Factors Associated with Parental Compliance with Supine Infant Sleep: An Integrative Review
Kristyn Zundo, Elizabeth A. Richards, Azza H. Ahmed, and Jennifer A. Codington
Despite educational programs, sudden infant death syndrome (SIDS) rates remain
unacceptably high, especially among low-income and African-American populations.
The purpose of this review is to examine reasons for parental noncompliance
with supine sleep recommendations. A database search in Cochrane Database of
Systematic Reviews, PubMed, EBSCOhost, and CINAHL was conducted using
keywords SIDS, prevention and control, parental compliance, nursing, supine position,
Back to Sleep campaign, and Safe to Sleep campaign. Literature was included
from 2002 to 2014. Types of studies included randomized control trials, literature
reviews, and descriptive studies. Literature from academic journals was also
included. Included literature discussed parental knowledge, the Back to Sleep and
the Safe to Sleep campaigns, compliance with recommendations from the
American Academy of Pediatrics (AAP), and interventions and education.
Seventeen studies were included that used data collection methods, including surveys,
focus groups, face-to-face interviews, and questionnaires. Major trends identified
as being associated with noncompliance included parent knowledge, sources
of advice, infant comfort and quality of infant sleep, safety concerns (i.e., choking),
race/ethnicity, education level, and income. Noncompliance was highest among
single, less-educated, low-income, or African-American parents.