NCT01713868

Brief Summary

The goal of this proposal is to address serious and ongoing challenges related to adherence to public health recommendations known to reduce the risk of SIDS. Adherence has reached a plateau at an unacceptably low level both in the overall US population and especially in Black infants leading to a halt in the decline in infant mortality and a widening in the racial disparity in infant mortality. The current proposal is a collaborative effort that will capitalize on the extensive experience of the investigators in studying barriers to adherence to safe sleep practices to develop two complementary, culturally competent, intervention strategies and to test the effectiveness of each strategy as well as both strategies in combination. Innovative aspects of the Social Media and Risk-reduction Training of Infant Care Practices (SMART) study include its: 1) unique collaboration of leaders in the field; 2) leveraging of the currently operational infant care practices study infrastructure and hospitals; 3) use of two complementary interventions with the potential for synergistic impact; 4) use of social marketing strategies;5) use of mobile technology (mHealth) to deliver messages; and 6) collaboration with community resources and expertise. The SMART study will have four arms in which 16 hospitals are randomly assigned to one of the following study groups: 1) Safe Sleep Nursery Education and Breastfeeding mHealth messaging; 2) Breastfeeding Nursery Education and Safe Sleep mHealth messaging; 3) Safe Sleep Nursery Education and Safe Sleep mHealth messaging; 4) Breastfeeding Nursery Education and Breastfeeding mHealth messaging. A total of 1600 mothers will be recruited (100/hospital), with 400 in each study group. The primary aim is to assess the effectiveness of the interventions aimed at promoting safe sleep practices compared with the breastfeeding control interventions. The secondary aim is to assess potential mediating factors that may explain the intervention effects on infant care practices and that may inform areas for future improved intervention approaches. With the successful completion of the SMART study, effectiveness data will have been provided for two interventions to improve adherence to safe sleep practices that are practical to disseminate nationally in multiple diverse settings.

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,600

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Mar 2015

Typical duration for not_applicable

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 19, 2012

Completed
6 days until next milestone

First Posted

Study publicly available on registry

October 25, 2012

Completed
2.3 years until next milestone

Study Start

First participant enrolled

March 1, 2015

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2016

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2017

Completed
1.3 years until next milestone

Results Posted

Study results publicly available

January 3, 2019

Completed
Last Updated

January 11, 2019

Status Verified

January 1, 2019

Enrollment Period

1.6 years

First QC Date

October 19, 2012

Results QC Date

November 14, 2018

Last Update Submit

January 9, 2019

Conditions

Keywords

BreastfeedingSafe SleepMessagingSocial Media

Outcome Measures

Primary Outcomes (4)

  • Adherence With Recommended Supine Sleep Position

    Hypothesis:For supine sleep position, when controlling for other variables, there will be: a) an increased adherence for mothers who received Safe Sleep Nursery Education; b) an increased adherence for mothers who received Safe Sleep mHealth messaging; and c) compared to mothers who received either Safe Sleep Nursery Education or Safe Sleep mHealth messaging alone, an increased adherence for mothers who received both Safe Sleep Nursery Education and Safe Sleep mHealth messaging. Outcome measures will be assessed by survey conducted when the infant is 2-5 months of age.

    6 months

  • Adherence With Recommended Roomsharing Without Bed Sharing

    Hypothesis: For roomsharing without bed sharing, when controlling for other variables, there will be: a) an increased adherence for mothers who received Safe Sleep Nursery Education; b) an increased adherence for mothers who received Safe Sleep mHealth messaging; and c) compared to mothers who received either Safe Sleep Nursery Education or Safe Sleep mHealth messaging alone, an increased adherence for mothers who received both Safe Sleep Nursery Education and Safe Sleep mHealth messaging. Outcome measures will be assessed by survey conducted when the infant is 2-5 months of age.

    6 months

  • Adherence With Recommended Pacifier Use

    Hypothesis: For pacifier use, when controlling for other variables, there will be: a) an increased adherence for mothers who received Safe Sleep Nursery Education; b) an increased adherence for mothers who received Safe Sleep mHealth messaging; and c) compared to mothers who received either Safe Sleep Nursery Education or Safe Sleep mHealth messaging alone, an increased adherence for mothers who received both Safe Sleep Nursery Education and Safe Sleep mHealth messaging. Outcome measures will be assessed by survey conducted when the infant is 2-5 months of age.

    6 months

  • Adherence With Recommended Avoiding Use of Soft Bedding

    Hypothesis: For each recommended avoidance of soft bedding use, when controlling for other variables, there will be: a) an increased adherence for mothers who received Safe Sleep Nursery Education; b) an increased adherence for mothers who received Safe Sleep mHealth messaging; and c) compared to mothers who received either Safe Sleep Nursery Education or Safe Sleep mHealth messaging alone, an increased adherence for mothers who received both Safe Sleep Nursery Education and Safe Sleep mHealth messaging. Outcome measures will be assessed by survey conducted when the infant is 2-5 months of age.

    6 months

Secondary Outcomes (4)

  • Number of Participants Reporting Positive/Nonpositive Attitudes Towards Supine Sleep

    6 months

  • Number of Participants Reporting Positive/Nonpositive Attitudes Towards Roomsharing Without Bedsharing.

    6 months

  • Number of Participants Reporting Positive/Nonpositive Social Norms re Supine Sleep

    6 months

  • Number of Participants Reporting Positive/Nonpositive Social Norms re: Roomsharing Without Bedsharing.

    6 months

Study Arms (4)

Safe Sleep Edu and Breastfeeding mHealth

OTHER

Participants will receive Safe Sleep Nursery Education and Breastfeeding Mobile Health messaging

Behavioral: Safe Sleep Nursery EducationBehavioral: Breastfeeding Mobile Health Messaging

Breastfeeding Edu and Safe Sleep mHealth

OTHER

Participants will receive the Breastfeeding Nursery Education and the Safe Sleep Mobile Health messaging

Behavioral: Breastfeeding Nursery EducationBehavioral: Safe Sleep Mobile Health Messaging

Safe Sleep Edu and Safe Sleep mHealth

OTHER

Participants will receive Safe Sleep Nursery Education and Safe Sleep Mobile Health messaging

Behavioral: Safe Sleep Nursery EducationBehavioral: Safe Sleep Mobile Health Messaging

Breastfeed Edu and Breastfeed mHealth

OTHER

Participants will receive Breastfeeding Nursery Education and Breastfeeding Mobile Health messaging

Behavioral: Breastfeeding Nursery EducationBehavioral: Breastfeeding Mobile Health Messaging

Interventions

Nursery-based program for safe sleep

Safe Sleep Edu and Breastfeeding mHealthSafe Sleep Edu and Safe Sleep mHealth

Nursery-based program to promote breastfeeding

Breastfeed Edu and Breastfeed mHealthBreastfeeding Edu and Safe Sleep mHealth

Mobile messaging to provide multiple short culturally competent videos to promote breastfeeding delivered via email.

Breastfeed Edu and Breastfeed mHealthSafe Sleep Edu and Breastfeeding mHealth

Mobile messaging to provide multiple short culturally competent videos to promote safe sleep practices delivered via email.

Breastfeeding Edu and Safe Sleep mHealthSafe Sleep Edu and Safe Sleep mHealth

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • \- mothers must live in the US, deliver a healthy infant in one of the study hospitals, plan to take her baby home with her, and be able to receive emails.

You may not qualify if:

  • \- mothers who are not English speaking, whose infant is deceased, those not having custody of the infant, and those whose infants require hospitalization for more than 1 week, or have an ongoing medical problem requiring subspecialty care and mothers who are unable to receive email messages.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (3)

  • Kellams A, Kerr SM, Moon RY, Hauck FR, Heeren T, Colson E, Parker MG, Rice F, Corwin MJ. The Impact of Breastfeeding and Safe Sleep Mobile Health Messaging on Breastfeeding and Bedsharing. Acad Pediatr. 2022 Aug;22(6):927-934. doi: 10.1016/j.acap.2022.01.016. Epub 2022 Feb 4.

  • Moon RY, Corwin MJ, Kerr S, Heeren T, Colson E, Kellams A, Geller NL, Drake E, Tanabe K, Hauck FR. Mediators of Improved Adherence to Infant Safe Sleep Using a Mobile Health Intervention. Pediatrics. 2019 May;143(5):e20182799. doi: 10.1542/peds.2018-2799.

  • Moon RY, Hauck FR, Colson ER, Kellams AL, Geller NL, Heeren T, Kerr SM, Drake EE, Tanabe K, McClain M, Corwin MJ. The Effect of Nursing Quality Improvement and Mobile Health Interventions on Infant Sleep Practices: A Randomized Clinical Trial. JAMA. 2017 Jul 25;318(4):351-359. doi: 10.1001/jama.2017.8982.

MeSH Terms

Conditions

Risk Reduction BehaviorBreast Feeding

Condition Hierarchy (Ancestors)

BehaviorFeeding Behavior

Limitations and Caveats

There was a 21% loss to follow-up, not generalizable to non-English-speaking populations, not powered to assess adverse events, did not measure clinical outcomes (i.e., rates of sudden unexpected infant death), and the results were self-reported

Results Point of Contact

Title
Michael Corwin, MD
Organization
Boston University

Study Officials

  • Michael Corwin, MD

    Boston University

    PRINCIPAL INVESTIGATOR
  • Eve R Colson, M.D.

    Yale University

    PRINCIPAL INVESTIGATOR
  • Fern R Hauck, M.D., M.S.

    University of Virginia

    PRINCIPAL INVESTIGATOR
  • Rachel Moon, MD

    University of Virginia

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
PREVENTION
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Rachel Moon, M.D.

Study Record Dates

First Submitted

October 19, 2012

First Posted

October 25, 2012

Study Start

March 1, 2015

Primary Completion

October 1, 2016

Study Completion

October 1, 2017

Last Updated

January 11, 2019

Results First Posted

January 3, 2019

Record last verified: 2019-01

Data Sharing

IPD Sharing
Will not share