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Sudden unexpected infant death (SUID) is the leading cause of death for infants. Physician advice on safe sleep is an important source of information for families. We sought to evaluate the safe sleep knowledge, attitudes, and behaviors of physicians by distributing a cross-sectional survey at a freestanding children's hospital. The survey included demographics, knowledge items, attitudinal assessment, and frequency of providing safe sleep guidance. Multivariable linear regression and logistic regression were used to evaluate associations between variables. 398 physicians were surveyed with 124 responses (31%). Females, those who received safe sleep training, and those who see infants in daily practice had higher knowledge scores. Physicians with higher knowledge scores had more positive attitudes toward safe sleep and provided safe sleep education to patients more often. Our study underlies the importance of education and repeated exposure in forming positive attitudes toward safe sleep recommendations and leads to increased provision of safe sleep guidance. [ABSTRACT FROM AUTHOR]

The Georgia Department of Public Health developed the Safe Sleep Shelter Program to expand Georgia Safe to Sleep campaign efforts. The program focused on engaging with housing support agencies, homeless shelters, and domestic violence shelters. The program offered a menu of resources that agencies could choose from, including portable cribs for agency use and distribution to families, safe sleep education for staff, assistance with creating/updating agency safe sleep policies, and Baby Bundle Safe Sleep kits with education and resources for families. The program showed promising results: 44 agencies across the state applied, serving an estimated 20,950 individuals annually. Agencies expressed strong interest in expanding safe sleep education and resources for the families they served. Most agencies reported that the program filled gaps in services, including having enough cribs to meet demand and limited safe sleep education and resources. Agencies reported that parents appreciated the cribs and Baby Bundle Safe Sleep kits as most did not have money to purchase an infant sleep surface. Agencies reported that the resources provided new information to infant parents, facilitated discussion, and reinforced safe sleep messaging. Evaluation challenges included difficulties collecting distribution data and a low response rate for parent surveys. Implications are discussed for others interested in implementing such a program, including to develop processes for communicating updated recommendations, leverage existing relationships to engage additional agencies, evaluate efforts to refine program components, and consider strategies to increase parent survey response rates. [ABSTRACT FROM AUTHOR]

To increase access to safe infant sleep surfaces and reduce risk of sleep-related infant deaths, the Georgia Department of Public Health implemented a portable crib distribution and safe sleep educational program. The aim of this evaluation was to compare parental knowledge and practices related to infant sleep before and after receipt of the safe sleep educational program and crib. A prospective, matched pre- and post-test cohort design with a follow-up survey was utilized to evaluate changes in knowledge and practices. Female participants were recruited through the county health department and met the following criteria: (1) between 32 and 40 weeks pregnant or within 3 months postpartum, and (2) demonstrated financial need. Participants completed a survey prior to the start of a group educational program and upon program completion. For those who agreed, a follow-up phone survey was conducted approximately 10 weeks after program completion or after the infant’s birth. McNemar’s Chi square tests were conducted to detect significant differences between specific items on pre-test, post-test, and follow-up surveys, and paired sample t tests were conducted to compare differences in knowledge and practice scores. A total of 132 participants completed matched pre- and post-test surveys and 76 completed follow-up surveys. Knowledge of recommendations regarding position, surface, environment, smoking, breastfeeding, and pacifier use increased significantly between pre- and post-test, with most participants maintaining knowledge at follow-up. The proportion of recommended practices also increased significantly. A group-based safe sleep educational program can be effective in reducing risky infant sleep practices. [ABSTRACT FROM AUTHOR]

Sleep-related infant deaths are a leading cause of infant mortality in Georgia, and these deaths are largely associated with unsafe sleep practices among caregivers. In early 2016, the Georgia Department of Public Health launched the Georgia Safe to Sleep Hospital Initiative, providing hospitals with safe infant sleep information and educational materials to be distributed to families and newborns. This study examined the knowledge and behaviors of a sample of Georgia parents after the implementation of the Hospital Initiative and identified the family characteristics and intervention components most closely associated with the knowledge and practice of safe infant sleep. The primary caretakers of all infants born in Georgia from August to October 2016 were invited to complete a web-based survey 1 month after hospital discharge. The final sample size included 420 parents of newborns, and the primary outcomes assessed included two measures of knowledge and four measures of infant sleep behaviors regarding infant sleep position and location. Most respondents demonstrated knowledge of the correct recommended sleep position (90%) and location (85%). Logistic regression revealed that receipt of information in the hospital was significantly correlated with safe sleep behaviors, and infant sleep habits tended to influence safe sleep practices. Additionally, Medicaid parents receiving bassinets from the hospital were 74% less likely to bed share (OR 0.26; 95% CI 0.007). Implementation of a statewide hospital initiative was associated with high levels of parental knowledge and behavior and may have been successful in reducing the practice of bed sharing among Medicaid parents. [ABSTRACT FROM AUTHOR]

Public health education commonly favours the 'single, simple, message' approach for delivery of key campaigns. This may be inappropriate where issues are complex, or individual circumstances necessitate more tailored information. We addressed the issue of infant safe sleep education, particularly with regard to parent-infant bed-sharing and risk of SIDS and accidental death--a topic which has often been the focus of single-message campaigns. The aim was to evaluate whether a more complex message would be understood and remembered by mothers. A leaflet-based tool was designed which addressed common infant sleep locations, with information on their risks and benefits. Novel components involved the inclusion of information regarding bed-sharing benefits, and a checklist that parents could use to assess their own risk. We found that the leaflet, when delivered by appropriately trained staff, is effective for enabling discussions with pregnant women that increase their knowledge surrounding the risks and benefits of infant sleep locations. [ABSTRACT FROM AUTHOR]

This review aimed to better understand the application of Quality Improvement (QI) processes to increase adherence to safe infant sleep recommendations in inpatient hospital settings. Following Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines, we searched MEDLINE/PubMed, CINAHL, and PsycINFO for articles published between 1992 and 2021 describing safe infant sleep QI processes in inpatient settings. Data were extracted from eligible articles based on the hospital setting, intervention target, and QI elements in addition to QI improvement efforts. Article quality was assessed using Standards for Quality Improvement Reporting Excellence (SQUIRE) criteria. The initial search yielded 331 articles; 27 met eligibility criteria for data extraction. QI was conducted in pediatric, maternity, and neonatal intensive care units, or a combination. The most often targeted practices were supine position and no objects in crib, followed by parent teaching, sleep location, flat surface, and appropriate bundling. Change approaches fit four broad categories: staff education, parent education, policy, and unit environment changes. All articles reported at least partial success in increasing adherence, and the "lessons learned" can assist hospital teams in tailoring their own safe sleep QI process. [ABSTRACT FROM AUTHOR]

Accidental suffocation and strangulation in bed is a leading cause of preventable Infant death. Bed sharing, teen motherhood, and Hispanic ethnicity have been associated with infant sleep suffocation death. Fifty-five Hispanic teen mothers were surveyed regarding acculturation/demographic characteristics and their infants' sleep behaviors. Most participants had 2 foreign-born parents from Latin America. Participants with 2 US-born parents were less likely to bed share than their less-acculturated peers. Many participants reported not always placing their infant in a supine sleep position. There is a significant need to reach out to Hispanic teen mothers, particularly from newer immigrant families, with culturally and linguistically appropriate multigenerational clinical messaging on the risks of infant bed sharing and nonsupine sleep positioning. [ABSTRACT FROM AUTHOR]