Factors Associated with Parental Compliance with Supine Infant Sleep: An Integrative Review

Area of Science:

• Public Health
• Pediatrics
• Sociology

Background:

• Sudden Infant Death Syndrome (SIDS) remains a significant concern, with persistent high rates.
• Disparities in SIDS rates are evident, disproportionately affecting low-income and African-American communities.
• Existing educational programs have not fully resolved parental noncompliance with safe sleep recommendations.

Purpose of the Study:

• To investigate the underlying reasons for parental noncompliance with the supine sleep position recommendation for infants.
• To identify factors contributing to low adherence to SIDS prevention guidelines.

Main Methods:

• A comprehensive literature review was conducted across major databases (Cochrane, PubMed, EBSCOhost, CINAHL) from 2002-2014.
• Keywords included SIDS, prevention, parental compliance, supine position, Back to Sleep, and Safe to Sleep campaigns.
• Seventeen studies utilizing surveys, focus groups, interviews, and questionnaires were analyzed.

Main Results:

• Parental knowledge, sources of advice, infant comfort, perceived safety (e.g., choking risk), race/ethnicity, education, and income were major factors in noncompliance.
• Noncompliance was most prevalent among single, less-educated, low-income, and African-American parents.
• Concerns about infant comfort and safety (choking) were significant barriers to supine sleep.

Conclusions:

• Addressing SIDS requires understanding and mitigating barriers related to parental knowledge, trust in advice sources, and socioeconomic factors.
• Targeted interventions are needed for vulnerable populations, including single, less-educated, low-income, and African-American parents.
• Future strategies must consider cultural contexts and address specific parental concerns to improve compliance with safe infant sleep practices.