The Study of Attitudes and Factors Effecting Infant Care Practices (SAFE)

SAFEThe purpose of this project is to evaluate trends in infant sleep practices and the adoption of the American Academy of Pediatrics’ and the Public Health Service’s “Back to Sleep” recommendations to reduce the risk of Sudden Infant Death Syndrome (SIDS). Expanding on past studies, this study will examine in greater depth the factors influencing these trends and the racial disparity in adoption of safe sleep practices. The study involves the recruitment of a nationally representative sample of 1,000 new mothers, annually for 3 years, from 32 statistically selected U.S. maternity hospitals. The recruitment includes an over-sampling of African-Americans, who traditionally have exhibited lower adherence to safe sleep recommendations and higher rates of SIDS. Mothers, after being consented at the hospital by our recruiters, are directed to go to our website when the baby is between 2-4 months of age to complete an in-depth survey. Mothers without internet access can complete the survey by phone.

The SAFE study surveys mothers about infant care practices that influence SIDS risk, including sleep position, bed sharing, and pacifier use. Not only will this approach result in a national probability sample of new mothers, it will also provide a sufficiently large sample of African-American mothers for separate analysis. The newly designed survey, based on the Theory of Planned Behavior, will institute specific methodologies designed to illuminate risk factors for non-adherence, particularly in the vulnerable socioeconomic and minority populations. With this approach, we will: 1) evaluate national trends and trends within specific vulnerable populations with regard to recommended infant sleep practices (supine sleep position, not sharing a bed, and use of pacifier); and 2) ascertain determinants of caregivers’ intentions and practices in relation to safe sleep recommendations.


CorwinMichael J. Corwin, M.D., Principal Investigator
Senior Epidemiologist, Slone Epidemiology Center
Associate Professor of Pediatrics and Epidemiology,
Boston University Schools of Medicine and Public Health



ColsonEve R. Colson, M.D., Co-Investigator
Director of Newborn Nursery, Yale New Haven Hospital
Associate Professor of Pediatrics, Yale University School of Medicine




Study Staff:

SAFE Staff

Counterclockwise from bottom

Jane Sheehan, R.N., M.S., Project Coordinator
Nicole Geller, M.P.H., Project Coordinator
Dena Margolis, B.A., Research Assistant



Not pictured

Taylor Platt, B.A., Research Assistant
Gabrielle Fortier, Research Assistant
Lisa Crowell, Interviewer
Laine Fletcher, Spanish Interviewer
Monica Martinez-Dale, Spanish Interviewer

    Source of Funding:

    Eunice Kennedy Shriver National Institute of Child Health and Human Development

    Study Period:

    August 2009 to July 2014

    • Baylor University Medical Center, TX
    • Baystate Medical Center, MA
    • Ben Taub General Hospital, TX
    • Bethesda Memorial Hospital, FL
    • Brookdale Hospital and Medical Center, NY
    • Camden-Clark Memorial Hospital, WV
    • Delaware County Memorial Hospital, PA
    • Geisinger Regional Medical Center, PA
    • Genesys Regional Medical Center, MI
    • Hamilton Medical Center, GA
    • Jersey Shore University Medical Center, NJ
    • Johns Hopkins Hospital and Medical Center, MD
    • Kaweah Delta Health Care District, CA
    • Lake Charles Memorial Hospital, LA
    • Medical Center of Arlington, TX
    • Moreno Valley Community Hospital, CA
    • Mount Carmel, OH
    • Nashville General Hospital, TN
    • Natchitoches Regional Medical Center, LA
    • Northcrest Medical Center, TN
    • Riverside County Regional Medical Center, CA
    • Riverside Regional Medical Center, VA
    • Rush-Copley Medical Center, IL
    • Saint Francis Hospital and Medical Center, CT
    • Saint Joseph Hospital, CA
    • Saint Mary’s Health Care, MI
    • Socorro General Hospital, NM
    • Sutter Roseville Medical Center, CA
    • Tacoma General Hospital, WA
    • Texas Health Presbyterian Hospital Plano, TX
    • University of California, Davis Medical Center, CA
    • Wheaton Franciscan Healthcare, WI

    Please contact Nicole Geller:

    Slone Epidemiology Center
    ATTN: Study of Attitudes and Factors Effecting Infant Care Practices
    1010 Commonwealth Avenue –- 4th Floor
    Boston, Massachusetts 02215-1201

    Phone: (617) 734-6006