Johns Hopkins School of Medicine, Baltimore, MD, USA.
Children's National Hospital, Washington, DC, USA.
Health Promot Pract. 2024 Mar;25(2):196-203. doi: 10.1177/15248399221131834. Epub 2022 Nov 11.
Sudden unexpected infant death (SUID) rates within the District of Columbia (DC) vary, with rates 3 times higher in certain geographical areas than the cumulative rate in DC and 7 times higher than the national rate. The majority SUIDs are due to unsafe sleep practices. Although safe sleep education and resources are available in these areas, the high sleep-related infant mortality suggests unmet barriers to infant safe sleep. We sought to investigate potential contributions to local infant mortality through focus groups regarding infant sleep practices among DC caregivers. In this qualitative study, caregivers were probed regarding barriers and facilitators of infant sleep practices. Data were collected until thematic saturation was reached, then coded. Themes were developed and revised in an iterative manner. Fifteen caregivers participated in three focus groups. Themes included sources of infant sleep knowledge, challenges for infant sleep, and motivators for infant sleep choice. All caregivers reported knowledge of safe sleep practices. Infant sleep practices varied, and included unsafe practices such as bed sharing, co-sleeping, and use of swings or bouncers for infant sleep. Challenges of adhering to safe sleep practices included infant needs, competing family demands, the overwhelming nature of newborn sleep, threats, and conflicting information. Motivators for infant sleep practices included better sleep, convenience, safety, tradition, and needs of the infant and caregiver. Although caregivers report knowledge of safe sleep recommendations, actual infant sleep practices vary and include unsafe sleep practices. More focused interventions are needed to address this gap between safe sleep knowledge and practice.
哥伦比亚特区（DC）的突发意外婴儿死亡（SUID）率存在差异，某些地区的 SUID 率是 DC 总 SUID 率的 3 倍，是全国 SUID 率的 7 倍。大多数 SUID 是由于不安全的睡眠习惯导致的。尽管这些地区提供了安全睡眠教育和资源，但高比例的与睡眠相关的婴儿死亡表明，婴儿安全睡眠存在未满足的障碍。我们试图通过有关 DC 照顾者婴儿睡眠习惯的焦点小组来调查导致当地婴儿死亡率的潜在因素。在这项定性研究中，我们探究了照顾者在婴儿睡眠习惯方面的障碍和促进因素。数据收集到达到主题饱和为止，然后进行编码。主题以迭代方式进行开发和修订。15 位照顾者参加了三个焦点小组。主题包括婴儿睡眠知识的来源、婴儿睡眠的挑战以及婴儿睡眠选择的动机。所有照顾者都报告了对安全睡眠习惯的了解。婴儿睡眠习惯各不相同，包括不安全的习惯，例如与婴儿同床共枕、与婴儿同睡、使用婴儿摇椅或婴儿蹦床。坚持安全睡眠习惯的挑战包括婴儿的需求、家庭需求的竞争、新生儿睡眠的压倒性性质、威胁和相互矛盾的信息。婴儿睡眠习惯的动机包括更好的睡眠、方便、安全、传统以及婴儿和照顾者的需求。尽管照顾者报告了安全睡眠建议的知识，但实际的婴儿睡眠习惯却有所不同，包括不安全的睡眠习惯。需要更有针对性的干预措施来解决安全睡眠知识和实践之间的差距。
