Abstract
BackgroundSudden Unexpected Infant Death (SUID) results in 3400 sleep-related deaths yearly in the United States, yet caregivers’ compliance with safe sleep recommendations remains less than optimal. Paternal caregiver’s attitudes toward infant safe sleep messages are largely unaddressed, despite established differences between female and male caregiver perceptions. This study aimed to explore the determinants of safe sleep practices among male caregivers.MethodsFocus groups were conducted in Arkansas with male caregivers of infants ages 2–12 months to discuss infant sleep routines, parental roles, sources for safe sleep information, and messaging suggestions for safe sleep promotion. The Health Belief Model of behavior change framed a moderator guide. Transcript-based analysis was used, and data were managed using HyperRESEARCH (version 2.8.3). The transcribed data were coded to identify significant themes.ResultsTen focus groups were conducted with 46 participants. Inconsistent adherence to safe sleep practices was reported. Participants were more likely to describe safe location (57% of participants) and supine position behaviors (42%) than an uncluttered bed environment (26%). Caregivers acknowledged the importance of recommended safe sleep behavior, but admitted to unsafe practices, such as co-sleeping and unsafe daytime sleep. Lack of perceived risk, comfort, and/or resources, and disagreement among family members about safety practices were identified as barriers. Participants voiced concerns that current advertising portrays males as incompetent caregivers. Suggestions included portraying positive images of fathers and male caregivers acting to promote safety and the incorporation of statistics about the hazards of unsafe sleep to better engage fathers. Potential distribution venues included sporting events, home improvement and/or automotive stores, and social media from trusted sites (e.g. hospitals or medical professionals).ConclusionsMale caregivers demonstrate some knowledge base about infant sleep safety, but are not fully practicing all aspects of safe sleep. Targeted messaging towards male caregivers that includes factual information and statistics along with representing males in a positive light is desired.
Highlights
Sudden Unexpected Infant Death (SUID) results in 3400 sleep-related deaths yearly in the United States, yet caregivers’ compliance with safe sleep recommendations remains less than optimal
Focus groups (FGs) have proved useful for gathering rich, qualitative data in past studies related to attitudes toward injury prevention and infant safe sleep (Adams et al 2013; Herman et al 2015; Poag et al 2016; Tong et al 2007)
Ten FG sessions were conducted with 2–11 participants in each session
Summary
Sudden Unexpected Infant Death (SUID) results in 3400 sleep-related deaths yearly in the United States, yet caregivers’ compliance with safe sleep recommendations remains less than optimal. Research has found that while female caregivers are more likely to be responsible for nighttime sleep behaviors, male caregivers are more likely to contribute to care during “night time waking” (Moon et al 2010; Tikotzky et al 2015; Ball et al 2000; Goodlin-Jones et al 2001; Tikotzky et al 2011). This suggests that male caregivers make critical decisions regarding sleep environment and positions for intermittent or short-term sleep of the infant. The majority of these fathers (81%) overcame their initial fears and co-slept, citing perceived benefits of triadic cosleeping (mother-father-baby) as a method of strengthening the paternal-child relationship (Ball et al 2000)
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