Social Media And Risk-reduction Training for Infant Care Practices (SMART)

描述（由申请人提供）：本提案的目标是解决与遵守已知的减少小岛屿发展中国家风险的公共卫生建议有关的严重和持续的挑战。在整个美国人口中，尤其是在黑人婴儿中，依从性已经达到了一个不可接受的低水平，导致婴儿死亡率的下降停止，婴儿死亡率的种族差异扩大。目前的建议是一项合作努力，将利用研究人员在研究坚持安全睡眠习惯的障碍方面的丰富经验，开发两种互补的、具有文化竞争力的干预策略，并测试每种策略以及两种策略结合使用的有效性。社交媒体和降低婴儿护理实践风险培训（SMART）研究的创新方面包括：1)该领域领导者的独特合作；2)利用目前开展的婴儿护理实践研究基础设施和医院3)使用两种互补的干预措施，可能产生协同影响；4)运用社会化营销策略；5)使用移动技术（mHealth）传递信息；6)与社区资源和专业知识的合作。SMART研究将分为四个部分，其中16家医院被随机分配到以下研究组之一：1)安全睡眠、托儿所教育和母乳喂养移动健康信息；2)母乳喂养幼儿教育和安全睡眠移动健康信息；3)安全睡眠幼儿教育和安全睡眠移动健康信息；4)母乳喂养幼儿教育和母乳喂养移动健康信息。总共将招募1600名母亲（每个医院100名），每个研究组400名。主要目的是评估旨在促进安全睡眠习惯的干预措施与母乳喂养控制干预措施的有效性。第二个目的是评估可能解释干预对婴儿护理实践影响的潜在中介因素，并可能为未来改进干预方法的领域提供信息。随着SMART研究的成功完成，将为两种干预措施提供有效性数据，以提高对安全睡眠习惯的坚持，这两种干预措施在全国多种不同环境中都是实用的。

DESCRIPTION (provided by applicant): The goal of this proposal is to address serious and ongoing challenges related to adherence to public health recommendations known to reduce the risk of SIDS. Adherence has reached a plateau at an unacceptably low level both in the overall US population and especially in Black infants leading to a halt in the decline in infant mortality and a widening in the racial disparity in infant mortality. The current proposal is a collaborative effort that will capitalize on the extensive experience of the investigators in studying barriers to adherence to safe sleep practices to develop two complementary, culturally competent, intervention strategies and to test the effectiveness of each strategy as well as both strategies in combination. Innovative aspects of the Social Media and Risk-reduction Training of Infant Care Practices (SMART) study include its: 1) unique collaboration of leaders in the field; 2) leveraging of the currently operational infant care practices study infrastructure and hospitals 3) use of two complementary interventions with the potential for synergistic impact; 4) use of social marketing strategies; 5) use of mobile technology (mHealth) to deliver messages; and 6) collaboration with community resources and expertise. The SMART study will have four arms in which 16 hospitals are randomly assigned to one of the following study groups: 1) Safe Sleep Nursery Education and Breastfeeding mHealth messaging; 2) Breastfeeding Nursery Education and Safe Sleep mHealth messaging; 3) Safe Sleep Nursery Education and Safe Sleep mHealth messaging; 4) Breastfeeding Nursery Education and Breastfeeding mHealth messaging. A total of 1600 mothers will be recruited (100/hospital), with 400 in each study group. The primary aim is to assess the effectiveness of the interventions aimed at promoting safe sleep practices compared with the breastfeeding control interventions. The secondary aim is to assess potential mediating factors that may explain the intervention effects on infant care practices and that may inform areas for future improved intervention approaches. With the successful completion of the SMART study, effectiveness data will have been provided for two interventions to improve adherence to safe sleep practices that are practical to disseminate nationally in multiple diverse settings. PUBLIC HEALTH RELEVANCE: SIDS is the most common cause of infant mortality beyond the neonatal period, and adherence to safe infant sleep practices has been proven to reduce the risk of SIDS. If, as we believe, the proposed and relatively simple to implement interventions improve adherence to safe sleep practice recommendations, SMART would be expected to have the following important implications: 1) Hospitals and healthcare providers nationally will adopt these strategies for safe sleep education. This will lead to increased adherence to safe sleep practices, in turn resulting in fewer sleep-related deaths; and 2) These methods will be used in interventions for other health conditions, particularly those with racial/ethnic, educationl or socioeconomic disparities.