Study of Attitudes and Factors Affecting Infant Care

描述（由申请人提供）：本项目的目的是继续评估婴儿睡眠实践的趋势和采用美国儿科学会和公共卫生服务的“回归睡眠”建议以降低婴儿猝死综合症（SIDS）的风险，并通过一项新的研究扩展当前的研究，更深入地研究影响这些趋势的因素和采用安全睡眠实践的种族差异。NISP电话调查是一项自1992年以来对大约1000名美国8个月以下婴儿看护人进行的年度电话调查，将继续进行2年，然后过渡到新开发的婴儿睡眠习惯影响因素评估调查（SAFE）。新的调查技术涉及每年从32家随机选择的美国妇产医院招募1000名具有全国代表性的样本，并进行为期2-4个月的深入随访调查；抽样设计还包括非裔美国人的过度抽样，他们传统上对安全睡眠建议的遵守程度较低，小岛屿发展中国家的发病率较高。国家安全管理局的研究将对母亲进行调查，了解影响小岛屿发展中国家风险的婴儿护理做法，包括睡眠姿势、同床共枕和安抚奶嘴的使用。这种方法不仅会产生一个全国范围的新妈妈概率样本，还会为单独分析提供一个足够大的非裔美国母亲样本。新设计的调查，基于计划行为理论，将建立特定的方法，旨在阐明不遵守的风险因素，特别是在弱势社会经济群体和少数群体中。通过这种方法，我们将：1)评估国家趋势，以及特定弱势群体的趋势，关于推荐的婴儿睡眠习惯（仰卧睡姿，不同床共枕和使用安抚奶嘴）；2)确定与安全睡眠建议相关的护理人员意图和实践的决定因素。

DESCRIPTION (provided by applicant): The purposes of this project are to continue to evaluate trends in infant sleep practices and adoption of the American Academy of Pediatrics' and the Public Health Service's "Back to Sleep" recommendations to reduce the risk of Sudden Infant Death Syndrome (SIDS), and to expand on current studies with a new study that examines in greater depth the factors influencing these trends and the racial disparity in adoption of safe sleep practices. The NISP telephone survey, an annual telephone survey of approximately 1,000 U.S. caregivers of infants <8 months of age carried out since 1992, will be continued for 2 additional years, and then be transitioned to a newly developed Survey to Assess Factors Effecting (SAFE) Infant Sleep Practices. The new survey technique involves the recruitment of a nationally representative sample of 1000 new mothers annually from 32 randomly selected U.S. maternity hospitals with an in-depth 2-4 month follow-up survey; the sampling design also includes an oversampling of African-Americans, who traditionally have had lower adherence to safe sleep recommendations and higher rates of SIDS. The SAFE study will survey mothers about infant care practices that influence SIDS risk, including sleep position, bed sharing, and pacifier use. Not only will this approach result in a national probability sample of new mothers, it will also provide a sufficiently large sample of African-American mothers for separate analysis. The newly designed survey, based on the Theory of Planned Behavior, will institute specific methodologies designed to illuminate risk factors for non-adherence, particularly in the vulnerable socioeconomic and minority populations. With this approach, we will: 1) evaluate national trends, and trends within specific vulnerable populations, with regard to recommended infant sleep practices (supine sleep position, non-bed sharing, and use of pacifier); and 2) ascertain determinants of caregivers' intentions and practices in relation to safe sleep recommendations. RELEVANCE: Since 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, understanding the reasons for nonadherence to infant sleep recommendations, especially among minority and other vulnerable populations who have the highest rates of SIDS, is a national public health priority.