A Decade of Empowerment: Strengthening Safe Sleep Awareness Among Black Birthing People

To evaluate Black birthing people's knowledge of American Academy of Pediatrics (AAP) infant safe sleep recommendations over time in the context of a substantial, county-wide, tailored public health initiative against infant mortality.

This is a nested case-control study within a prospective cohort of N = 606 adult birthing people who delivered at a single academic medical center between 2011 and 2022. The outcome of interest was knowledge of the AAP infant safe sleep recommendations which was determined by participants demonstrating knowledge of five factors. We separated data according to the bimodal distribution of responses: 2011-2014 and 2019-2022. We used Chi square analysis to evaluate change in demonstrated knowledge of AAP guidelines over time for each race. We utilized binomial logistic regression modeling to determine crude odds ratios and calculated 95% confidence intervals to quantify the relationship between the outcome and demographic variables.

We found both the non-Hispanic Black and non-Hispanic White groups significantly increased demonstrated knowledge of AAP recommendations over time (p = .01 and p < .01 respectively). In the pre-intervention period, non-Hispanic Black birthing people were significantly less likely to demonstrate knowledge than non-Hispanic White birthing people (OR 0.52 95% CI [0.31-0.85]). In the post-intervention period, there was no significant difference in demonstrated knowledge between non-Hispanic Black and non-Hispanic White birthing people (OR 0.36 95% CI [0.13-1.03]).

Our results provide insight into the potential impact of robust infant mortality public health initiatives on the awareness of safe sleep recommendations in birthing people within Hamilton County, Ohio.