The Social Ecology of Sleep Environments among Non-Hispanic Black Infants

 描述(由申请人提供)：本R15提案的目的是(1)在低收入城市社区中使用照片启发访谈作为参与性研究的一种形式，以探索三个非西班牙裔黑人亚群(非洲裔美国人、非洲裔加勒比移民和非洲移民)的育儿生活经验和婴儿护理做法的背景，以及(2)利用有声计算机辅助自我访谈(ACASI)定量确定社会文化和环境对这些社区与睡眠相关的婴儿护理做法的影响，以促进婴儿睡眠环境的社会生态模型。在美国，婴儿死亡率的极端差异仍然存在，低收入的非西班牙裔黑人婴儿的死亡率是最高的。与睡眠有关的婴儿伤害是 这是导致婴儿死亡的主要原因，被认为可以通过改变婴儿的睡眠环境来预防。大多数干预措施都侧重于改变被认为会使婴儿面临这些类型死亡的更高风险的做法(例如，不安全的睡眠表面、与人同床、俯卧睡眠姿势和过多的床铺)，这一方法被批评为过于宽泛。很少有研究致力于这些做法的总体背景，包括与贫困相关的因素如何影响睡眠相关伤害风险的选择。此外，尽管非西班牙裔黑人类别所包括的种族和民族之间的婴儿死亡率差异很大，但很少有研究调查与睡眠有关的婴儿护理做法的影响以及这些做法本身的流行率是否因出生地和原产地而有所不同。社会生态学理论认为，个体与多个层面的社会现象相互作用并受其影响，从二元互动到家庭(或微系统)、邻里和社区(中系统)、国家(外系统)和文化(大系统)维度。这项研究将婴儿睡眠环境概念化为这些领域的复杂交叉点，并采用了婴儿睡眠的社会生态模型，在该模型中，从个人层面的信念和文化态度到与生活条件有关的结构性因素，多种因素都可能影响婴儿睡眠环境。 这项研究是基础性的，因为它将建立一个知识基础，在此基础上可以建立文化上适当的干预研究。

 DESCRIPTION (provided by applicant): The purpose of this R15 proposal is to (1) use photo-elicitation interviewing as a form of participatory research in low-income urban communities to explore the lived experience of parenting and contextualize infant care practices among three non-Hispanic Black subgroups (African Americans, Afro-Caribbean immigrants, and African immigrants), and (2) quantitatively identify socio-cultural and environmental influences on sleep-related infant care practices in these communities using audio computer-assisted self-interviews (ACASI) to contribute to a social ecological model of infant sleep environments. In the United States (US), extreme disparities in infant mortality persist, with low-income non-Hispanic Black infants evidencing some of the highest rates of mortality. Sleep-related infant injuries are one of the leading causes of infant mortality and are thought to be preventable by altering the infant sleep environment. Most interventions have focused on changing practices thought to place infants at higher risk for these types of deaths (e.g., unsafe sleep surface, bed-sharing, prone sleep positioning, and excess bedding), an approach that has been criticized as overly broad. Little research has been devoted to the overarching context of these practices, including how factors related to poverty affect choices around risks for sleep-related injury. Moreover, despite the wide variation in infant mortality rate among racial and ethnic groups encompassed by the non- Hispanic Black category, little research has examined whether influences on sleep-related infant care practices, as well as the prevalence of the practices themselves, differ by nativity and region of origin. Social ecological theory posits that individuals interact with, and are influenced by, multiple levels of social phenomena, ranging from dyadic interaction, to family (or microsystem), neighborhood and community (mesosystem), state (exosystem) and cultural (macrosystem) dimensions. The research proposed conceptualizes the infant sleep environment as a complex intersection of these domains and employs a social ecological model of infant sleep in which multiple levels of factors, from individual-level beliefs and cultural attitudes, to structural factors related to living conditions, may influence the sleep environment. This study is foundational in that it will establish a base of knowledge upon which culturally appropriate intervention research can be built.