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Impact of State Prioritization of Safe Infant Sleep Programs on Supine Sleep Positioning for Non-Hispanic White and Non-Hispanic Black Infants
Objective Investigate whether safe infant sleep prioritization by states through the Title V Maternal and Child Block Grant in 2010 differentially impacted maternal report of supine sleep positioning (SSP) for Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) U.S.-born infants.
Methods We analyzed retrospective cross-sectional data from the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2005 to 2015 from 4 states: WV and OK (Intervention) and AR and UT (Control). PRAMS is a population-based surveillance system of maternal perinatal experiences which is linked to infant birth certificates. Piece-wise survey linear regression models were used to estimate the difference in the change in slopes of SSP percents in the pre- (2005–2009) and post- (2011–2015) periods, controlling for maternal and infant characteristics. Models were also stratified by race/ethnicity.
Results From 2005 to 2015, for NHW infants, SSP improved from 61.5% and 70.2% to 82.8% and 82.3% for intervention and control states, respectively. For NHB infants, SSP improved from 30.6% and 26.5% to 64.5% and 53.1% for intervention and control states, respectively. After adjustment for maternal characteristics, there was no difference in the rate of SSP change from the pre- to post- intervention periods for either NHW or NHB infants in intervention or control groups.
Conclusions and relevance Compared with control states that did not prioritize safe infant sleep in their 2010 Title V Block Grant needs assessment, intervention states experienced no difference in SSP improvement rates for NHW and NHB infants. While SSP increased for all infants during the study period, there was no causal relationship between states' prioritization of safe infant sleep and SSP improvement. More targeted approaches may be needed to reduce the racial/ethnic disparity in SSP and reduce the risk for sleep-associated infant death.
Supine sleep positioning improved for Black and White infants in the U.S.
State prioritization of safe infant sleep did not directly impact SSP for NHB or NHW infants.
More targeted approaches may be needed to reduce racial/ethnic disparities in safe sleep practices
Received: 25 February 2021
Accepted: 20 July 2021
20 September 2021 (online)
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- 1 Malloy MH. Prematurity and sudden infant death syndrome: United States 2005-2007. J Perinatol 2013; 33 (06) 470-475
- 2 Centers for Disease Control and Prevention. Sudden unexpected infant death and sudden infant death syndrome. http://www.cdc.gov/sids/data.htm . Accessed October 20, 2017
- 3 Centers for Disease Control and Prevention. Sudden Unexpected Infant Death and Sudden Infant Death Syndrome: Data and Statistics. https://www.cdc.gov/sids/data.htm#cause . Accessed August 30, 2018
- 4 Parks SE, Erck Lambert AB, Shapiro-Mendoza CK. Racial and Ethnic Trends in Sudden Unexpected Infant Deaths: United States, 1995-2013. Pediatrics 2017; 139 (06) e20163844
- 5 Oyen N, Markestad T, Skaerven R. et al. Combined effects of sleeping position and prenatal risk factors in sudden infant death syndrome: the Nordic Epidemiological SIDS Study. Pediatrics 1997; 100 (04) 613-621
- 6 Schnitzer PG, Covington TM, Dykstra HK. Sudden unexpected infant deaths: sleep environment and circumstances. Am J Public Health 2012; 102 (06) 1204-1212
- 7 Shapiro-Mendoza CK, Kimball M, Tomashek KM, Anderson RN, Blanding S. US infant mortality trends attributable to accidental suffocation and strangulation in bed from 1984 through 2004: are rates increasing?. Pediatrics 2009; 123 (02) 533-539
- 8 Laws COTSS. TITLE V—MATERNAL AND CHILD HEALTH SERVICES BLOCK GRANT. https://www.ssa.gov/OP_Home/ssact/title05/0500.htm . Accessed Ooctober 1, 2018, 2018
- 9 Kandasamy V, Hirai AH, Kogan MD, Lawler M, Volpe E, Title V. Title V Maternal and Child Health Services Block Grant Priority Needs and Linked Performance Measures: Current Patterns and Trends (2000-2015). Matern Child Health J 2018; 22 (12) 1725-1737
- 10 Shulman HB, Gilbert BC, Msphbrenda CG, Lansky A. The Pregnancy Risk Assessment Monitoring System (PRAMS): current methods and evaluation of 2001 response rates. Public Health Rep 2006; 121 (01) 74-83
- 11 Shulman HB, D'Angelo DV, Harrison L, Smith RA, Warner L. The Pregnancy Risk Assessment Monitoring System (PRAMS): Overview of Design and Methodology. Am J Public Health 2018; 108 (10) 1305-1313
- 12 Prevention CfDCa. Detailed PRAMS Methodology. https://www.cdc.gov/prams/methodology.htm . Accessed 12/15/2018
- 13 Hirai AH, Sappenfield WM, Kogan MD. et al. Contributors to excess infant mortality in the U.S. South. Am J Prev Med 2014; 46 (03) 219-227
- 14 Colson ER, Geller NL, Heeren T, Corwin MJ. Factors Associated With Choice of Infant Sleep Position. Pediatrics 2017; 140 (03) e20170596
- 15 Colson ER, Rybin D, Smith LA, Colton T, Lister G, Corwin MJ. Trends and factors associated with infant sleeping position: the national infant sleep position study, 1993-2007. Arch Pediatr Adolesc Med 2009; 163 (12) 1122-1128
- 16 Colson ER, Willinger M, Rybin D. et al. Trends and factors associated with infant bed sharing, 1993-2010: the National Infant Sleep Position Study. JAMA Pediatr 2013; 167 (11) 1032-1037
- 17 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 (04) 788-798
- 18 Moon RY, Hauck FR, Colson ER. Safe Infant Sleep Interventions: What is the Evidence for Successful Behavior Change?. Curr Pediatr Rev 2016; 12 (01) 67-75
- 19 Colson ER, Levenson S, Rybin D. et al. Barriers to following the supine sleep recommendation among mothers at four centers for the Women, Infants, and Children Program. Pediatrics 2006; 118 (02) e243-e250
- 20 Colson ER, McCabe LK, Fox K. et al. Barriers to following the back-to-sleep recommendations: insights from focus groups with inner-city caregivers. Ambul Pediatr 2005; 5 (06) 349-354
- 21 Moon RY, Oden RP, Joyner BL, Ajao TI. Qualitative analysis of beliefs and perceptions about sudden infant death syndrome in African-American mothers: implications for safe sleep recommendations. J Pediatr 2010; 157 (01) 92-97.e2, e92
- 22 NICHD Safe to Sleep Public Education Campaign. https://www.nichd.nih.gov/sts/Pages/default.aspx . Accessed February 16, 2017
- 23 Legislatures NCoS.. State Approaches to Reducing Health Disparities. http://www.ncsl.org/Portals/1/HTML_LargeReports/HealthDisparity_1.htm . Accessed October 1, 2018, 2018
- 24 Lu MC, Lauver CB, Dykton C. et al. Transformation of the title V maternal and child health services block grant. Matern Child Health J 2015; 19 (05) 927-931
- 25 Dimick JB, Ryan AM. Methods for evaluating changes in health care policy: the difference-in-differences approach. JAMA 2014; 312 (22) 2401-2402
- 26 Kochanek KD, Murphy SL, Xu J, Tejada-Vera B. Deaths: Final Data for 2014. Natl Vital Stat Rep 2016; 65 (04) 1-122
- 27 Moon RY. TASK FORCE ON SUDDEN INFANT DEATH SYNDROME. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. Pediatrics 2016; 138 (05) e20162940