Barriers to Following the Back-to-Sleep Recommendations: Insights From Focus Groups With Inner-City Caregivers
Section snippets
Participant Selection
Participants were recruited on site from women, infant, and children centers (WICs) at Yale-New Haven Hospital and at Boston South End Health Center as well as from the maternity unit at Yale-New Haven Hospital. The WIC Supplemental Nutrition Program is a federally funded program for low-income women who are pregnant, breastfeeding, and/or postpartum and for children under age 5 from low-income families. Those recruited from the maternity unit at the hospital planned to bring their children to
RESULTS
A total of 49 caregivers participated. Most identified themselves as Black (86%) and most were female (92%). Sixteen percent were grandmothers. The ages of the participants' biological children ranged from newborn to 26 years (Table 1).
In this section, we present brief transcript excerpts representative of each core theme to illustrate the issues at stake from the respondents' perspectives in their own voices. Excerpts were also selected for inclusion here in light of the investigators'
DISCUSSION
In 1994, the Back-to-Sleep campaign was initiated to get caregivers to place their infants in the supine position for sleep. Ten years later, some caregivers, particularly African Americans, are still not following the recommendations.4, 5, 7, 8, 9 With this qualitative research study, we identified 4 themes that are important to inner-city, primarily African American caregivers when deciding about infant care practices related to SIDS.
The first major barrier was fear that the supine position
ACKNOWLEDGMENTS
Supported by funds from the National Institute of Child Health and Human Development grant U10 HD029067-09A1.
We thank Amy Margolis for her research assistance and Drs Eugene Shapiro and Marian Willinger for review of this manuscript. Thanks also to the Deborah Diehl and her staff at the WIC center at Yale-New Haven Hospital and Rhonda Dickson and her staff at the South End WIC center in Boston.
REFERENCES (33)
- et al.
Prospective cohort study of prone sleeping position and sudden infant death syndrome
Lancet
(1991) - et al.
A competing risk model of sudden infant death syndrome incidence in two US birth cohorts
J Pediatr
(2001) - et al.
The prone sleep position impairs arousability in term infants
J Pediatr
(2001) - et al.
Deaths: Final data for 2002. National Vital Statistics Report. Volume 53. Number 2
(2004) - et al.
Results from the first year of the New Zealand cot death study
N Z Med J
(1991) - et al.
Change in sleep position during infancy: a prospective longitudinal assessment
JAMA
(1998) - et al.
Factors associated with caregivers' choice of infant sleep position, 1994–1998: the National Infant Sleep Position Study
JAMA
(2000) - et al.
Infant sleep placement after the back to sleep campaign
Pediatrics
(2002) - et al.
Prevalence and predictors of the prone sleep position among inner-city infants
JAMA
(1998) - et al.
The contribution of prone sleeping position to the racial disparity in sudden infant death syndrome: the Chicago Infant Mortality Study
Pediatrics
(2002)
Prone infant sleeping despite the “Back to Sleep” campaign
Arch Pediatr Adolesc Med
Factors associated with the transition to nonprone sleep positions of infants in the United States: The National Infant Sleep Position Study
JAMA
Cultural issues in pediatric care
The Illness Narratives: Suffering, Healing, and the Human Condition
Local worlds of suffering: an interpersonal focus of illness experience
Qualitative Health Res
Ethnography in health research and practice
Ambul Child Health
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Presented in part at the Pediatric Academic Societies Meeting, May 2004.