Study of Attitudes and Factors Effecting PREterm infant care Practices (SAFE PREP)

项目摘要 早产儿（出生< 37周）的婴儿意外猝死率（SUID）高出2-3倍 妊娠），与足月婴儿（妊娠≥ 37周出生）相比。为了解决这个问题，美国科学院 儿科（AAP）和美国预防服务工作组建议父母坚持可修改的SUID 减少婴儿护理做法，包括安全睡眠做法、母乳喂养和避免产前和产后护理， 产后吸烟尽管早产儿中SUID的风险较高， 对于新生儿住院期间和出院后早期的健康教育， 这些可改变的风险因素是次优的。调查人员此前进行了一次全国代表性的 在3300名以上足月婴儿母亲中进行的监测研究，以确定婴儿护理做法的普遍性， 描述了影响遵守这些做法的一系列因素，这些因素直接导致了成功的 干预性试验研究人员使用计划行为理论（TPB）作为研究框架， 健康行为这项研究计划的目标是复制以前的定性和国家监测 方法在早产儿的母亲。拟议研究的重点将放在独特的特征上 可能影响婴儿护理实践依从性的母亲-早产儿二人组，例如医疗 早产儿的复杂性和母亲的心理困扰。这将填补一个关键的知识 需要为干预措施的制定提供信息，以减少这一脆弱群体中的SUID死亡率 人口在目标1中，定性方法将用于探索TPB的领域（态度，感知 主观规范和感知控制）和一系列感知的障碍和促进因素， AAP建议早产儿母亲在家中进行婴儿护理。结果将通知 对1500名从医院出院的早产儿母亲进行了一项全国代表性调查。 新生儿重症监护病房和特殊护理托儿所。调查将采用 各种查询技术，包括媒体来源，并将使目标2-4的完成。目标2将 确定母亲遵守AAP推荐的婴儿护理实践的流行率，并确定 根据母亲的特征和婴儿医疗复杂程度，患病率存在差异。目标3将 确定城规会域与执行意图和实际执行的关联程度 AAP推荐的婴儿护理实践。目标4将确定产妇、婴儿和其他 在我们的定性分析中确定的因素与TPB领域和AAP的依从性相关 推荐的做法。

PROJECT SUMMARY The rate of sudden unexpected infant death (SUID) is 2-3-fold higher among preterm infants (born < 37 weeks gestation), compared to term infants (born ≥ 37 weeks gestation). To combat this, the American Academy of Pediatrics (AAP) and US Preventive Services Task Force recommend parental adherence to modifiable SUID reducing infant care practices, including safe sleep practices, breastfeeding, and avoidance of prenatal and postnatal tobacco smoke. Despite the higher risk of SUID among preterm infants and extended opportunities for health-related education during the neonatal hospitalization and early post-discharge period, adherence to these modifiable risk factors is suboptimal. The investigators previously conducted a nationally-representative surveillance study among >3300 mothers of term infants to identify prevalences of infant care practices and characterize the array of factors impacting adherence to these practices, which directly led to a successful interventional trial. The investigators used the Theory of Planned Behavior (TPB) as a framework to study health behavior. The goal of this research plan is to replicate previous qualitative and national surveillance methods among mothers of preterm infants. The focus in the proposed study will be on unique characteristics of mother-preterm infant dyads that may impact adherence to infant care practices, such as the medical complexities of the preterm infant and psychological distress of the mother. This will fill a critical knowledge gap which is needed to inform intervention development to reduce SUID mortality among this vulnerable population. In Aim 1, qualitative methods will be used to explore domains of the TPB (attitudes, perceived subjective norms, and perceived control) and the array of perceived barriers and facilitators of adherence to AAP recommended infant care practices in the home among mothers of preterm infants. Results will inform the development of a nationally representative survey of 1500 mothers of preterm infants discharged from neonatal intensive care units and special care nurseries across the US. The survey will be conducted using a variety of query techniques, including media sources, and will enable completion of Aims 2-4. Aim 2 will determine prevalence of maternal adherence to AAP recommended infant care practices and determine variation in prevalence based on maternal characteristics and degree of infant medical complexity. Aim 3 will determine the extent to which TPB domains are associated with intention to perform and actual performance of AAP recommended infant care practices. Aim 4 will determine the extent to which maternal, infant, and other factors identified in our qualitative analysis are associated with TPB domains and adherence to AAP recommended practices.