Safe Sleep Education Across Healthcare Settings: A Systematic Review of Delivery, Content, and Outcomes

IF 2.8 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2026-09-01 Epub Date: 2026-07-28 DOI:10.1016/j.acap.2026.103415

Mary Beth Howard MD, MSc, Olivia A. Wilson-Lall HBSc, Sarah Sprauer MD, Stephanie K. Napolitano MD, Katie Lobner MLIS, Rachel Y. Moon MD, Leticia M. Ryan MD, MPH, Lara B. McKenzie PhD, MA, FAAHB

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引用次数: 0

Abstract

Background

Sleep-related infant deaths remain a leading cause of postneonatal mortality. Healthcare systems represent critical touchpoints for delivering safe sleep education, yet delivery varies across clinical settings.

Objectives

To synthesize how safe sleep education is delivered across healthcare settings, evaluate its impact on caregiver knowledge and adherence, and identify gaps to inform scalable, equitable interventions.

Data Sources

PubMed/MEDLINE, Embase, CINAHL, PsycINFO, Scopus, and Cochrane CENTRAL were searched from inception through July 15, 2025.

Study Eligibility Criteria, Participants, and Interventions

Eligible studies evaluated healthcare-delivered safe sleep education for caregivers of infants ≤12 months and reported caregiver-level outcomes.

Study Appraisal and Synthesis Methods

Four reviewers independently screened studies, extracted data, and assessed risk of bias using Cochrane RoB1. Due to heterogeneity in design and outcomes, findings were synthesized narratively.

Results

Twenty-three studies across eight countries were included. Interventions included bedside counseling, written materials, videos, quality improvement initiatives, mobile health messaging, and sleep space provision. Most studies reported improved caregiver knowledge and adherence, particularly supine positioning. Multicomponent interventions incorporating clinician modeling and post-discharge reinforcement demonstrated the most consistent improvements across behaviors.

Limitations

Evidence was limited by heterogeneity, reliance on self-reported outcomes, short follow-up periods, and moderate-to-high risk of bias.

Conclusions and Implications of Key Findings

Healthcare-delivered safe sleep education is associated with improved caregiver knowledge and behaviors, but effectiveness varies across settings. Multicomponent, system-level strategies extending beyond hospitalization may offer the most scalable approach. Future research should prioritize rigorous evaluation of equitable, implementable interventions across healthcare systems.

Systematic Review Registration Number

PROSPERO CRD420251050656.

查看原文本刊更多论文

安全睡眠教育在医疗保健设置：交付，内容和结果的系统回顾。

背景：与睡眠相关的婴儿死亡仍然是新生儿后期死亡的主要原因。医疗保健系统是提供安全睡眠教育的关键接触点，但在不同的临床环境中，提供的内容各不相同。目的：综合医疗机构如何提供安全睡眠教育，评估其对护理人员知识和依从性的影响，并确定差距，为可扩展、公平的干预措施提供信息。数据来源：PubMed/MEDLINE， Embase， CINAHL, PsycINFO， Scopus和Cochrane CENTRAL从成立到2025年7月15日。研究资格标准、参与者和干预措施：符合条件的研究评估了≤12个月婴儿护理人员的卫生保健安全睡眠教育，并报告了护理人员水平的结果。研究评价和综合方法：四名审稿人独立筛选研究，提取数据，并使用Cochrane RoB1评估偏倚风险。由于设计和结果的异质性，研究结果以叙述的方式综合。结果：纳入了来自8个国家的23项研究。干预措施包括床边咨询、书面材料、视频、质量改进举措、移动健康信息和提供睡眠空间。大多数研究报告提高了护理人员的知识和依从性，特别是仰卧位。结合临床医生建模和出院后强化的多组分干预在行为方面表现出最一致的改善。局限性：证据受到异质性、依赖于自我报告的结果、随访时间短和中高偏倚风险的限制。主要发现的结论和含义：医疗保健提供的安全睡眠教育与改善护理人员的知识和行为有关，但效果因环境而异。超出住院治疗范围的多组件、系统级战略可能提供最具可扩展性的方法。未来的研究应优先考虑对卫生保健系统中公平、可实施的干预措施进行严格评估。系统评价注册号：PROSPERO CRD420251050656。

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.