scholarly journals Field assessment of a safe sleep instrument using smartphone technology

2019 ◽  
Vol 4 (5) ◽  
pp. 451-456
Author(s):  
Rosemary Nabaweesi ◽  
Leanne Whiteside-Mansell ◽  
Samantha H. Mullins ◽  
Mallikarjuna R. Rettiganti ◽  
Mary E. Aitken

AbstractIntroduction:Sudden unexpected infant death is the leading cause of infant mortality with black: white infant mortality remaining at 2:1 for the last decade. Smartphone technology provides a convenient and accessible tool for injury prevention anticipatory guidance among at-risk communities.Materials and Methods:A convenience sample of pregnant teen mothers who own a smartphone. During a 1-month postnatal home visit, a safe sleep environment survey was administered, infant sleep practices were observed, and mothers trained to take and submit standard infants’ sleep environment photographs. Photographs were independently assessed for inter-rater reliability (IRR) across five sleep safety domains (primary outcome): sleep location, surface, position, presence of soft items, and hazards near the sleep area. Expert and novice coders IRR was measured using Cohen’s kappa coefficient (K). Sleep safety correlation between photographs and observation, and parent report and observation was determined.Results:Sixteen (57.1%) mothers completed the home visit. Most parents reported infants sleeping supine (78.5) in parents’ bedroom (85.9%). Photographs demonstrated sleep position, soft items without the baby present, and hanging toys had perfect agreement across all three coder pairs. Safe sleep experts’ IRR demonstrated perfect agreement for sleep location, position, and soft items. While 83.8% of parents were observed putting their infants down to sleep on their back, 78.5% of parents reported doing the same and 82.4% of the photographs demonstrated supine infant sleep position.Conclusion:Using photographs, coders can reliably categorize some key infant sleep safety aspects, and photograph sleep safety is comparable to parent report and direct observation.

2021 ◽  
Author(s):  
Samuel Chin ◽  
Rebecca Carlin ◽  
Anita Mathews ◽  
Rachel Moon

BACKGROUND Parenting practices are highly influenced by perceived social norms. Social norms and American Academy of Pediatrics (AAP) guidelines for infant safe sleep practices are often inconsistent. Instagram has become one of the most popular social media websites among young adults (including many expectant and new parents). We hypothesized that the majority of Instagram images of infant sleep and sleep environments are inconsistent with AAP guidelines, and that the number of “likes” for each image would not correlate with adherence of the image to these guidelines. OBJECTIVE To determine the extent of adherence of Instagram images of infant sleep and sleep environments to safe infant sleep guidelines. METHODS We searched Instagram using hashtags that were relevant to infant sleeping practices and environments. We then used an open-source web scraper to collect images and the number of “likes” for each image from 27 hashtags. Images were analyzed for adherence with AAP safe sleep guidelines. RESULTS A total of 1563 images (1134 of sleeping infant; 429 of infant sleep environment without sleeping infant) met inclusion criteria and were analyzed. Only 117 (7.5%) of the 1563 images were consistent with AAP guidelines. The most common reasons for inconsistency with AAP guidelines were presence of bedding (75%) and non-recommended sleep position (42.2%). The number of “likes” was not correlated with adherence of the image to AAP guidelines. CONCLUSIONS Although individuals who use Instagram and post pictures of sleeping infants or infant sleep environments may not actually use these practices regularly, the consistent portrayal of images inconsistent with AAP guidelines reinforce that these practices are normative and may influence the practice of young parents. CLINICALTRIAL not applicable


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ethan A. Canty ◽  
Benjamin N. Fogel ◽  
Erich K. Batra ◽  
Eric W. Schaefer ◽  
Jessica S. Beiler ◽  
...  

Abstract Background With increased use of telehealth, interventions to improve infant sleep environments have not been explored. This study sought to assess the feasibility and efficacy of using electronic health record patient portals to transmit photographs of infant sleep between mothers and healthcare professionals as part of an intervention to promote sleep environments consistent with AAP guidelines. Methods One hundred eighty-four mother-newborn dyads consented to participate in a randomized trial requiring patient portal registration within 1 month of delivery. We first assessed feasibility as measured by a) the proportion of consented mothers enrolling in the portal and b) maternal adherence to prompts to submit photographs of their infant sleeping to the research team through the patient portal. Intervention group mothers were prompted at 1 and 2 months; controls were prompted only at 2 months. Efficacy was determined via research assistant review of submitted photographs. These assistants were trained to detect sudden unexplained infant death risk factors utilizing AAP guidelines. Standardized feedback was returned to mothers through the patient portal. We used Fisher’s Exact test to assess group differences in guideline adherence at 2 months. Results One hundred nine mothers (59%) enrolled in the patient portal and were randomized to intervention (N = 55) and control (N = 54) groups. 21 (38, 95% CI 25–52%) intervention group participants sent photographs at 1 month and received personalized feedback. Across both groups at 2 months, 40 (37, 95% CI 28–46%) sent photographs; 56% of intervention group participants who submitted photographs met all safe sleep criteria compared with 46% of controls (difference 0.10, 95% CI − 0.26 to 0.46, p = .75). Common reasons for guideline non-adherence were sleeping in a room without a caregiver (43%), loose bedding (15%) and objects (8%) on the sleep surface. Conclusions Utilizing the patient portal to individualize safe infant sleep is possible, however, we encountered numerous barriers in this trial to assess its effects on promoting safe infant sleep. Photographs of infants sleeping showed substantial non-adherence to AAP guidelines, suggesting further needs for improvement to promote safe infant sleep practices. Trial registration Name: Improving Infant Sleep Safety With the Electronic Health Record; Clinicaltrials.gov: NCT03662048; Date of Registration: September 7, 2018; Data Sharing Statement: None


2017 ◽  
Vol 25 (3) ◽  
pp. 146-151
Author(s):  
Eileen M McDonald ◽  
Amanda Davani ◽  
Akisha Price ◽  
Patricia Mahoney ◽  
Wendy Shields ◽  
...  

BackgroundFew randomised controlled trials (RCTs) have been conducted to improve infant sleep practices. There is limited research on how best to integrate safe sleep information into routine paediatric anticipatory guidance delivered at well child visits (WCVs). This protocol paper describes the design of the Safe Start Study, which aims to evaluate the impact of safe sleep interventions on parents’ knowledge, beliefs and behaviours related to creating and maintaining a safe sleep environment for their infants.MethodsSafe Start is a three-group RCT comparing a safe sleep health education intervention delivered as part of the 2-week WCV, an attention-matched control group that receives a scald burn prevention intervention, and a standard of care group. A baseline survey is completed at the 2-week WCV; follow-up surveys and observations are completed in the home at 2–4 weeks and 2–3 months. Participants include mother–baby dyads attending a large urban paediatric primary care practice and their paediatricians. Primary outcomes are self-reported behaviours (baby sleeps alone, on back, in crib and in a smoke-free environment), observations of the sleep environment, paediatricians’ anticipatory guidance counselling about safe sleep and participants’ reported exposure to an existing city-wide safe sleep campaign.DiscussionProviding a theory-driven and evidenced-based safe sleep intervention is both a research and a clinical practice priority. This study will advance the application of educational and environmental interventions in the primary care setting to improve the safety of infant sleep environments in high-risk families.Trial registration numberNCT03070639; Pre-results.


Author(s):  
Trina C. Salm Ward ◽  
Terri J. Miller ◽  
Iman Naim

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.


2019 ◽  
Vol 10 (3) ◽  
pp. 59-61
Author(s):  
Matthew Engel ◽  
Carolyn R. Ahlers-Schmidt ◽  
Bonita Suter

Introduction. Risk of infant sleep-related death can be reducedthrough safe sleep practices. Barriers to infant safe sleep have beenmitigated through education and crib distribution, however, previousstudies have not explored whether distributed cribs are put to use. Methods. In a rural Michigan county, the Great Start Sleep Initiativesupplied cribs and education shortly after infant birth to familieswith high-risk of infant mortality, as assessed through comprehensiveinterviews with families by program staff. Participant knowledgewas evaluated using structured pre- and post-assessments beforeand after education. Further, a home visit was conducted to evaluatethe infant’s sleeping environment. Data from the program, collectedbetween January 2012 and December 2014, were evaluated. Results. Cribs and concomitant education were delivered to 75caregivers. Knowledge of safe sleep practices increased significantlyat follow-up with 67 caregivers (89%) affirming back positioning,68 (91%) endorsing removal of unsafe items or soft objects, suchas blankets, from the sleeping area, and 42 (56%) renouncing bedsharing.At the home visit, 74 caregivers (99%) were using a crib toput their infant down to sleep, 70 (93%) were using the providedcrib, and 67 (89%) had no unsafe items in the child’s sleeping area. Conclusion. Providing education to high-risk mothersresulted in improved safe sleep knowledge and providedcribs are used in these homes. KS J Med 2017;10(3):59-61.


2003 ◽  
Vol 157 (5) ◽  
pp. 469 ◽  
Author(s):  
Carl E. Hunt ◽  
Samuel M. Lesko ◽  
Richard M. Vezina ◽  
Rosha McCoy ◽  
Michael J. Corwin ◽  
...  

PEDIATRICS ◽  
1994 ◽  
Vol 94 (1) ◽  
pp. 105-107
Author(s):  
Carl E. Hunt

I fully support a comprehensive professional and public intervention campaign in the US to establish supine as the standard sleep position. Although other preventive health objectives can be included, the emphasis needs to be clearly focused on sleep position. Achieving the lowest possible prone prevalence rate in the US is thus the first goal of this new campaign. The second and equally important goal of the new campaign should be to utilize this opportunity to maximum advantage to enhance our knowledge regarding the epidemiological risk factors causally related to SIDS and their interactions, and the interactions between epidemiological and biological risk factors. In addition to quantifying changes in infant mortality and in infant sleep position, we will also need to characterize both the supine and the persistent prone infant groups in regard to all of the putative epidemiological risk factors for SIDS. This campaign can thus enhance our understanding of the epidemiological risk factors for SIDS as long as a significant decrease in prone prevalence can be achieved.


PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 55-58
Author(s):  
Bonnie B. Hudak ◽  
Jane O'Donnell ◽  
Nadine Mazyrka

Objective. The American Academy of Pediatrics' (AAP) recommendation for side or supine sleep position in healthy babies has generated much controversy. We surveyed primary care physicians to determine the effect of the AAP statement on physician attitude toward infant sleep position and advice to parents. Methods. We sent a 23-question survey to 194 physicians in Western New York. The survey addressed their attitude toward the AAP recommendations and its impact on their advice to parents. Results. Of the 149 physicians treating newborns, 121 (82%) completed the questionnaire; 98% were aware of the AAP statement. The most common sources of information were the AAP (86%) and professional literature (77%). Of the respondents, 79% agreed with the AAP statement. Reasons for reservation were lack of data (64%), potential adverse consequences of supine position (52%), and their own experience (47%). Gender, years in practice, and type of reimbursement did not influence attitude toward the AAP recommendation. The AAP statement increased the frequency with which physicians routinely discussed sleep position from 34 to 70% (P < .02). Physicians recommending the prone position decreased from 57 to 7% (P < .001), while those recommending supine sleep position increased from 10 to 42% (P < .001). Conclusions. Most physicians agreed with the AAP statement and more frequently discussed sleep position following the AAP recommendations. However, they did not routinely recommend supine sleep position. The majority (69%) recommended the side position even though it is unstable. Although the AAP statement has increased discussion of infant sleep position by primary care physicians in WNY, only a minority recommend that infants sleep supine.


Sign in / Sign up

Export Citation Format

Share Document