Date of Award
Doctor of Philosophy
Mary K. Madsen
Ron A. Cisler, Paul Florsheim, Jennifer Doering, Emmanuel Ngui
Bed-Sharing, Co-Sleeping, Infant Sleep, Infant Sleep Position, Prams
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's 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 < .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.
Salm Ward, Trina C., "Factors Associated with Bed-Sharing Within Racial Groups in a Sample of Mothers and Young Infants in Wisconsin" (2012). Theses and Dissertations. 204.