Evaluating caregivers arrangement of infant sleeping environments in the home

Abstract

Sleep‐related infant deaths are one of the top causes of infant mortality in the United States. A few behavior analytic studies have examined behavioral skills training to teach adults to arrange safe infant sleeping environments. These studies were conducted in an analogue environment, and no data were collected outside the training setting. The purpose of the current study was to replicate and extend the extant literature. We taught caregivers to arrange safe infant sleeping environments in a community‐based organization. Thereafter, we assessed the feasibility and effectiveness of a technology‐based contingency management procedure to examine caregivers' adherence with arrangement of a safe sleeping environment for their newborns across a 2‐week period. As in previous studies, behavioral skills training resulted in positive outcomes, and follow‐up data suggested that the technology‐based contingency management procedure may be a promising approach to promoting adherence with infant sleeping environment recommendations.

The influence of video‐based training on caregiver arrangement of infant sleeping environments

“…Sleep‐related infant deaths have remained stable for the past few decades (Centers for Disease Control and Prevention, 2022), prompting additional research on how to train caregivers in arranging safe sleep environments. A growing number of studies have shown the effectiveness of BST to train adults to engage in safe infant sleeping practices (Carrow et al, 2020; Mery et al, 2022; Mery et al, 2023; Vladescu et al, 2020), thereby demonstrating the efficacy of the training protocol developed by Carrow et al (2020) and Vladescu et al (2020). Interestingly, we found outcomes similar to the aforementioned studies.…”

“…Previous studies have evaluated behavioral skills training (BST; DiGennaro Reed et al, 2018) to teach college students (Carrow et al, 2020), expectant caregivers (Mery et al, 2023;Vladescu et al, 2020), and medical students (Mery et al, 2022) to arrange an analogue infant sleeping environment that corresponded with the recommendations of the American Academy of Pediatrics (Moon et al, 2022a(Moon et al, , 2022b. In all studies, participants responded with low to moderate levels of correct responding across scored safe-sleeping categories (i.e., surface, materials, position) during baseline measures, and they subsequently reached the mastery criterion following the implementation of BST.…”

“…Participant skills in all studies also occurred in untrained contexts, including while at home with their infant. In addition, Mery et al (2023) arranged a contingency management (CM) component following training as an incentive for caregivers to arrange a safe sleeping environment when placing their infant to sleep at home without the trainer present. Three participants were initially taught to arrange an analogue safe infant sleeping environment.…”

“…Although this training resulted in desirable outcomes, several considerations are worth mentioning. First, Mery et al (2023) and Vladescu et al (2020) required that trainers be present during the training and travel to the community health organizations on multiple days per week to meet with participants. The requirements posed barriers with respect to the accessibility and sustainability of the training package for continued, future use.…”

“…The purpose of the current study was to replicate and extend Mery et al (2023) and Vladescu et al (2020) by using VBT to teach expecting and current caregivers to arrange infant sleeping environments in an analogue setting. Similar to Mery et al, we conducted identical pre-VBT and post-VBT sessions across a single day and implemented a mobile-phone-based CM procedure to evaluate arrangement of an infant sleeping environment in the caregivers' home with their newborns.…”