Mobile Health Intervention Improves Adherence to Safe Sleep Practices for Infants

Among mothers of newborns, participation in a mobile health intervention that included receiving frequent educational emails or texts resulted in improved adherence to infant safe sleep practices such as the appropriate sleep position and no soft-bedding use, according to a study published by JAMA.
 
A national public awareness campaign (Back to Sleep) to improve rates of supine infant sleep positioning to reduce the risk of sudden infant death syndrome (SIDS) was successful in halving the U.S. SIDS rate; however, in 2014 there were still approximately 3,500 infant deaths due to SIDS, accidental suffocation or strangulation in bed, or ill-defined causes. Inadequate adherence to recommendations known to reduce the risk of sudden unexpected infant death has contributed to a slowing in the decline of these deaths.
 
Rachel Y. Moon, M.D., of the University of Virginia, Charlottesville, and colleagues assessed the effectiveness of two interventions separately and combined to promote infant safe sleep practices compared with control interventions. The study included 1,600 mothers of healthy term newborns who were randomly assigned to four groups: all participants were beneficiaries of a nursing quality improvement (NQI) campaign in infant safe sleep practices (intervention; targeted initial adherence) or breastfeeding (control), and then received a 60-day mobile health program, in which mothers received frequent emails or text messages containing short videos with educational content about infant safe sleep practices (intervention) or breastfeeding (control) and queries about infant care practices.
 
Of the 1,600 mothers who were randomized, 79 percent completed a study survey (between 2-8 months after study entry). The researchers found that mothers receiving the safe sleep mobile health intervention had higher prevalence of placing their infants supine compared with mothers receiving the control mobile health intervention (89 percent vs 80 percent), room sharing without bed sharing (83 percent vs 70 percent), no soft bedding use (79 percent vs 68 percent), and any pacifier use (69 percent vs 60 percent). The safe sleep NQI intervention alone did not significantly affect any of these outcomes.
 
A limitation of the study was the lost to follow-up rate of 21 percent.
 
“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,” the authors write.
 
(doi:10.1001/jama.2017.8982)