The Effect of Nursing Quality Improvement and Mobile Health Interventions on Infant Sleep Practices: A Randomized Clinical Trial.

摘要: Importance Inadequate adherence to recommendations known reduce the risk of sudden unexpected infant death has contributed a slowing in decline these deaths. Objective To assess effectiveness 2 interventions separately and combined promote safe sleep practices compared with control interventions. Design, Setting, Participants Four-group cluster randomized clinical trial mothers healthy term newborns who were recruited between March 2015 May 2016 at 16 US hospitals more than 100 births annually. Data collection ended October 2016. Interventions All participants beneficiaries nursing quality improvement campaign (intervention) or breastfeeding (control), then received 60-day mobile health program, which frequent emails text messages containing short videos educational content about (control) queries care practices. Main Outcomes Measures The primary outcome was maternal self-reported 4 position (supine), location (room sharing without bed sharing), soft bedding use (none), pacifier (any); data collected by survey when aged 60 240 days. Results Of 1600 1 groups (400 per group), 1263 completed (78.9%). mean (SD) age 28.1 years (5.8 years) 32.8% respondents non-Hispanic white, 32.3% Hispanic, 27.2% black, 7.7% other race/ethnicity. 11.2 weeks (4.4 weeks) 51.2% female. In adjusted analyses, receiving intervention had higher prevalence placing their infants supine (89.1% vs 80.2%, respectively; difference, 8.9% [95% CI, 5.3%-11.7%]), room (82.8% 70.4%; 12.4% 9.3%-15.1%]), no (79.4% 67.6%; 11.8% 8.1%-15.2%]), any (68.5% 59.8%; 8.7% 3.9%-13.1%]). independent effect not significant for all outcomes. Interactions only position. Conclusions Relevance Among newborns, intervention, but improved Whether widespread implementation is feasible if it reduces rates remains be studied. Trial Registration clinicaltrials.gov Identifier:NCT01713868