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

项目总结 在早产儿(出生37周)中，婴儿意外猝死(SUID)的比率高出2-3倍 与足月儿(出生时≥怀孕37周)进行比较。为了应对这一问题，美国科学院 儿科(AAP)和美国预防服务工作组建议父母遵守可修改的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 出生后吸烟。尽管早产儿患尿毒症的风险更高，机会也更多 对于新生儿住院期间和出院后早期的健康教育，坚持 这些可修改的风险因素是次优的。调查人员此前进行了一次具有全国代表性的 对3300名足月婴儿母亲进行的监测研究，以确定婴儿护理做法和 描述影响遵守这些实践的一系列因素，这些因素直接导致成功 干预性试验。研究人员使用计划行为理论(TPB)作为框架来研究 健康行为。这项研究计划的目标是复制以前的定性监测和国家监测 方法对早产儿母亲进行问卷调查。拟议研究的重点将放在独特的特征上。 可能影响对婴儿护理做法的遵守的母亲-早产儿二元组，例如医疗保健 早产儿的复杂性和母亲的心理痛苦。这将填补批判性知识的空白 GAP，需要为干预发展提供信息，以降低这一弱势群体中的SUID死亡率 人口。在目标1中，将使用定性方法来探索TPB的领域(态度、感知 主观规范和感知控制)以及一系列感知到的障碍和遵守的促进者 美国儿科学会建议早产儿的母亲在家中进行婴儿护理。结果将通知 对1500名早产儿母亲的全国代表性调查的进展 美国各地的新生儿重症监护病房和特别护理托儿所。这项调查将使用 各种查询技术，包括媒体来源，将使目标2-4得以完成。目标2将 确定产妇遵守AAP建议的婴儿护理做法的流行率，并确定 基于母亲特征和婴儿医疗复杂性程度的患病率差异。目标3将 确定TPB域在多大程度上与执行意向和实际绩效相关联 美国儿科学会推荐婴儿护理实践。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结构域和遵守AAP有关 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.