Effective intervention will target barriers, high-risk groups
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Mobile health interventions targeting mothers of healthy newborns significantly improved safe sleep practices, compared with controls, in a randomized trial of 1,600 mothers published online July 25 in JAMA.

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In the Social Media and Risk-Reduction Training (SMART) study to assess the effectiveness of mobile intervention on safe sleep practices, the researchers randomized 1,600 mothers affiliated with 16 hospitals nationwide to four groups: breastfeeding nursing quality intervention (NQI) and breastfeeding mobile health intervention (mHealth); safe sleep NQI, and breastfeeding mHealth; breastfeeding NQI and safe sleep mHealth; or safe sleep NQI and safe sleep mHealth. The mHealth intervention consisted of daily messages and videos for the first 11 days and then every 3-4 days for 60 days; the content was about safe sleep for infants (intervention) or about breastfeeding (control).

A total of 1,263 mothers completed the study, and mothers who received the mobile messages about safe sleep were significantly more likely than those who received the control messages to engage in safe sleep practices, including placing babies on their backs (89% vs. 80%), sharing a room without cosleeping (83% vs. 70%), avoiding the use of soft bedding (79% vs. 68%), and use of pacifiers (69% vs. 60%). The initial nursing quality intervention alone had no significant impact on any of the safe sleep practices, the researchers noted.

The results were limited by several factors, including the 21% lost to follow up and lack of data on adverse events and clinical outcomes, the researchers said. However, the results suggest that mobile messages could be cost effective and easily implemented by hospitals.

“Furthermore, because the rates of opening and viewing messages in this study were consistently higher than 50%, and almost all adults now have cell phones or email access, it is likely that this type of intervention would be feasible and well received by parents,” Dr. Moon and her associates added. “Whether widespread implementation is feasible or if it reduces sudden and unexpected infant death rates remains to be studied.”

“The messages and videos were timed to address challenges and questions that arise at specific time points; therefore, providing this additional information to parents at critical times may have been important in assuaging concerns about adherence to recommended practices. Furthermore, receiving frequent videos and email or text messages may have served as a virtual support system for mothers, reinforcing safe parental practices,” Dr. Moon and her associates noted.

The researchers had no financial conflicts to disclose. The study was supported in part by the National Institute of Child Health and Human Development and by the CJ Foundation for SIDS.

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In this study by Dr. Moon and her associates, new mothers who received both the nursing educational intervention and mobile intervention for safe sleep reported the highest percentages for adhering to safe sleep practices, and moms who received the safe sleep mobile intervention alone had the second-highest percentages.

However, the study was underpowered and too short termed to determine whether this intervention actually will reduce the occurrence of SIDS.

Limitations of this study include that the mothers who did not respond at follow-up were more likely to be younger, black, single, and less educated – all risk factors for SIDS. The study also was restricted to healthy term infants, and preterm babies are another high-risk SIDS group.

Nonetheless, the fact that this study chose to use multifaceted approaches was promising, combining “health messaging, education of health care professionals, and interventions aimed at reducing barriers to safe sleep practices for infant caregivers.” Whatever interventions are tried, they “need to be adapted for implementation among the highest-risk groups such as non-Hispanic black, American Indian, and Alaskan Native mothers and families because these are the populations with the highest rates of SIDS and sleep-related infant death.”
 

Carrie K. Shapiro-Mendoza, PhD, MPH is affiliated with the division of reproductive health at the Centers for Disease Control and Prevention in Atlanta, Georgia. She commented in an editorial accompanying the report by Moon et al. (JAMA. 2017;318:336-8). Dr. Shapiro-Mendoza had no financial conflicts to disclose.

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In this study by Dr. Moon and her associates, new mothers who received both the nursing educational intervention and mobile intervention for safe sleep reported the highest percentages for adhering to safe sleep practices, and moms who received the safe sleep mobile intervention alone had the second-highest percentages.

However, the study was underpowered and too short termed to determine whether this intervention actually will reduce the occurrence of SIDS.

Limitations of this study include that the mothers who did not respond at follow-up were more likely to be younger, black, single, and less educated – all risk factors for SIDS. The study also was restricted to healthy term infants, and preterm babies are another high-risk SIDS group.

Nonetheless, the fact that this study chose to use multifaceted approaches was promising, combining “health messaging, education of health care professionals, and interventions aimed at reducing barriers to safe sleep practices for infant caregivers.” Whatever interventions are tried, they “need to be adapted for implementation among the highest-risk groups such as non-Hispanic black, American Indian, and Alaskan Native mothers and families because these are the populations with the highest rates of SIDS and sleep-related infant death.”
 

Carrie K. Shapiro-Mendoza, PhD, MPH is affiliated with the division of reproductive health at the Centers for Disease Control and Prevention in Atlanta, Georgia. She commented in an editorial accompanying the report by Moon et al. (JAMA. 2017;318:336-8). Dr. Shapiro-Mendoza had no financial conflicts to disclose.

Body

 

In this study by Dr. Moon and her associates, new mothers who received both the nursing educational intervention and mobile intervention for safe sleep reported the highest percentages for adhering to safe sleep practices, and moms who received the safe sleep mobile intervention alone had the second-highest percentages.

However, the study was underpowered and too short termed to determine whether this intervention actually will reduce the occurrence of SIDS.

Limitations of this study include that the mothers who did not respond at follow-up were more likely to be younger, black, single, and less educated – all risk factors for SIDS. The study also was restricted to healthy term infants, and preterm babies are another high-risk SIDS group.

Nonetheless, the fact that this study chose to use multifaceted approaches was promising, combining “health messaging, education of health care professionals, and interventions aimed at reducing barriers to safe sleep practices for infant caregivers.” Whatever interventions are tried, they “need to be adapted for implementation among the highest-risk groups such as non-Hispanic black, American Indian, and Alaskan Native mothers and families because these are the populations with the highest rates of SIDS and sleep-related infant death.”
 

Carrie K. Shapiro-Mendoza, PhD, MPH is affiliated with the division of reproductive health at the Centers for Disease Control and Prevention in Atlanta, Georgia. She commented in an editorial accompanying the report by Moon et al. (JAMA. 2017;318:336-8). Dr. Shapiro-Mendoza had no financial conflicts to disclose.

Title
Effective intervention will target barriers, high-risk groups
Effective intervention will target barriers, high-risk groups

 

Mobile health interventions targeting mothers of healthy newborns significantly improved safe sleep practices, compared with controls, in a randomized trial of 1,600 mothers published online July 25 in JAMA.

Halfpoint/thinkstock
In the Social Media and Risk-Reduction Training (SMART) study to assess the effectiveness of mobile intervention on safe sleep practices, the researchers randomized 1,600 mothers affiliated with 16 hospitals nationwide to four groups: breastfeeding nursing quality intervention (NQI) and breastfeeding mobile health intervention (mHealth); safe sleep NQI, and breastfeeding mHealth; breastfeeding NQI and safe sleep mHealth; or safe sleep NQI and safe sleep mHealth. The mHealth intervention consisted of daily messages and videos for the first 11 days and then every 3-4 days for 60 days; the content was about safe sleep for infants (intervention) or about breastfeeding (control).

A total of 1,263 mothers completed the study, and mothers who received the mobile messages about safe sleep were significantly more likely than those who received the control messages to engage in safe sleep practices, including placing babies on their backs (89% vs. 80%), sharing a room without cosleeping (83% vs. 70%), avoiding the use of soft bedding (79% vs. 68%), and use of pacifiers (69% vs. 60%). The initial nursing quality intervention alone had no significant impact on any of the safe sleep practices, the researchers noted.

The results were limited by several factors, including the 21% lost to follow up and lack of data on adverse events and clinical outcomes, the researchers said. However, the results suggest that mobile messages could be cost effective and easily implemented by hospitals.

“Furthermore, because the rates of opening and viewing messages in this study were consistently higher than 50%, and almost all adults now have cell phones or email access, it is likely that this type of intervention would be feasible and well received by parents,” Dr. Moon and her associates added. “Whether widespread implementation is feasible or if it reduces sudden and unexpected infant death rates remains to be studied.”

“The messages and videos were timed to address challenges and questions that arise at specific time points; therefore, providing this additional information to parents at critical times may have been important in assuaging concerns about adherence to recommended practices. Furthermore, receiving frequent videos and email or text messages may have served as a virtual support system for mothers, reinforcing safe parental practices,” Dr. Moon and her associates noted.

The researchers had no financial conflicts to disclose. The study was supported in part by the National Institute of Child Health and Human Development and by the CJ Foundation for SIDS.

 

Mobile health interventions targeting mothers of healthy newborns significantly improved safe sleep practices, compared with controls, in a randomized trial of 1,600 mothers published online July 25 in JAMA.

Halfpoint/thinkstock
In the Social Media and Risk-Reduction Training (SMART) study to assess the effectiveness of mobile intervention on safe sleep practices, the researchers randomized 1,600 mothers affiliated with 16 hospitals nationwide to four groups: breastfeeding nursing quality intervention (NQI) and breastfeeding mobile health intervention (mHealth); safe sleep NQI, and breastfeeding mHealth; breastfeeding NQI and safe sleep mHealth; or safe sleep NQI and safe sleep mHealth. The mHealth intervention consisted of daily messages and videos for the first 11 days and then every 3-4 days for 60 days; the content was about safe sleep for infants (intervention) or about breastfeeding (control).

A total of 1,263 mothers completed the study, and mothers who received the mobile messages about safe sleep were significantly more likely than those who received the control messages to engage in safe sleep practices, including placing babies on their backs (89% vs. 80%), sharing a room without cosleeping (83% vs. 70%), avoiding the use of soft bedding (79% vs. 68%), and use of pacifiers (69% vs. 60%). The initial nursing quality intervention alone had no significant impact on any of the safe sleep practices, the researchers noted.

The results were limited by several factors, including the 21% lost to follow up and lack of data on adverse events and clinical outcomes, the researchers said. However, the results suggest that mobile messages could be cost effective and easily implemented by hospitals.

“Furthermore, because the rates of opening and viewing messages in this study were consistently higher than 50%, and almost all adults now have cell phones or email access, it is likely that this type of intervention would be feasible and well received by parents,” Dr. Moon and her associates added. “Whether widespread implementation is feasible or if it reduces sudden and unexpected infant death rates remains to be studied.”

“The messages and videos were timed to address challenges and questions that arise at specific time points; therefore, providing this additional information to parents at critical times may have been important in assuaging concerns about adherence to recommended practices. Furthermore, receiving frequent videos and email or text messages may have served as a virtual support system for mothers, reinforcing safe parental practices,” Dr. Moon and her associates noted.

The researchers had no financial conflicts to disclose. The study was supported in part by the National Institute of Child Health and Human Development and by the CJ Foundation for SIDS.

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Key clinical point: Email and text messages effectively communicated safe infant sleep practices to mothers.

Major finding: Overall, 89% of mothers who received mobile messages about safe sleep placed babies on their backs to sleep, compared with 80% of mothers who received control messages.

Data source: The data come from a randomized trial of 1,600 mothers with healthy newborns.

Disclosures: The researchers had no financial conflicts to disclose. The study was supported in part by the National Institute of Child Health and Human Development and by the CJ Foundation for SIDS.

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