Find Established Evidence

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Training (Parent/Family), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Provision of Safe Sleep Item
Intervention Description: The purpose was to describe participants’ knowledge and intentions regarding safe sleep following a Community Baby Shower.
Conclusion: Our Baby Showers were attended by the target audience, who exhibited high levels of safe sleep knowledge, and stated intentions to utilize most safe sleep recommendations following the Shower. However, some participants were resistant to following at least some of the recommendations. Additional venues and other educational strategies may be needed to maximize the uptake of these recommendations.
Study Design: Survey following Baby Shower
Setting: Community Baby Showers
Target Audience: 60% AA women
Data Source: Survey
Sample Size: 364 participants
Age Range: Infant

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Training (Parent/Family), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Sleep Environment Modification, PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Nurse/Nurse Practitioner, Guideline Change and Implementation
Intervention Description: We evaluated a comprehensive hospital-based infant safe sleep education program on parental education and safe sleep behaviors in the home using a cross-sectional survey of new parents at hospital discharge (HD) and 4-month follow-up (F/U).
Conclusion: Reinforcing the infant sleep safety message through intensive hospital-based education improves parental compliance with sudden infant death syndrome risk reduction guidelines.
Study Design: Quasi-experimental nonequivalent control group design
Setting: Hospital, postpartum maternity units
Target Audience: Nurses + New parents
Data Source: Cross-sectional survey of parents at time of hospital discharge and at 4-month well-child visit
Sample Size: 1,092 in hospital sample 490 at 4-month follow-up
Age Range: Infant

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Assessment (caregiver), PROFESSIONAL_CAREGIVER, PARENT_FAMILY, Notification/Information Materials (Online Resources, Information Guide)
Intervention Description: To evaluate formative evaluation, a pedagogic method that sensitizes mothers to sudden infant death syndrome (SIDS), as a new way to improve prevention of SIDS.
Conclusion: Formative evaluation using an educative questionnaire could improve maternal awareness on SIDS risk factors and their compliance with recommendations about SIDS prevention.
Study Design: RCT
Significant Findings: No
Setting: Maternity department of the Rennes University Hospital
Target Audience: Mothers hospitalized during the immediate postpartum period between Jun 19 and Aug 28, 2005 who were not hospitalized for abnormal or high-risk pregnancies and did not have newborns hospitalized in neonatology
Data Source: Mother report
Sample Size: Baseline (n=320) Follow-up (n=292)  Intervention (n=148)  Control (n=144)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Education/Training (caregiver), Educational Material (caregiver)
Intervention Description: The aim of this study was to evaluate the effect on mothers of an individual educational intervention in the maternity ward about infant sleep position.
Conclusion: An individual educational session in the maternity ward about infant sleep position significantly increased the prevalence of supine position for sleeping in the infant's third month. Nevertheless, the intervention was not sufficient to guarantee that most mothers would put their infants to sleep in the recommended position.
Study Design: RCT
Setting: Maternity ward of the Hospital de Clínicas in Porto Alegre
Target Audience: Mothers of infants in an area of Porto Alegre born between Sep 2005 and Sep 2006
Data Source: Mother/doll observation
Sample Size: Intervention (n=112/91) Control (n=116/100)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): Note-Taking (caregiver), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver)
Intervention Description: A pilot randomised controlled trial was conducted with postpartum mothers to assess the feasibility and impact of note-taking during newborn teaching. Controls received standard teaching; the intervention group received pen and paper to take notes.
Conclusion: Maternal note-taking is feasible and potentially efficacious in promoting desirable infant care.
Study Design: RCT
Setting: Postpartum ward of an urban safetynet hospital
Target Audience: Mothers on the postpartum ward (infant gestational age >35 weeks, no prolonged hospitalization of the mother or the infant, expecting to retain custody of the infant)
Data Source: Mother report
Sample Size: Intervention (n=61/48) Control (n=65/58)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Education/Training (caregiver)
Intervention Description: The purpose of this study was to determine if a one-on-one teaching intervention improved the effectiveness of patient education and led to an increase in the desired behavior of placing the infant to sleep in the supine position.
Conclusion: Compared to mothers in the control group, mothers in the experimental group demonstrated greater compliance in selecting supine sleep position in the first week home from the hospital and on the day of follow-up 6 weeks later. However, no difference in "usual position" was reported at 6 weeks and for the night previous to follow-up.
Study Design: RCT
Significant Findings: Yes
Setting: Rural, western, mountain community hospital
Target Audience: Newly delivered primiparas between 18 and 35 years of age unacquainted with the researcher, whose infants did not require more than the usual newborn care
Data Source: Mother report
Sample Size: Intervention (n=32) Control (n=29)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Provision of Safe Sleep Item, Assessment (Provider), HOSPITAL, Quality Improvement, Policy/Guideline (Hospital), Crib Card, CAREGIVER, Education/Training (caregiver), Assessment (caregiver), Educational Material (caregiver)
Intervention Description: The aims of this project were to increase the percentage of infants following safe sleep practices in the NICU before discharge and to determine if improving compliance with these practices would influence parent behavior at home.
Conclusion: Multifactorial interventions improved compliance with safe sleep practices in the NICU and at home.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Children’s Memorial Hermann Hospital NICU in Houston, TX
Target Audience: Infants in open cribs eligible for safe sleep practices; Parents of infants after discharge
Data Source: Crib audit/infant observation; Parent report
Sample Size: Baseline (n=62) Follow-up (n=79); Baseline (n=66) Follow-up (n=98)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, HOSPITAL, Quality Improvement, Policy/Guideline (Hospital), Crib Card, Sleep Environment Modification, Promotional Event, POPULATION-BASED SYSTEMS, COMMUNITY, Social Media, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Visual Display (Community)
Intervention Description: To improve sleep environment safety for inpatient infants.
Conclusion: Staff education, swaddle sleep sacks, and bedside storage containers were associated with improved sleep safety among pediatric inpatients at our institution and may help at other institutions.
Study Design: QE: pretest-posttest
Significant Findings: No
Setting: University of Iowa Children’s Hospital
Target Audience: Infants less than 1 year of age developmentally ready for a crib and asleep
Data Source: Crib audit/infant observation
Sample Size: Baseline (n=22) Follow-up 1 (not reported) Follow-up 2 (n=37) Follow-up 3 (n=18)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Provision of Safe Sleep Item, POPULATION-BASED SYSTEMS, NATIONAL, Campaign, Mass Media, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver)
Intervention Description: To assess parental risk behaviour before and after a sudden infant death syndrome (SIDS) information campaign with special emphasis on associations with maternal age, education, marital status and birth order.
Conclusion: Non-supine sleeping decreased to a level that has never been reported before. In future campaigns, subgroup-specific measures may be needed.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: N/A
Target Audience: All mothers registered with the Medical Birth Registry of Norway as having given birth between Oct and Nov 1998 and Oct and Nov 1999 without a pathological condition
Data Source: Mother report
Sample Size: Baseline (n=5539) Follow-up (n=4143)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, HOSPITAL, Crib Card, Visual Display (Hospital), CAREGIVER, Education/Training (caregiver)
Intervention Description: To increase the percentage of eligible infants engaging in safe sleep practices (SSP) in two level III neonatal intensive care units (NICUs) in the Boston, Massachusetts area.
Conclusion: Safe infant sleep practices can be integrated into the routine care of preterm infants in the NICU. Modeling SSP to families far in advance of hospital discharge may improve adherence to SSP at home and reduce the risk of sleep-related morbidity and mortality in this vulnerable population of infants.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Two level III NICUs at South Shore Hospital and St Elizabeth’s Medical Center in MA
Target Audience: Infants eligible for safe sleep practices as determined by an algorithm and clinical status of the infant
Data Source: Crib audit/infant observation
Sample Size: Baseline (n=112) Follow-up (n=118)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Provision of Safe Sleep Item, HOSPITAL, Policy/Guideline (Hospital), Sleep Environment Modification, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), HEALTH_CARE_PROVIDER_PRACTICE, Audit/Attestation
Intervention Description: The purpose of this study was to improve safe sleep practices for infants in nonneonatal pediatric units with implementation of specific interventions.
Conclusion: Implementation of site-specific interventions seems to improve overall safe sleep in inpatient pediatric units, although continued improvement is needed. Specifically, extra items are persistently left in the sleeping environment.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Eight children’s hospitals
Target Audience: Infants aged 0 to 6 months admitted to the general pediatric unit (excluding infants in the NICUs, PICUs, and maternal fetal units)
Data Source: Crib audit/infant observation
Sample Size: Baseline (n=234) Follow-up (n=210)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, HOSPITAL, Quality Improvement, Policy/Guideline (Hospital), Sleep Environment Modification, CAREGIVER, Education/Training (caregiver)
Intervention Description: This project assessed the change in infant safe sleep practices within 6 children's hospitals after the implementation of a statewide quality improvement program.
Conclusion: Multifactorial interventions by hospitalist teams in a multi-institutional program within 1 state's children's hospitals improved observed infant safe sleep behaviors and family report of safe sleep education. These behavior changes may lead to more appropriate safe sleep practices at home.
Study Design: QE: pretest-posttest
Significant Findings: No
Setting: Six children’s hospitals without internal maternity centers or wellbaby nurseries (academic tertiary or quaternary care institutions) in OH
Target Audience: Infants ≤1 year of age admitted to the general medical/surgical units who were not awake during the audit (excluding those in the ICUs, with tracheostomies, ventilator or noninvasive ventilator dependence, recent spinal surgeries, or upper airway anatomic abnormalities)
Data Source: Crib audit/infant observation
Sample Size: Baseline (n=856) Follow-up (n=189)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Provision of Safe Sleep Item, HOSPITAL, Quality Improvement, Policy/Guideline (Hospital), Crib Card, Visual Display (Hospital), Sleep Environment Modification, Promotional Event, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Attestation (caregiver), HEALTH_CARE_PROVIDER_PRACTICE, Audit/Attestation
Intervention Description: The purpose of this quality improvement project was to promote the AAP safe sleep recommendations and provide appropriate role modeling of these recommendations for hemodynamically stable infants throughout their hospital stay.
Conclusion: There was inconsistency between nursing knowledge and practice about safe infant sleep. Nurses were aware of the AAP recommendations, but it took time to achieve close to full compliance in changing clinical practice. Observation was an important part of this initiative to reinforce knowledge and role model best practice for parents.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Golisano Children’s Hospital at the University of Rochester in NY
Target Audience: Hemodynamically stable infants less than 1 year of age in the mother-baby unit and nine pediatric units
Data Source: Crib audit/infant observation
Sample Size: Baseline (n=65) Follow-up (n=60)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), HOSPITAL, Crib Card, Visual Display (Hospital), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver)
Intervention Description: To determine the impact, at 60 days of life, of an educational intervention conducted in maternity centers aimed at improving adherence to the recommendations on safe infant sleep.
Conclusion: The educational intervention was useful to improve adherence to the recommendations on safe sleep at 60 days of life: using the supine position and breastfeeding improved, and the rate of co-sleeping decreased. No changes were observed in the number of household members who smoke, bedroom sharing, and pacifier use.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Hospital Municipal Comodoro Meisner and Hospital Universitario Austral
Target Audience: Live newborns with >36 gestation weeks born in two hospitals whose mothers lived in the District of Pilar without major congenital malformations and/or hospitalization in the NICU for more than 10 days
Data Source: Caregiver report
Sample Size: Baseline (n=251) Follow-up (n=248)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, HOSPITAL, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Visual Display (Hospital)
Intervention Description: To determine infant sleep positioning practices and SIDS awareness before and after a hospital-based Back to Sleep campaign.
Conclusion: The Back to Sleep campaign was effective in our hospital setting. Our data indicate the need for special targeting of young, unmarried, and non-breast-feeding mothers. Fear of choking remains an important deterrent to proper infant sleep positioning.
Study Design: QE: pretest-posttest
Significant Findings: No
Setting: Pediatric ambulatory care center of Wyckoff Heights Medical Center in NY
Target Audience: Mothers of healthy term infants 6 months and younger born in the hospital and attending the pediatric outpatient clinics
Data Source: Mother report
Sample Size: Baseline (n=250) Follow-up (n=250)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Assessment (Provider), HOSPITAL, Quality Improvement, Policy/Guideline (Hospital), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Sleep Environment Modification
Intervention Description: The dual aims of this project were to develop a safe sleep educational model for our neonatal intensive care unit (NICU), and to increase the percentage of eligible infants in a safe sleep environment.
Conclusion: With formal staff and family education, optional wearable blanket, and data sharing, safe sleep compliance increased and patient safety improved.
Study Design: QE: pretest-posttest
Significant Findings: No
Setting: The Children’s Mercy Hospital NICU in MO
Target Audience: Safe sleep eligible infants (medically stable and transitioned to open cribs)
Data Source: Crib audit/infant observation
Sample Size: Baseline (n=28) Follow-up (n=26)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Education/Training (caregiver)
Intervention Description: The objective of this study was to determine whether a 15-minute educational intervention is effective in changing sleep position practice among black parents.
Conclusion: A 15-minute educational session with small groups of black parents is effective in informing parents about the importance of safe sleep position and in changing parent behavior. The effect of the intervention is sustained throughout the first 6 months of life, when the infant is at the highest risk for SIDS.
Study Design: QE: nonequivalent control group
Significant Findings: Yes
Setting: WIC Clinic at Children’s National Medical Center in Washington, DC
Target Audience: Current and prospective caregivers of young infants
Data Source: Caregiver report
Sample Size: Intervention- Follow-Up (n=76) Comparison (n=113)
Age Range: Not specified

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Provision of Safe Sleep Item, Education/Training (caregiver), Educational Material (caregiver), PARENT/FAMILY, Training (Parent/Family), NATIONAL, Campaign, Mass Media
Intervention Description: The objective of this study was to describe parental knowledge and practices regarding infant sleep position, bedsharing, pacifier use, and feeding practices before and after receipt of a free crib and safe sleep education.
Conclusion: Crib distribution and safe sleep education positively influence knowledge and practices about safe sleep.

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Education/Training (caregiver), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Quality Improvement/Practice-Wide Intervention
Intervention Description: To assess the effectiveness of 2 interventions separately and combined to promote infant safe sleep practices compared with control interventions.
Conclusion: Among mothers of healthy term newborns, a mobile health intervention, but not a nursing quality improvement intervention, improved adherence to infant safe sleep practices compared with control interventions. Whether widespread implementation is feasible or if it reduces sudden and unexpected infant death rates remains to be studied.

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROFESSIONAL_CAREGIVER, Education/Training (caregiver), Provision of Safe Sleep Item, COMMUNITY, Presentation
Intervention Description: With the support of the Kansas Infant Death SIDS (KIDS) Network, safe sleep instructors in four rural counties (Geary, Cloud, Harvey, and Shawnee) held virtual Safe Sleep Community Baby Showers in 2020. Safe sleep, breastfeeding, and tobacco cessation/avoidance education was provided to participants regardless of education format. In-person events were interactive by nature, using presentation and demonstration, but also included video components. For virtual events, Geary and Cloud counties chose to provide educational videos and prerecorded presentations to participants (passive). Harvey and Shawnee counties held real-time interactive education over a virtual platform. Data was collected via pre- and postsurveys. Those who completed both surveys received a portable crib and wearable blanket.
Conclusion: Although both event formats demonstrated increased knowledge/intentions to follow safe sleep recommendations, virtual events may further marginalize groups who are at high risk for poor birth outcomes. Strategies to increase technology access, recruit priority populations, and ensure disparities are not exacerbated will be critical for the implementation of future virtual events.
Significant Findings: Yes
Setting: Four rural counties in Kansas
Target Audience: Pregnant or postpartum women