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

描述(由申请人提供)：本提案的目标是应对与遵守已知可降低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。无论是在美国总人口中，还是在黑人婴儿中，这一坚持都达到了令人无法接受的低水平，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做法的障碍方面的广泛经验，制定两种互补的、具有文化能力的干预策略，并测试每种策略以及两种策略组合的有效性。婴儿护理实践的社交媒体和降低风险培训(SMART)研究的创新方面包括：1)领域领导者的独特合作；2)利用目前正在运作的婴儿护理实践研究基础设施和医院；3)使用两种可能产生协同影响的互补干预措施；4)使用社会营销战略；5)使用移动技术(MHealth)传递信息；以及6)与社区资源和专业知识合作。这项智能研究将有四个分支，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mHealth消息；2)母乳喂养托儿所教育和安全睡眠mHealth消息；3)安全睡眠托儿所教育和安全睡眠mHealth消息；4)母乳喂养托儿所教育和母乳喂养mHealth消息。总共将招募1600名母亲(100名/医院)，每个研究组400人。主要目的是评估旨在促进安全睡眠做法的干预措施与母乳喂养控制干预措施的有效性。第二个目标是评估潜在的中介因素，这些因素可能解释干预对婴儿护理实践的影响，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，将为两项干预措施提供有效性数据，以改善对安全睡眠做法的遵守，这两项实践可在多种不同环境中在全国范围内传播。

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.