Division of General Pediatrics and Community Health, Children's National Medical Center, Washington, DC, USA.
Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
J Community Health. 2018 Oct;43(5):977-985. doi: 10.1007/s10900-018-0514-0.
Sudden infant death syndrome (SIDS) rates in African-Americans are more than twice national rates, and historically, African-American parents are more likely than other groups to place infants prone, even when they are aware of supine sleep recommendations. Prior studies have shown African-Americans have low self-efficacy against SIDS but high self-efficacy against suffocation. This study aimed to determine the impact of a specific health message about suffocation prevention on African-American parental decisions regarding infant sleep position. We conducted a randomized controlled trial of 1194 African-American mothers, who were randomized to receive standard messages about safe sleep practices to reduce the risk of SIDS, or enhanced messages about safe sleep practices to prevent SIDS and suffocation. Mothers were interviewed about knowledge and attitude, self-efficacy and current infant care practices when infants were 2-3 weeks, 2-3 months and 5-6 months old. Analyses of covariance were conducted to estimate the change in knowledge, attitudes and practice in each group, and chi square tests were used to compare sleep position with each variable. Over the first 6 months, the proportion of African-American infants placed supine gradually decreased and was unchanged by enhanced education about SIDS, suffocation risk and sleep safety. While initially high self-efficacy against SIDS and suffocation correlated with supine positioning, by 5-6 months self-efficacy did not correspond to sleep position in either group.
婴儿猝死综合征（SIDS）在非裔美国人中的发生率是全国平均水平的两倍多，而且从历史上看，非裔美国父母比其他群体更倾向于让婴儿趴着睡，即使他们知道仰卧睡眠的建议。先前的研究表明，非裔美国人对 SIDS 的自我效能感较低，但对窒息的自我效能感较高。本研究旨在确定关于预防窒息的特定健康信息对非裔美国父母关于婴儿睡眠姿势的决策的影响。我们对 1194 名非裔美国母亲进行了一项随机对照试验，这些母亲被随机分配接受关于安全睡眠实践的标准信息，以降低 SIDS 的风险，或接受关于安全睡眠实践的强化信息，以预防 SIDS 和窒息。当婴儿 2-3 周、2-3 个月和 5-6 个月大时，母亲们接受了关于知识、态度、自我效能感和当前婴儿护理实践的访谈。协方差分析用于估计每组知识、态度和实践的变化，卡方检验用于比较睡眠姿势与每个变量。在最初的 6 个月里，非裔美国婴儿仰卧的比例逐渐下降，但强化教育关于 SIDS、窒息风险和睡眠安全并没有改变这种情况。虽然最初对 SIDS 和窒息的自我效能感较高与仰卧姿势相关，但到 5-6 个月时，两组的自我效能感都与睡眠姿势无关。
