Implementation of Infant Behavioral Sleep Intervention in a Diverse Sample of Mothers

ABSTRACT

Objective/Background

Behavioral Sleep Interventions (BSI) is an efficacious class of treatment approaches for infant sleep disturbance. Little is known about BSI implementation in the real world. Objectives were to a) examine the prevalence of BSI implementation and related factors in a diverse sample of US mothers; b) assess racial-ethnic group differences; and c) examine predictors of BSI implementation.

Participants

Participants included mothers (n= 353) with an infant (6–18 months) from one of the three racial-ethnic groups: White Hispanic (n= 113), White non-Hispanic (n= 122), Black non-Hispanic (n= 118).

Methods

Respondents completed an online survey assessing BSI implementation, familiarity, barriers, sleep knowledge, cognitions, and sleep patterns.

Results

Approximately one-third (36%) of the sample endorsed BSI implementation and 59% reported BSI familiarity. Black non-Hispanic mothers were more likely to report stopping a BSI prior to completion (OR = 4.92, p <.05) and more likely to hear about BSI from a health-care professional (OR = 1.32, p <.05) compared to White non-Hispanic mothers. Racial-ethnic group differences were identified for a variety of sleep practices, including bedsharing, independent sleep onset, and score on a validated measure of problematic sleep. No racial-ethnic group differences were found in BSI implementation, cognitions, or barriers. BSI implementation was predicted by BSI familiarity, more maternal education, and cognitions around infant self-soothing.

Conclusions

Differential BSI implementation does not appear to be a major driver of sleep disparities, although Black non-Hispanic mothers who decide to implement BSI do report notably lower completion rates. Future studies should examine alternative mechanisms of sleep disparities as well as strategies to promote sleep health in diverse families.

Conflict of interest

Dr. Mindell receives grant support and is a consultant for Johnson & Johnson Consumer Inc. Dr. Honaker is a consultant for Google LLC. Dr. Schwichtenberg receives grant support from the National Institute of Mental Health, National Institute of Child Health and Human Development, Purdue Institute for Integrative Neuroscience, and the Purdue Research Foundation.Study data were collected and managed using REDCap electronic data capture tools hosted at Indiana University. REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies, providing: 1) an intuitive interface for validated data entry; 2) audit trails for tracking data manipulation and export procedures; 3) automated export procedures for seamless data downloads to common statistical packages; and 4) procedures for importing data from external sources.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This study was funded, in part, with support by Indiana University Health, with the assistance from the Indiana Clinical and Translational Sciences Institute funded by a grant from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award. Dr. Honaker’s time was supported by Grant Number UL1TR002529 (A Shekhar, PI) from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award and the Indiana University School of Medicine.