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Health care professionals’ knowledge and recommendations about SIDS and its risk factors: who are the best at giving advices to parents and what’s the effect of the training campaigns?

Giovanna Boccuzzo, University of Padova 
*Federico de Luca, University of Southampton 

Keywords: SIDS; training campaigns; sleep position; Back to Sleep; policy decisions;

INTRODUCTION. This paper analyses the data resulting from the SIDS Project, a cross country study that investigated health care professionals’ knowledge and recommendations about Sudden Infant Death Syndrome (SIDS) and its risk factors. With a particular focus on knowledge and recommendations about infants’ sleep position (which is the most important risk factor for SIDS), this paper aims at determining which demographic and professional characteristics influence health care professionals’ knowledge and recommendations. By identifying the best and worst prepared health care professionals, policymakers will be allowed to reconsider the structure of their respective health care system and to implement targeted training initiatives. Besides, from a policymaker’s perspective, an investment in health care professionals’ training is both cheaper and more efficient than an investment in courses to be delivered to newborns’ parents (the other option to raise awareness among the population). These courses, in fact, would need to be entirely repeated every few months, while initiatives meant for health care professionals could have longer intervals between them METHODS. The data were retrieved through two cross-sectional surveys of 2,216 health care professionals in England and in Spain which were carried out between May 2012 and March 2013. Additionally, the data belonging to the national campaign ‘GenitoriPiù’ (run in Italy between September 2008 and June 2009) was made available to the researchers. Overall, then, we analyzed 349 responses from the English survey, 638 responses from the Spanish one and 6,081 responses from the Italian campaign, for a total of 7,068 responses. Relative risks were used to examine the demographic and professional variables as predictors of health care professionals’ knowledge and compliance with the SIDS prevention recommendations. Moreover, Rasch models were used to develop synthetic indices of knowledge about the considered risk factors, and quantile regression analysis was used to analyze which health care professionals’ characteristics influenced the indices. RESULTS. Overall, 85% of respondents were aware that the supine position is the safest for preventing SIDS. However, only 59% of respondents recommended exclusively the supine sleeping position to infants’ parents, while 80% recommended a nonprone position. Professional role, workplace and region all play an important role in determining the respondents’ knowledge, but they have different effects depending on the country which is considered. When the overall knowledge of all the risk factors was considered, significant differences are still evident, and the effect of training initiatives is proven as a way to rectify these differences (at least for what regards the Italian reality). DISCUSSION. The overall knowledge about infants’ sleep positioning is encouraging, but much more needs to be done in order to raise the percentage of professionals recommending exclusively the supine position. When various risk factors are considered altogether, a disparity in knowledge emerges between workplaces and professional roles. This is worrying because after birth newborns’ parents do not seek care for their child some of the workplaces with the best performances. Having been able to prove the efficacy of such health care professionals training campaigns could be determinant for future researchers and policymakers during the fundraising process. NOTE: because the last survey was concluded in the first half of March 2013, a detailed analysis of the 7,068 responses has not been carried out yet. However, we are more than confident that by October 2013 this will be the case.