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Mobile reminders reinforce safe sleep practices
The use of emails and text messaging —independent from nursing quality interventions — could improve the use of safe sleep practices in healthy term infants, according to a study published in JAMA.
“[The Back to Sleep] campaign to improve rates of supine infant sleep positioning to reduce the risk of sudden infant death syndrome (SIDS) was successful in halving the United States SIDS rate,” Rachel Y. Moon, MD, from the department of pediatrics in the School of Medicine at the University of Virginia, and colleagues wrote. “However, in 2014, there were still approximately 3,500 infant deaths due to SIDS, accidental suffocation or strangulation in bed or ill-defined causes.”
To analyze the efficacy of a nursing quality improvement campaign, the researchers conducted a four-group cluster randomized clinical trial in which mothers who had healthy term babies were placed into a nursing quality improvement campaign in safe infant sleep practices and then compared to the findings with those of a control breast-feeding group. All received a 60-day mobile health program that delivered short videos and educational content through text messaging and emails.
The information sent to mothers of the healthy term infants included content on infant safe sleep practices, or breast-feeding and queries about infant care practices. The researchers assessed maternal self-reported adherence to four measures: supine sleep position, room sharing without bed sharing, no soft bedding use and any pacifier use. All data was collected when the child was aged 60 to 240 days.
Of the 1,263 mothers who submitted survey information, 32.8% were white, 32.3% were Hispanic, 27.2% were non-Hispanic black and 7.7% were of another race/ethnicity. The average maternal age was 28.1 years, and the average infant age was 11.2 weeks (51.2%, female). Mothers were more likely to place their child in a supine position to sleep if they were in the group receiving information about safe sleep practices than if they were not (89.1% vs. 80.2; adjusted risk difference, 8.9% [95% CI, 5.3%-11.7%].
Additionally, those who were in the group receiving safe sleep practice mobile interventions were more likely to room-share without bed-sharing (82.8% vs. 70.4%; adjusted risk difference, 12.4% [95% CI, 9.3%-15.1%]), not use soft bedding (79.4% vs. 67.6%; adjusted risk difference, 11.8% [95% CI, 8.1%-15.2%]), and implement any pacifier use (68.5% vs. 59.8%; adjusted risk difference, 8.7% [95% CI, 3.9%-13.1%]).
The use of nursing quality improvement interventions made no significant improvement for all outcomes, and supine sleep position was the only outcome affected by interaction between the two interventions.
“The messages and videos were timed to address challenges and questions that arise at specific time points; therefore, providing this additional information to parents at critical times may have been important in assuaging concerns about adherence to recommended practices,” Moon and colleagues wrote. “Furthermore, receiving frequent videos and email or text messages may have served as a virtual support system for mothers, reinforcing safe sleep parental practices.” — by Katherine Bortz
Disclosure: The researchers provide no relevant financial disclosures.
