Tierra D Burrell1, Eileen M McDonald2, Patricia Mahoney3, Rashelle J Musci4, Wendy Shields3, Andrea Gielen2, Barry S Solomon5. 1. Department of Pediatrics (TD Burrell and BS Solomon), Johns Hopkins University School of Medicine, Baltimore, Md. Electronic address: tierra.d.burrell@kp.org. 2. Johns Hopkins Center for Injury Research and Policy (EM McDonald, P Mahoney, W Shields, A Gielen, and BS Solomon), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; Department of Health, Behavior and Society (EM McDonald and A Gielen), Johns Hopkins Bloomberg School of Public Health, Baltimore Md. 3. Johns Hopkins Center for Injury Research and Policy (EM McDonald, P Mahoney, W Shields, A Gielen, and BS Solomon), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; Department of Health Policy and Management (P Mahoney and W Shields), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. 4. Department of Mental Health (RJ Musci), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. 5. Department of Pediatrics (TD Burrell and BS Solomon), Johns Hopkins University School of Medicine, Baltimore, Md; Johns Hopkins Center for Injury Research and Policy (EM McDonald, P Mahoney, W Shields, A Gielen, and BS Solomon), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
Abstract
OBJECTIVE: Sudden Infant Death Syndrome is a leading cause of mortality in infants, and pediatric providers can influence caregiver infant safe sleep practices. We described the content of safe sleep counseling by pediatric providers and examined pediatric provider and caregiver factors that may be related to the delivery of safe sleep counseling. METHODS: A sample of mothers and providers enrolled in the Safe Start Study, a randomized controlled trial assessing a safe sleep intervention, were audio-recorded during the 2-week well child visits (WCV) at a large urban pediatric practice in Baltimore, Maryland from October 2015 to April 2017. Provider counseling content related to infant sleep was transcribed and coded based on American Academy of Pediatrics (AAP) policy statement Grade A recommendations. Maternal reported infant sleep practices were defined by items on an interviewer administered survey. Multivariate logistic regression analyses were used to examine the relation between maternal reported infant sleep practices and provider counseling. RESULTS: Most, 92%, of WCVs included at least 1 safe sleep topic, but there was inconsistency in content delivered based on AAP recommendations. Yet, only 12% of WCVs included all 4 components of ABC counseling. Maternal report of infant sleeping with a person or an object in sleep space was associated with decreased odds of receiving counseling on alone no person, no objects (adjusted odds ratio: 0.34, 95% confidence interval: 0.13, 0.90). CONCLUSIONS: Pediatric provider counseling on safe sleep is inconsistent across AAP recommendations demonstrating a need for enhanced provider education and a more standardized approach to assess infant sleep practices.
OBJECTIVE:Sudden Infant Death Syndrome is a leading cause of mortality in infants, and pediatric providers can influence caregiver infant safe sleep practices. We described the content of safe sleep counseling by pediatric providers and examined pediatric provider and caregiver factors that may be related to the delivery of safe sleep counseling. METHODS: A sample of mothers and providers enrolled in the Safe Start Study, a randomized controlled trial assessing a safe sleep intervention, were audio-recorded during the 2-week well child visits (WCV) at a large urban pediatric practice in Baltimore, Maryland from October 2015 to April 2017. Provider counseling content related to infant sleep was transcribed and coded based on American Academy of Pediatrics (AAP) policy statement Grade A recommendations. Maternal reported infant sleep practices were defined by items on an interviewer administered survey. Multivariate logistic regression analyses were used to examine the relation between maternal reported infant sleep practices and provider counseling. RESULTS: Most, 92%, of WCVs included at least 1 safe sleep topic, but there was inconsistency in content delivered based on AAP recommendations. Yet, only 12% of WCVs included all 4 components of ABC counseling. Maternal report of infant sleeping with a person or an object in sleep space was associated with decreased odds of receiving counseling on alone no person, no objects (adjusted odds ratio: 0.34, 95% confidence interval: 0.13, 0.90). CONCLUSIONS: Pediatric provider counseling on safe sleep is inconsistent across AAP recommendations demonstrating a need for enhanced provider education and a more standardized approach to assess infant sleep practices.