Revisiting Safe Sleep Recommendations for African-American Infants: Why Current Counseling is Insufficient
Revisiting Safe Sleep Recommendations for African-American Infants: Why Current Counseling is Insufficient
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DOI：
10.1007/s10995-014-1530-z
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发表时间：
2015-03-01
影响因子：
2.3
通讯作者：
Dalmida, Safiya George
中科院分区：
文献类型：
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作者：
Gaydos, Laura M.;Blake, Sarah C.;Dalmida, Safiya George
美国儿科学会（American Academy of Pediatrics）建议让孩子仰卧在牢固的床上，不要与父母或其他孩子同睡一张床。卫生专业人员越来越了解许多非裔美国父母不遵循这些建议，但很少有研究存在提供者对这种不遵守的反应。这项研究旨在更好地了解低收入的非裔美国母亲是如何理解并采取新生儿安全睡眠建议的，以及提供者如何为这些母亲提供咨询。我们对60名非裔美国人、低收入人群、首次生育的母亲进行了焦点小组调查，并对20名为这些人群服务的医疗服务提供者进行了电话采访，以探讨医疗服务提供者的咨询和患者的决策。绝大多数母亲都表示理解，但没有遵循安全睡眠的建议。不遵守的主要原因包括感知到的安全性、便利性、婴儿睡眠质量和来自家庭成员的相互矛盾的信息。母亲们通常会采取措施来减轻与不遵守规定有关的风险，而不是增加小岛屿发展中国家的风险。提供者认识到许多母亲不遵守规定，并将不遵守规定主要归因于文化和家庭影响。然而，很少有供应商试图减轻小岛屿发展中国家不合规行为带来的风险。我们建议咨询策略应适应：(1)为小岛屿发展中国家预防建议提供更详细的理由；(2)纳入或承认家庭和文化偏好。忽视非裔美国父母决定睡眠的原因可能会使小岛屿发展中国家的种族/民族差异持续存在。
The American Academy of Pediatrics recommends that children be placed in the supine position on firm bedding and not bed share with parents or other children. Health professionals increasingly understand that many African-American parents do not follow these recommendations, but little research exists on provider reactions to this non-compliance. This study was intended to better understand how low-income, African-American mothers understand and act upon safe sleep recommendations for newborns and how providers counsel these mothers. We conducted focus groups with 60 African-American, low-income, first-time mothers and telephone interviews with 20 providers serving these populations to explore provider counseling and patient decision making. The large majority of mothers reported understanding, but not following, the safe-sleeping recommendations. Key reasons for non-compliance included perceived safety, convenience, quality of infant sleep and conflicting information from family members. Mothers often take measures intended to mitigate risk associated with noncompliance, instead increasing SIDS risk. Providers recognize that many mothers are non-compliant and attribute non-compliance largely to cultural and familial influence. However, few provider attempts are made to mitigate SIDS risks from non-compliant behaviors. We suggest that counseling strategies should be adapted to: (1) provide greater detailed rationale for SIDS prevention recommendations; and (2) incorporate or acknowledge familial and cultural preferences. Ignoring the reasons for sleep decisions by African-American parents may perpetuate ongoing racial/ethnic disparities in SIDS.