 6, 134–152. 10.1016/j.prrv.2005.03.006

25.

Miltenberger

R. G.

(2012). Behavior modification: Principles and procedures (5th ed.). Belmont, CA: Wadsworth.

26.

National Institute of Child Health and Human Development . (2017). Key moments in Safe to Sleep history: 2004–2013. Retrieved from https://www.nichd.nih.gov/sts/campaign/moments/Pages/2004-2013.aspx

27.

Ross

(2013). Preoperative assessment and teaching of postoperative discharge instructions: The importance of understanding health literacy. Journal of Perianesthesia Nursing, 28, 318–320. 10.1016/j.jopan.2013.07.002

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 and Child Health Journal, 19, 675–690. 10.1007/s10995-014-1557-1

29.

Salm Ward

T. C.

Balfour

G. M.

(2016). Infant safe sleep interventions, 1990–2015: A review. Journal of Community Health: The Publication for Health Promotion and Disease Prevention, 41, 180–196. 10.1007/s10900-015-0060-y

30.

Schank

R. C.

(2002). Designing world class e-learning: How IBM, GE, Harvard Business School, and Columbia University are succeeding at e-learning. New York, NY: McGraw-Hill.

31.

Sørensen

Van den Broucke

Fullam

Doyle

Pelikan

Slonska

. . . (HLS-EU) Consortium Health Literacy Project European . (2012). Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health, 12, 80. 10.1186/1471-2458-12-80

32.

Vanselow

N. R.

Hanley

G. P.

(2014). An evaluation of computerized behavioral skills training to teach safety skills to young children. Journal of Applied Behavior Analysis, 47, 51–69. 10.1002/jaba.105

33.

Wong

P. K. K.

Christie

Johnston

Bowling

Freeman

Joshua

. . . Bagga

(2014). How well do patients understand written instructions?: Health literacy assessment in rural and urban rheumatology outpatients. Medicine, 93, e129. 10.1097/MD.0000000000000129

Using Technology to Teach Parents to Create a Safe Infant Sleep Space

Abstract

Implications for Impact Statement

Get full access to this article

References