Factors Associated with Parental Compliance with Supine Infant Sleep: An Integrative Review.

Despite educational programs, sudden infant death syndrome (SIDS) rates remain unacceptably high, especially among low-income and African-American populations. The purpose of this review is to examine reasons for parental noncompliance with supine sleep recommendations. A database search in Cochrane Database of Systematic Reviews, PubMed, EBSCOhost, and CINAHL was conducted using keywords SIDS, prevention and control, parental compliance, nursing, supine position, Back to Sleep campaign, and Safe to Sleep campaign. Literature was included from 2002 to 2014. Types of studies included randomized control trials, literature reviews, and descriptive studies. Literature from academic journals was also included. Included literature discussed parental knowledge, the Back to Sleep and the Safe to Sleep campaigns, compliance with recommendations from the American Academy of Pediatrics (AAP), and interventions and education. Seventeen studies were included that used data collection methods, including surveys, focus groups, face-to-face interviews, and questionnaires. Major trends identified as being associated with noncompliance included parent knowledge, sources of advice, infant comfort and quality of infant sleep, safety concerns (i.e., choking), race/ethnicity, education level, and income. Noncompliance was highest among single, less-educated, low-income, or African-American parents.