Get Social Media and Risk-Reduction Training (GET SMART)

项目摘要 婴儿猝死综合症（Sudden and Unexpected Infant Deaths，SUID） 意外伤害相关的婴儿死亡，仍然是美国新生儿后期死亡的主要原因，约3400 死亡/年许多SUID是可以预防的，更严格地遵守安全婴儿睡眠指南。有 种族和社会经济差异遵守这些准则和SUID率。我们进行了 成功的婴儿护理实践社交媒体和风险降低培训（SMART; 1 R 01 HD 072815） 在一项研究中，1600名来自美国16家妇产医院的母亲被随机分配接受简短的教育视频， 通过电子邮件或短信提供，重点是安全睡眠（TodaysBabyTM）与控制，在前2个月 出生后与接受注意力匹配控制信息的母亲相比， 干预后安全睡眠的比例高出10个百分点。重要的是，种族和 在研究人群中消除了安全睡眠实践的社会经济差异。鉴于我们 已经证明了SMART干预的有效性，我们现在建议GET SMART（获取社交媒体 和降低风险培训），一项3型混合实施效果的随机分组试验， 医院，以确定最佳的战略，在现实世界的条件下实施这种干预。我们将 比较SMART中使用的“高接触”（HT）实施策略（医院工作人员介绍了该方案， 获得知情同意，与他们一起观看2个视频），具有“低接触”（LT，即，资源密集程度较低） 战略，该战略将以直接面向消费者的方式利用社会营销技术， 在产后住院期间，通过QR码很容易在医院环境中看到， 将用于注册TodaysBabyTM计划。鉴于SUID和安全睡眠实践的差异，GET SMART将在主要为低收入人群服务的县的医院中进行， 全国SUID率。我们将使用实施研究的普罗克特概念模型， 执行战略和成果。我们将比较以医院为基础的HT和LT的影响 关于普及率差异的战略（登记参加保健服务的合格母亲比例） TodaysBabyTM）、根据收入和种族/民族划分的普及率公平性以及每位母亲的计划成本 报名次要的实施成果将是可行性、可接受性、可持续性;以及对 干预（观看视频的数量）。有效性结局将是遵守4项安全睡眠实践 （睡眠姿势、睡眠位置、不使用柔软寝具、使用奶嘴）。后 完成这项执行效果研究后，我们将能够产生与政策有关的宝贵数据 对于公众决策所需的易于复制的移动传输视频安全睡眠干预， 卫生组织和卫生保健系统，以告知具有历史上最高水平的群体之间的广泛可扩展性 SUID的比率。

Project Summary Sudden and Unexpected Infant Deaths (SUID), which include Sudden Infant Death Syndrome and unintentional injury-related infant deaths, remains a leading cause of US postneonatal mortality, with ~3400 deaths/year. Many SUIDs are preventable with greater adherence to safe infant sleep guidelines. There are racial and socioeconomic disparities in adherence to these guidelines and in SUID rates. We conducted the successful Social Media and Risk-Reduction Training for Infant Care Practices (SMART; 1R01HD072815) study in which 1600 mothers at 16 US birth hospitals were randomized to receive short educational videos, delivered by email or text message, focused on safe sleep (TodaysBabyTM) vs. control, in the first 2 months after birth. Compared to mothers receiving attention-matched control messages, those receiving this intervention had ~10 percentage point higher rates of following safe sleep practices. Importantly, racial and socioeconomic disparities in safe sleep practices were eliminated among the study population. Given that we have demonstrated effectiveness in the SMART intervention, we now propose GET SMART (Get Social Media and Risk-Reduction Training), a type 3 hybrid implementation-effectiveness cluster randomized trial of 20 hospitals to determine optimal strategies to implement this intervention in real-world conditions. We will compare the “high touch” (HT) implementation strategy used in SMART (hospital staff introduced the program, obtained informed consent, watched 2 videos with them) with a “low touch” (LT, i.e., less resource-intensive) strategy, which will leverage social marketing techniques in a direct-to-consumer approach to reach mothers during the postpartum hospitalization through QR codes easily visible in the hospital environment that mothers will use to sign up for the TodaysBabyTM program. Given the disparities in SUID and safe sleep practices, GET SMART will occur in hospitals serving predominantly low-income populations in counties with >1.5 times the national SUID rate. We will use the Proctor Conceptual Model of Implementation Research to inform our implementation strategies and outcomes. We will compare the impact of the hospital-based HT and LT strategies with regards to differences in penetration (proportion of eligible mothers who sign up for TodaysBabyTM), equity of penetration according to income and race/ethnicity, and the program cost per mother sign up. Secondary implementation outcomes will be feasibility, acceptability, sustainability; and fidelity to the intervention (number of videos watched). Effectiveness outcomes will be adherence to 4 safe sleep practices (sleep position, sleep location, nonuse of soft bedding, pacifier use) after the 2-month intervention. After completion of this implementation-effectiveness study, we will be able to generate valuable policy-relevant data for an easily replicated mobile-delivered video safe sleep intervention needed for decision-making by public health organizations and health care systems to inform broad scalability among groups with historically high rates of SUID.