Assessment of Safe Sleep: Validation of the Parent Newborn Sleep Safety Survey.
Leanne Whiteside-Mansell, Rosemary Nabaweesi, Alison Rose Caballero, Samantha Hope Mullins, Beverly Kaye Miller, Mary Elizabeth Aitken
Author Information
Leanne Whiteside-Mansell: Department of Family and Community Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States. Electronic address: WhitesideMansellLeanne@uams.edu.
Rosemary Nabaweesi: Center for Applied Research and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences, and Injury Prevention Center, Arkansas Children's Hospital, Little Rock, AR, United States.
Alison Rose Caballero: Arkansas Children's Hospital, Little Rock, AR, United States.
Samantha Hope Mullins: Center for Applied Research and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences, and Injury Prevention Center, Arkansas Children's Hospital, Little Rock, AR, United States.
Beverly Kaye Miller: Center for Applied Research and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences, and Injury Prevention Center, Arkansas Children's Hospital, Little Rock, AR, United States.
Mary Elizabeth Aitken: Center for Applied Research and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences, and Injury Prevention Center, Arkansas Children's Hospital, Little Rock, AR, United States.
PURPOSE: Sudden Infant Death Syndrome (SIDS) and suffocation account for more than half of all Sudden Unexpected Infant Deaths (SUID). The American Academy of Pediatrics (AAP) recommendations describe the safest environments to protect infants. This study compared parent responses on the Newborn Sleep Safety Survey and observational assessments (N=72) of infant sleep environments in families thought to be at high-risk for non-compliance with AAP recommendations. DESIGN AND METHODS: A naturalistic study of participants enrolled in two home visitation support programs was used. Observed risks ranged from 36.6% (never use pacifier) to 4.3% (never use firm mattress). RESULTS: Results comparing report to observation demonstrated acceptable concordance. Five items had fair concordance (Kappa>.4), four showed moderate concordance (Kappa>.6), and one excellent concordance (Kappa>.8). Although direct observation of safety behaviors is the gold standard in the injury prevention field, direct observation is logistically difficult, time consuming, and costly. CONCLUSIONS: Research and interventions aimed at a reduction of Sudden Infant Death Syndrome (SIDS) and suffocation require accurate assessment of the infant sleep environment. This study provides acceptable evidence for the use of the Newborn Sleep Safety Survey as an alternative to direct observation to assess parent adherence to recommendations. Limitations are discussed. PRACTICAL IMPLICATIONS: This study provided evidence of the usefulness of the Newborn Sleep Safety Survey, a parent survey of infant sleep environments. This tool will provide medical and research professionals a reliable, inexpensive tool to evaluation of the quality of sleep environments using a standard definition.
