Newcastle University, Newcastle upon Tyne, Tyne and Wear, United Kingdom.
Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom.
PLoS One. 2024 Mar 8;19(3):e0298383. doi: 10.1371/journal.pone.0298383. eCollection 2024.
Despite a decline in Sudden Unexpected Death in Infancy in the UK since 2004, inequalities have widened with higher rates among families from deprived backgrounds and those known to child protection services. Almost all cases involve parents who had engaged in unsafe sleeping practices despite awareness of safer sleeping advice.
To understand the perspectives surrounding safer sleep of families supported by statutory child protection agencies, and use behavior change theory to inform how approaches to providing safer sleep advice to these families may be modified.
We interviewed 14 mothers, 2 fathers and one grandmother, who had recent contact with child protection services in northeast England.
In-depth, semi-structured interviews, with purposive sampling. The COM-B model (Capability, Opportunity, and Motivation) structured our analysis.
Parents described how anxiety, sleep deprivation, settling infants, illness, and a desire to bond with infants influence their decision making about sleep. Parents valued credible, trusted sources and understanding how safer sleep practices protect infants. Responses to questions about 'out of routine' situations suggested social pressures surrounding routines and 'good parenting' may preclude parents from acknowledging risks and planning for these situations.
Open conversations tailored to the needs of families, focused upon understanding why and when parent(s) do or do not follow safer sleep guidance seem a promising way of promoting safer sleep practices. Safer sleep discussions with these families are likely to be best delivered as part of wider infant care by professionals who have an established and continuing trusting relationship with parents. While advice and information should be provided by any professional in contact with the family with the necessary expertise, sensitive conversations around sleeping practices, particularly co-sleeping, may be more easily facilitated by professionals where the statutory responsibility for safeguarding is less apparent.
尽管自 2004 年以来，英国婴儿猝死症的发病率有所下降，但不平等现象却加剧了，来自贫困背景和已知受儿童保护服务机构照顾的家庭的发病率更高。几乎所有病例都涉及到父母，尽管他们已经意识到更安全的睡眠建议，但他们仍然存在不安全的睡眠行为。
了解受法定儿童保护机构支持的家庭在更安全的睡眠方面的观点，并利用行为改变理论来了解如何修改向这些家庭提供更安全睡眠建议的方法。
我们采访了 14 位母亲、2 位父亲和一位祖母，他们最近在英格兰东北部与儿童保护服务机构有过接触。
采用深入的、半结构化的访谈方法，并进行了有针对性的抽样。COM-B 模型（能力、机会和动机）指导了我们的分析。
父母描述了焦虑、睡眠剥夺、安抚婴儿、疾病以及与婴儿建立联系的愿望如何影响他们对睡眠的决策。父母重视可信、可信赖的来源，并理解更安全的睡眠实践如何保护婴儿。对“非常规”情况的回答表明，围绕常规和“良好育儿”的社会压力可能会阻止父母承认风险并为这些情况做好计划。
针对家庭需求进行开放的对话，重点关注了解父母为什么以及何时会或不会遵循更安全的睡眠指导，这似乎是促进更安全睡眠实践的一种有前途的方法。与这些家庭进行更安全的睡眠讨论最好由与父母建立了既定和持续信任关系的专业人员在更广泛的婴儿护理中进行。虽然任何与家庭有联系的专业人员都应该提供建议和信息，并且具有必要的专业知识，但围绕睡眠习惯的敏感对话，特别是同睡，可能更容易由那些对保护儿童的法定责任不太明显的专业人员进行。
