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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Mediators of Improved Adherence to Infant Safe Sleep Using a Mobile Health Intervention
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Mediators of Improved Adherence to Infant Safe Sleep Using a Mobile Health Intervention

机译：使用移动健康干预改善婴儿安全睡眠的介面

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摘要

This mediation analysis was conducted to determine mediators of improvements in infant SS practices in an effective mHealth intervention. OBJECTIVES:To determine mediators of improvements in infant safe-sleep (SS) practices in a mobile health intervention.METHODS:In a cluster-randomized controlled trial, mothers received SS intervention or breastfeeding control videos for 60 days. Maternal responses about infant sleep position and location (outcomes) and mediators (attitudes, perceived social norms, and perceived control) from the theory of planned behavior were assessed. Intervention effects on mediators and association between mediators and outcomes were examined.RESULTS:Of 1600 recruited, 1263 mothers participated. Mothers receiving SS videos were more likely to have positive attitudes and norms for supine sleep (attitudes: adjusted odds ratio [aOR] = 2.35 [95% confidence interval (CI) 1.72 to 3.20]; norms: aOR = 1.75 [95% CI 1.27 to 2.42]) and recommended sleep location (attitudes: aOR = 1.91 [95% CI 1.54 to 2.36]; norms: aOR = 1.37 [95% CI 1.13 to 1.66]). Positive attitudes and norms toward supine sleep and room-sharing without bed-sharing were associated with higher odds of both practices (supine: aOR = 8.25 [95% CI 4.72 to 14.43] for positive attitudes and aOR = 6.67 [95% CI 4.25 to 10.46] for norms; room-sharing: aOR = 7.14 [95% CI 5.35 to 9.53] for positive attitudes and aOR = 4.44 [95% CI 3.03 to 6.51] for norms). Both positive attitudes and positive norms mediated the effect of the intervention.CONCLUSIONS:The intervention achieved success in improving adherence to SS recommendations by changing maternal attitudes and norms about supine sleeping and room-sharing without bed-sharing. Recognition that these attitudes and norms appear to be the main drivers of mothers' choices regarding infant-sleep practices should inform health messaging strategies to promote SS.
机译：进行了这种调解分析，以确定有效的MHealth干预中婴儿SS实践的改善介质。目标：在移动健康干预中确定婴儿安全睡眠（SS）实践的改进的调解员。方法：在群集随机对照试验中，母亲接受了SS干预或母乳喂养控制视频60天。评估了关于婴儿睡眠地位和地点（结果）的母体响应以及计划行为理论的介质（结果）和调解员（态度，感知的社会规范和感知控制）。审查了对调解员和结果与结果的干预影响。结果：1600人招募，1263名母亲参加。接收SS视频的母亲更有可能具有仰卧睡眠的阳性态度和规范（态度：调整后的差距[AOR] = 2.35 [95％置信区间（CI）1.72至3.20]; AOR = 1.75 [95％CI 1.27 [95％CI 1.27到2.42]）和推荐的睡眠位置（态度：AOR = 1.91 [95％CI 1.54至2.36];规范：AOR = 1.37 [95％CI 1.13至1.66]）。对于没有床分享的仰卧睡眠和房间共享的阳性态度和准则与两种实践的几率较高有关（仰卧：AOR = 8.25 [95％CI 4.72至14.43]，用于阳性态度和AOR = 6.67 [95％CI 4.25至10.46]对于规范;房间共享：AOR = 7.14 [95％CI 5.35至9.53]，用于阳性态度和AOR = 4.44 [95％CI 3.03至6.51]的规范）。阳性态度和阳性规范介导干预的效果。结论：干预取得了成功通过改变孕产妇态度和规范，在没有床上分享的情况下改变孕产妇态度和规范，改善纯睡眠和规范。认识到这些态度和规范似乎是母亲的主要驱动因素，母亲的睡眠实践应该告知卫生消息传递战略促进SS。

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