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Eve R. Colson, MD; Sharon Cohen Joslin, MSN, APRN, IBCLC, NNP

Arch Pediatr Adolesc Med. 2002;156:717-720.

Objective  To determine whether an educational intervention to change nursery practice would result in more inner-city parents placing their infants in the supine position for sleep.

Design  We conducted semistructured interviews at the 2-week health supervision visit with 1 convenience sample of parents before and a different convenience sample of parents after an educational intervention was conducted to change nursery practice in positioning infants for sleep.

Setting  University hospital clinic located in an urban setting.

Participants  Parents of 2-week-old infants at their first health supervision visit in an urban, university-affiliated clinic. All parents who were approached agreed to participate.

Intervention  Nurses were instructed to place infants exclusively in the supine position in the nursery and to instruct parents to exclusively place infants in the supine sleeping position at home.

Main Outcome Measure  The usual sleeping position in which parents reported placing their 2-week old infants.

Results  Before the intervention, 41% of parents reported that a clinician had told them to place their infants to sleep in the supine position compared with 81% after the intervention (odds ratio [OR], 6.1; 95% confidence interval [CI], 3.1-12.3). Before the intervention, 37% of parents reported that the nursery staff placed their infants to sleep in the supine position, compared with 88% after the intervention (OR, 12.5; 95% CI, 5.7-27.7). Before the intervention, 42% of parents reported that they usually placed their infants to sleep in the supine position at home compared with 75% after the intervention (OR, 4.2; 95% CI, 2.1-7.9).

Conclusion  After an educational intervention to change practice in a well-newborn nursery, many more parents reported placing their infants in the supine position for sleep, which suggests that such an intervention may have an impact on the position in which parents place their children to sleep.

From the Department of Pediatrics, Yale University School of Medicine (Dr Colson); Yale New Haven Hospital (Ms Joslin); and Yale University School of Nursing (Ms Joslin), New Haven, Conn.

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