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Strengthen the Evidence for Maternal and Child Health Programs

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Displaying records 21 through 40 (52 total).

Task Force on Sudden Infant Death Syndrome. The changing concept of sudden infant death syndrome: diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics. 2005;116(5):1245-1255. Access Abstract

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): Sleep Environment Modification
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: There has been a major decrease in the incidence of sudden infant death syndrome (SIDS) since the American Academy of Pediatrics (AAP) released its recommendation in 1992 that infants be placed down for sleep in a nonprone position. Although the SIDS rate continues to fall, some of the recent decrease of the last several years may be a result of coding shifts to other causes of unexpected infant deaths. Since the AAP published its last statement on SIDS in 2000, several issues have become relevant, including the significant risk of side sleeping position; the AAP no longer recognizes side sleeping as a reasonable alternative to fully supine sleeping. The AAP also stresses the need to avoid redundant soft bedding and soft objects in the infant's sleeping environment, the hazards of adults sleeping with an infant in the same bed, the SIDS risk reduction associated with having infants sleep in the same room as adults and with using pacifiers at the time of sleep, the importance of educating secondary caregivers and neonatology practitioners on the importance of "back to sleep," and strategies to reduce the incidence of positional plagiocephaly associated with supine positioning. This statement reviews the evidence associated with these and other SIDS-related issues and proposes new recommendations for further reducing SIDS risk.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

Moon RY. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics. 2011;128(5):1030-1039. Access Abstract

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): Sleep Environment Modification
Intervention Description: The AAP, therefore, is expanding its recommendations from focusing only on SIDS to focusing on a safe sleep environment that can reduce the risk of all sleep-related infant deaths, including SIDS.
Primary Outcomes: N/A
Conclusion: The recommendations described in this policy statement include supine positioning, use of a firm sleep surface, breastfeeding, room-sharing without bed-sharing, routine immunizations, consideration of using a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: updated 2016 recommendations for a safe infant sleeping environment. Pediatrics. 2016:e20162938. Access Abstract

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): Sleep Environment Modification
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

Moon RY, Horne RSC, Hauck FR. Sudden infant death syndrome. Lancet. 2007; 370(9598):1578-1587. Access Abstract

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): Sleep Environment Modification, Campaign
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: to reduce the incidence even further, greater strides must be made in reducing prenatal smoke exposure and implementing other recommended infant care practices. Continued research is needed to identify the pathophysiological basis of SIDS.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

Ward TCS, Balfour GM. Infant safe sleep interventions, 1990–2015: a review. J Community Health. 2016;41(1):180-196. Access Abstract

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): Group Education, Sleep Environment Modification, Media Campaign (Print Materials, Public Address System, Social Media)
Intervention Description: We conducted a systematic review of the international research literature to synthesize research on interventions to reduce the risk of sleep-related deaths and their effectiveness in changing infant sleep practices.
Primary Outcomes: N/A
Conclusion: Future studies should incorporate rigorous evaluation plans, utilize comparison groups, and collect demographic and collect follow-up data.
Study Design: Systematic review
Significant Findings: N/A
Setting: N/A
Data Source: PubMed, CINAHL, PsycINFO, and Google Scholar
Sample Size: 29 articles
Age Range: N/A

Moon RY, Hauck FR, Colson ER. Safe infant sleep interventions: what is the evidence for successful behavior change? Curr Pediatr Rev. 2016;12(1):67-75. Access Abstract

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): Other Media, Sleep Environment Modification, Access, Group Education
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: Countless interventions to improve the sleep safety of infants have been implemented. It is important to consider the different levels of barriers to and incentives for behavior change when developing interventions. Using a multi-level approach is ideal and may be more effective than targeting one specific level. Despite the multiple challenges and limitations of intervention evaluation, evaluation is still important, as it provides details of the intervention that are helpful for others considering similar interventions. Particularly as the success of an intervention may be context-dependent, it is important and helpful for those who implement interventions to conduct formal program evaluations that include both quantitative and qualitative components so that processes are transparent and that interventions are more easily translated to other communities. Further, if an intervention is found to be effective, there is more likelihood of sustainability. Therefore, formal process evaluation and testing of effectiveness are critical if interventions are to become independently sustainable. Continued funding, sustainability, and expansion for such projects are most possible if effectiveness data are available. Although the RCT is the gold standard for determining effectiveness of an intervention, it is currently not feasible in many instances. In those cases, the most rigorous evaluation design possible should be implemented. Agencies funding interventions should also include funding to evaluate the interventions to ensure that they are completed.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

Ahlers-Schmidt CR, Schunn C, Nguyen M, Nimeskern-Miller J, Ilahe R, Kuhlmann S. Does providing infant caregivers with a wearable blanket increase safe sleep practices? A randomized controlled trial. Clin Pediatr (Phil). 2015:0009922815572077. Access Abstract

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): Provision of Safe Sleep Item, CAREGIVER
Study Design: RCT
Significant Findings: No
Setting: University of Kansas Pediatric Clinic
Target Audience: Caregivers of patients in the waiting room at the 1-month well-baby visit and the 2-month well-baby visit
Data Source: Caregiver report
Sample Size: Baseline  Intervention (n=75)  Control (n=77) Follow-up (Analysis)  Intervention (n=57)  Control (n=58)
Age Range: Not specified

D’Halluin AR, Roussey M, Branger B, Venisse A, Pladys P. Formative evaluation to improve prevention of sudden infant death syndrome (SIDS): a prospective study. Acta Paediatr. 2011;100(10):e147-e151. Access Abstract

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)
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

Issler RM, Marostica PJ, Giugliani ER. Infant sleep position: a randomized clinical trial of an educational intervention in the maternity ward in Porto Alegre, Brazil. Birth. 2009;36(2):115-121. Access Abstract

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

Kistin CJ, Barrero-Castillero A, Lewis S, et al. Maternal note-taking and infant care: a pilot randomised controlled trial. Arch Dis Child. 2012;97(10):916-918. Access Abstract

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

Goetter M, Stepans M. First-time mothers' selection of infant supine sleep positioning. Journal of perinatal education. 2005;14(4):16-23. Access Abstract

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

Moon RY, Calabrese T, Aird L. Reducing the risk of sudden infant death syndrome in child care and changing provider practices: lessons learned from a demonstration project. Pediatrics. 2008;122(4):788-798. Access Abstract

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
Intervention Description: The goal was to evaluate, through an American Academy of Pediatrics demonstration project, the effectiveness of a curriculum and train-the-trainer model in changing child care providers' behaviors regarding safe infant sleep practices.
Conclusion: A sudden infant death syndrome risk reduction curriculum using a train-the-trainer model is effective in improving the knowledge and practices of child care providers.
Study Design: Cluster RCT
Significant Findings: Yes
Setting: California, Louisiana, Montana, and Pennsylvania
Target Audience: Child care professionals (child care facility directors and child care providers)
Data Source: Infant observation
Sample Size: Intervention  Initial (n=328)  Follow-up (n=282) Control  Initial (n=285)  Follow-up (n=253)
Age Range: Not specified

Colson ER, Joslin SC. Changing nursery practice gets inner-city infants in the supine position for sleep. Arch Pediatr Adolesc Med. 2002;156(7):717-720. Access Abstract

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
Intervention Description: To determine whether an educational intervention to change nursery practice would result in more inner-city parents placing their infants in the supine position for sleep.
Conclusion: After an educational intervention to change practice in a well-newborn nursery, many more parents reported placing their infants in the supine position for sleep,
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Yale-New Haven Hospital (New Haven, CT); Pediatric Primary Care center of the Yale-New Haven Hospital
Target Audience: Infants in the well-newborn nursery during the postpartum stay; Parents of infants at the infants’ 2-week health supervision visit
Data Source: Infant observation and Parent report
Sample Size: Baseline (n=100) Follow-up (n=100)
Age Range: Not specified

Gelfer P, Cameron R, Masters K, Kennedy KA. Integrating "Back to Sleep" recommendations into neonatal ICU practice. Pediatrics. 2013;131(4):e1264-1270. Access Abstract

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

Geyer JE, Smith PK, Kair LR. Safe sleep for pediatric inpatients. J Spec Pediatr Nurs. 2016;21(3):119-130. Access Abstract

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

Hiley CM, Morley CJ. Evaluation of government's campaign to reduce risk of cot death. BMJ. 1994;309(6956):703-704. Access Abstract

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): NATIONAL, Campaign
Intervention Description: This study compared the way mothers cared for their infants before and after the Department of Health's “Back to Sleep” campaign.
Conclusion: Although the incidence of cot death has decreased dramatically, the risks have not been reduced for all babies.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Cambridge, Huntingdon, and Bury St Edmunds
Target Audience: Random selection of mothers of normal term babies who gave birth at least 8 months before the campaign and those who gave birth after the campaign when their children were 6 months old
Data Source: Mother report
Sample Size: Baseline (n=385) Follow-up (n=399)
Age Range: Not specified

Hill SA, Hjelmeland B, Johannessen NM, Irgens LM, Skjaerven R. Changes in parental risk behaviour after an information campaign against sudden infant death syndrome (SIDS) in Norway. Acta Paediatr. 2004;93(2):250-254. Access Abstract

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

Hwang SS, O'Sullivan A, Fitzgerald E, Melvin P, Gorman T, Fiascone JM. Implementation of safe sleep practices in the neonatal intensive care unit. J Perinatol. 2015;35(10):862-866. Access Abstract

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

Kuhlmann S, Ahlers-Schmidt CR, Lukasiewicz G, Truong TM. Interventions to improve safe sleep among hospitalized infants at eight children's hospitals. Hosp Pediatr. 2016;6(2):88-94. Access Abstract

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), Attestation (Provider)
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

Macklin JR, Gittelman MA, Denny SA, Southworth H, Arnold MW. The EASE quality improvement project: improving safe sleep practices in Ohio children's hospitals. Pediatrics. 2016;138(4). Access Abstract

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

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This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.