Social Media and Risk-reduction Training for Infant Care Practices (SMART)

The purpose of this project is to address serious and ongoing challenges related to adherence to public health recommendations known to reduce the risk of Sudden Unexpected Infant Deaths. Adherence has reached a plateau at an unacceptably low level leading to a halt in the decline in infant mortality and a widening in the racial disparity in infant mortality.

This project is a collaborative effort that will capitalize on the extensive experience of the investigators in studying barriers to adherence to safe sleep practices to develop two complementary, culturally competent, intervention strategies and to test the effectiveness of each strategy as well as both strategies in combination. Innovative aspects of the Social Media and Risk-reduction Training of Infant Care Practices (SMART) study include its: 1) unique collaboration of leaders in the field; 2) leveraging of the currently operational Study of Attitudes and Factors Effecting Infant Care Practices (SAFE) study infrastructure and hospitals; 3) use of two complementary interventions with the potential for synergistic impact; 4) use of social marketing strategies; 5) use of mobile technology (mHealth) to deliver messages; and 6) collaboration with community resources and expertise.

The SMART study will have four arms in which 16 hospitals are randomly assigned to one of the following study groups: 1) Safe Sleep Nursery Education and Breastfeeding mHealth messaging; 2) Breastfeeding Nursery Education and Safe Sleep mHealth messaging; 3) Safe Sleep Nursery Education and Safe Sleep mHealth messaging; 4) Breastfeeding Nursery Education and Breastfeeding mHealth messaging. A total of 1600 mothers will be recruited (100/hospital), with 400 in each study group. Consented mothers will then complete the follow-up survey, either online or over the phone, once their baby is between 2-5 months of age.  The survey asks about past, current, and anticipated future behavior in relation to infant care practices (including feeding and sleep practices).

The primary aim is to assess the effectiveness of the interventions aimed at promoting safe sleep practices compared with the breastfeeding control interventions. The secondary aim is to assess potential mediating factors that may explain the intervention effects on infant care practices and that may inform areas for future improved intervention approaches. With the successful completion of the SMART study, effectiveness data will have been provided for two practical interventions to improve adherence to safe sleep practices that could be disseminated nationally in multiple diverse settings.


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

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

Fern R. Hauk, M.D., M.S.
Principal Investigator
Director, International Family Medicine Clinic, University of Virginia
Professor of Family Medicine and Public Health Sciences, University of Virginia

Rachel Y. Moon, M.D.
Principal Investigator
Associate Chief, Division of General Pediatrics and Community Health,
Children’s National Medical Center
Director, Academic Development, Children’s National Medical Center
Professor of Pediatrics, George Washington University School of Medicine and Health Sciences

Ann Kellams, M.D., F.A.A.P., I.B.C.L.C., F.A.B.M.
Medical Director of the Newborn Nursery and Breastfeeding Medicine Program,
University of Virginia
Assistant Professor, Department of Pediatrics, University of Virginia

Study Staff:

Boston University:
Lisa Crowell, R.N., Project Coordinator
Nicole Geller, M.P.H., Project Coordinator

Children’s National Medical Center:
Brandi Joyner, M.S.A., Research Assistant

University of Virginia
Kawai Tanabe, M.P.H., Research Assistant

Source of Funding:

Eunice Kennedy Shriver National Institute of Child Health and Human Development

Study Period:

September 2012 to May 2017

Please contact Nicole Geller:

Slone Epidemiology Center
1010 Commonwealth Avenue –- 4th Floor
Boston, Massachusetts 02215-1201

Phone: (617) 734-6006