Racial and Educational Disparities in Adherence to Safe Sleep Recommendations : Knowledge and Behavior in Kalamazoo

Abstract

Black infant deaths occurring in unsafe sleep environments is a pertinent issue in Kalamazoo. The Black infant sleep-related death rate is 3 times higher than the White infant rate. Though the American Academy of Pediatrics has recommended safe sleep practices and the overall infant mortality rate (IMR) has decreased, there is still a persistent disparity. This study is part of a larger study evaluating the efficacy of motivational interviewing for home visitors to talk to their clients effectively about infant safe sleep; the current study examines whether self-reported knowledge of safe sleep recommendations and adherence to safe sleep behaviors differ by race and education level. Participants (N = 56) completed a demographics questionnaire and a pre-test questionnaire with subscores for knowledge, attitudes, behavior, and barriers for safe sleep. Data were analyzed in SPSS with 2 (Education Level: £ high school vs. > high school) x 2 (Race: Black vs. White) between-subjects factorial analyses of variance where knowledge and behavior subscores were the dependent variables, a paired-samples t-test evaluating differences between knowledge and behaviors, and Pearson’s r correlations of knowledge and behavior. Data show that there were no differences between knowledge and behavior scores, and that overall level knowledge and behavior scores are associated; furthermore, on average, mothers had similar knowledge scores and behavior scores, regardless of race or education level. These results reveal that there may be factors beyond race and education level that play a role in the Black-White IMR disparity. Overall, despite the Black-White IMR disparity, participants in this homevisiting-client sample appears to not differ in safe sleep recommendation knowledge and behaviors.