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


The 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.