Factors Associated with Bed-Sharing Within Racial Groups in a Sample of Mothers and Young Infants in Wisconsin

Since 2005, the American Academy of Pediatrics has recommended a separate but proximate sleep surface for infants (AAP, 2005). However, racial differences in the prevalence of bed-sharing and infant mortality (especially as a result of SIDS or unsafe sleep) continue. Limited research has examined predictors of bed-sharing by racial group, especially the AAP\u27s 2005 policy statement against it. The purpose of this study was to explore maternal-infant bed-sharing and infant sleep position for African-Americans and Whites in a sample of 2,530 respondents (822 African-American and 1,708 Whites) to the Wisconsin Pregnancy Risk Assessment and Monitoring System (PRAMS), a stratified sample of linked survey and birth certificate data between 2007 and 2010. Significantly more African-Americans (70.5%) reported bed-sharing than Whites (53.5%), z = 56.67, SEM = 0.005, p \u3c .001 (one-tailed). Factors associated with bed-sharing varied by race. In the final models, for African-Americans, a higher likelihood of bed-sharing was associated with ≥ 16 years of education (Odds Ratio[OR]: 2.540, 95% CI: 1.098-5.875), 13-15 years of education (OR: 1.924, 95% CI: 1.129-3.278), partner-related stress (OR: 1.859, 95% CI: 1.272-2.715), currently breastfeeding (OR: 1.598, 95% CI: 1.012-2.522), non-supine infant sleep (OR: 1.573, 95% CI: 1.077-2.297), and maternal age (OR: 0.963, 95% CI: 0.931-0.995). When Medicaid as method of payment was included, it reduced the likelihood of bed-sharing (OR: 0.550, 95% CI: 0.372-0.814). For Whites, bed-sharing was associated with currently breastfeeding (OR: 2.444, 95% CI: 1.939-3.081), income of $10,000-$14,999 (OR: 1.833, 95% CI: 1.004-3.344), income of $35,000-$49,999 (OR: 1.704, 95% CI: 1.234-2.351), being unmarried (OR: 1.667, 95% CI: 1.184-2.346), non-supine infant sleep (OR: 1.407, 95% CI: 1.069-1.852), and partner-related stress (OR: 1.381, 95% CI: 1.058-1.802). Needing money for food was also associated with bed-sharing (OR: 1.575, 95% CI: 1.158-2.143). Overall, subtle differences in the factors at play for African-American and White families who bed-share were demonstrated. Practice implications include culturally-relevant discussions and interventions. In-depth investigation of the family level context of bed-sharing, the ecology of infant sleep, and information received by families is suggested. These results help inform development of a targeted, culturally sensitive approach to educating families on sleep-related infant safety

Dual Master of Social Work / Master of Public Health Degrees: Perceptions of Graduates and Field Instructors

Despite growing interest in Master of Social Work/Master of Public Health (MSW/MPH) programs, limited research literature is available on MSW/MPH graduates and none has examined field instructors’ perceptions of MSW/MPH students. This study describes the perceptions and experiences of MSW/MPH alumni and field instructors from a recently implemented MSW/MPH program at the University of Georgia. Electronic surveys were administered to 32 alumni and 34 field instructors; response rates were 71.9% (n=23) and 70.6% (n=24), respectively. Alumni reported satisfaction with the dual degree and utilization of both social work and public health skills in the workplace. Field instructors underscored the complementary skill sets of dually-trained students and noted the added value of MSW/MPH professionals in their agencies. Dually-trained MSW/MPH practitioners are uniquely prepared to address the need for transdisciplinary and interprofessional collaborations to address long-standing social and health issues

Evaluation of a Multisite Safe Infant Sleep Education and Crib Distribution Program

Rates of sleep-related infant deaths have plateaued in the past few decades despite ongoing infant sleep practice recommendations to reduce risk of sleep-related infant deaths by the American Academy of Pediatrics. The state department of public health trained facilitators at 28 sites across the state to facilitate a group safe sleep educational program. A prospective, matched pre- and post-test cohort design with follow-up was used to evaluate changes in self-reported knowledge, intentions, and practices. The final sample included 615 matched pre- and post-test surveys, and 66 matched follow-up surveys. The proportion of correct responses on all knowledge and intended practice items increased significantly from pre- to post-test. When asked where their babies would have slept if they had not received the portable crib, 66.1% of participants planned to use a recommended sleep location (e.g., crib or bassinet). At post-test, 62.3% planned to change something about their infant’s sleep based on what they learned. At follow-up, knowledge was maintained for all but two items and practices and for half of practice items. The results suggest that participating in the education program was associated with increased knowledge and intended adherence, but that these changes were not maintained at follow-up. These results are in line with the research literature that finds a difference in intentions and actual practices after the baby is born

Trends and progress in reducing teen birth rates and the persisting challenge of eliminating racial/ethnic disparities

PURPOSE: We examined progress made by the Milwaukee community toward achieving the Milwaukee Teen Pregnancy Prevention Initiative\u27s aggressive 2008 goal of reducing the teen birth rate to 30 live births/1000 females aged 15-17 years by 2015. We further examined differential teen birth rates in disparate racial and ethnic groups. METHOD: We analyzed teen birth count data from the Wisconsin Interactive Statistics on Health system and demographic data from the US Census Bureau. We computed annual 2003-2014 teen birth rates for the city and four racial/ethnic groups within the city (white non-Hispanic, black non-Hispanic, Hispanic/Latina, Asian non-Hispanic). To compare birth rates from before (2003-2008) and after (2009-2014) goal setting, we used a single-system design to employ two time series analysis approaches, celeration line, and three standard deviation (3SD) bands. RESULTS: Milwaukee\u27s teen birth rate dropped 54 % from 54.3 in 2003 to 23.7 births/1000 females in 2014, surpassing the goal of 30 births/1000 females 3 years ahead of schedule. Rate reduction following goal setting was statistically significant, as five of the six post-goal data points were located below the celeration line and points for six consecutive years (2010-2014) fell below the 3SD band. All racial/ethnic groups demonstrated significant reductions through at least one of the two time series approaches. The gap between white and both black and Hispanic/Latina teens widened. CONCLUSION: Significant reduction has occurred in the overall teen birth rate of Milwaukee. Achieving an aggressive reduction in teen births highlights the importance of collaborative community partnerships in setting and tracking public health goals