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Dissertation FINAL VERSION 070816.pdf (6.39 MB)

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Infant Safe Sleep in Ohio: Where Do Prenatal and Postnatal Healthcare Providers Fit In?

Hodges, Nichole Laureen
http://rave.ohiolink.edu/etdc/view?acc_num=osu1467982677

Abstract Details

2016, Doctor of Philosophy, Ohio State University, Public Health.
Introduction: Sudden infant death syndrome (SIDS) and sleep-related sudden unexpected infant death (SUID) are among the leading causes of infant mortality in the United States (U.S.) and are associated with significant health disparity. Healthcare professionals can influence their patients’ infant safe sleep choices; however, little is known about the practices of prenatal and postnatal healthcare providers related to this topic. The purpose of this study was to assess the infant safe sleep knowledge, attitudes, and behaviors of lactation consultants, obstetric physicians, and certified nurse midwives (CNMs) in Ohio and identify barriers and enabling/reinforcing factors associated with providing infant safe sleep education in the obstetric environment. Methods: A mixed-methods approach was used. Focus groups were held with certified lactation consultants in Ohio to discuss their role and the advice they provide to women about infant safe sleep and reducing the risk of SIDS and other causes of infant sleep-related death. Cross-sectional surveys were conducted with physicians and CNMs. Surveys were sent to a census of all licensed physicians in the registry of the State Medical Board of Ohio with “obstetrics,” “obstetrics and gynecology,” or “maternal and fetal medicine” as their first area of specialty (n=1,771) as well as all nurses included in the licensing registry of the Ohio Board of Nursing as a CNM (n=333). Results: Four focus groups were held with certified lactation consultants (n=22). Major themes that emerged included: lactation consultants’ belief in the importance of bedsharing for supporting breastfeeding; frustration with policies that prohibit lactation consultants from discussing bedsharing with clients; and the impact of employer policies on the advice they provide while on the job. Preliminary findings from the focus groups were discussed and checked with a subgroup of participants to ensure the credibility of the findings. Response rates for the obstetric physician and CNM surveys were 30% and 55%, respectively. Most participants were relatively knowledgeable about the American Academy of Pediatrics’ (AAP) infant safe sleep recommendations. CNMs were more likely than physicians to express positive attitudes about providing infant safe sleep education and to report that they regularly discuss this topic with their patients. Greater knowledge, positive attitudes, and prior SIDS training were significant predictors of whether respondents provided infant safe sleep education to their patients. The majority of survey participants perceived barriers to providing infant safe sleep education in the obstetric environment, but many expressed interest in doing so. Discussion: Prenatal and postnatal healthcare providers interact with expectant mothers and mothers of newborns at a critical time for infant safe sleep decision-making. This study reveals that mothers may not be receiving messages from lactation consultants that are consistent with the AAP’s infant safe sleep recommendations. Also, although many obstetric physicians and CNMs had knowledge about the topic, most are not regularly recommending infant safe sleep information to their patients. More should be done to ensure that expectant mothers and mothers of newborns are receiving frequent infant safe sleep advice from their healthcare providers and that the information is consistent with the recommendations of the AAP.
Mira Katz (Advisor)
Sarah Anderson (Committee Member)
Lara McKenzie (Committee Member)
Mary Ellen Wewers (Committee Member)
270 p.
Health Care; Nursing; Obstetrics; Public Health
infant mortality; infant safe sleep; SIDS

Recommended Citations

Citations

  • Hodges, N. L. (2016). Infant Safe Sleep in Ohio: Where Do Prenatal and Postnatal Healthcare Providers Fit In? [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1467982677

    APA Style (7th edition)

  • Hodges, Nichole. Infant Safe Sleep in Ohio: Where Do Prenatal and Postnatal Healthcare Providers Fit In? 2016. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1467982677.

    MLA Style (8th edition)

  • Hodges, Nichole. "Infant Safe Sleep in Ohio: Where Do Prenatal and Postnatal Healthcare Providers Fit In?" Doctoral dissertation, Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1467982677

    Chicago Manual of Style (17th edition)

osu1467982677
299
© 2016, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.