Improving the Self-Efficacy of African American Parents in Infant Supine Sleep

项目摘要 非裔美国父母比非西班牙裔白色父母更不可能让婴儿睡觉 以仰卧的姿势。非洲裔美国婴儿也死于婴儿猝死综合症（SIDS）， 是非西班牙裔白色婴儿的两倍。让婴儿以仰卧位睡觉 大大降低了SIDS的死亡风险。被定义为“突然，不明原因的死亡， 小岛屿发展中国家是一岁以下婴儿死亡的主要原因， 生活大多数SIDS死亡（90%）发生在6个月大时，最高发生率在2至4个月之间。 非裔美国人和白色婴儿之间仰卧睡眠流行率的差异自2000年以来一直存在。 1992年首次提出仰卧睡眠的建议，尽管仰卧睡眠的总体比例在2000年有所增加， 非裔美国人和非西班牙裔白人。 尽管公共卫生部门做出了协调一致的努力，让父母了解 从医生、护士、报纸和其他媒体上了解婴儿仰卧睡眠的情况。家长教育的重点是 婴儿仰卧睡眠的安全性，虽然最近的研究表明，父母现在使用非仰卧 主要是因为婴儿的舒适性。这部分父母面临的具体障碍以及如何 仰睡婴儿的父母遇到并克服这些障碍的情况尚不清楚。 我们提出了一个随机对照试验，以测试多媒体的有效性，定制的，父母- 重点干预，以增加非洲裔美国婴儿仰卧睡眠的患病率， 现有的非定制材料。使用焦点小组数据和参与者访谈，干预 材料将包含与文化相关的解决方案，以解决父母报告的障碍和信仰， 帮助父母将婴儿安置在适合婴儿发育的仰卧位， 阶段沿着关于睡眠环境和姿势的推荐指南。 控制和干预材料将在两个发展阶段发送：当哭泣/绞痛是 突出（6周大），以及婴儿身体活动量增加时（4个月大）。的 干预材料将包括一本包含上述信息的小册子和一张DVD 说明适当的环境、位置和安置技术。对照组家长将收到 现有的关于婴儿仰卧睡眠的教育小册子和关于婴儿安全的通用DVD。 因为我们的初步数据表明，有非裔美国医生的非裔美国父母 为他们的孩子保持婴儿仰卧睡姿的时间比那些孩子的医生是 另一个种族，我们将随机改变干预材料中医生模型的种族。我们假设 1）接受干预的父母会让他们的婴儿以高于对照组的速度仰卧睡觉 组父母，和2）这种效果是增强时，医生模型是种族一致的。

PROJECT SUMMARY African American parents are less likely than non-Hispanic White parents to place their infant to sleep in a supine position. African American infants also die of Sudden Infant Death Syndrome (SIDS) at rates 2-3 times greater than non-Hispanic White infants. Placing infants to sleep in the supine position significantly reduces the risk of death from SIDS. Defined as the "sudden, unexplained death of an infant younger than one year old," SIDS is the leading cause of infant deaths occurring after the first month of life. Most SIDS deaths (90%) occur by 6 months of age with the highest incidence between 2 and 4 months. The disparity between African American and White infants in supine sleep prevalence has persisted since the first supine sleep recommendation was made in 1992, although overall rates of supine sleep have increased for both African American and non-Hispanic Whites. This disparity endures despite a concerted public health effort to inform parents about the importance of infant supine sleep from physicians, nurses, newspapers, and other media. Parent education has focused on the safety of infant supine sleep, though recent studies demonstrate that parents now use the non-supine position primarily because of infant comfort. The specific barriers faced by this subset of parents and how parents of supine-sleeping infants have met and overcome those barriers is unknown. We propose a randomized controlled trial to test the effectiveness of a multi-media, tailored, parent- focused intervention to increase the prevalence of African American infant supine sleep as compared to currently available non-tailored materials. Using focus group data and participant interviews, the intervention materials will contain culturally relevant solutions to parent reported barriers and beliefs, specific techniques to assist parents in settling the infant in the supine position that are appropriate to the infant's developmental stage along with the recommended guidelines about the sleep environment and position. Control and intervention materials will be sent at two developmental stages: when crying /colic is prominent (6 weeks of age), and when the infant is becoming more physically active (4 months of age). The intervention materials will consist of a brochure containing the information mentioned above and a DVD illustrating the appropriate environment, position, and settling techniques. Control group parents will receive currently available educational brochures about infant supine sleep and a generic DVD on infant safety. Because our preliminary data suggests that African American parents who have an African American physician for their child maintain the infant supine sleeping position longer than those whose child's physician is of another race, we will randomly vary the race of physician-model in the intervention materials. We hypothesize that 1) parents who receive the intervention will keep their infants sleeping supine at a higher rate than control group parents, and 2) this effect is enhanced when the physician-model is race-concordant.