Assessing knowledge of Sudden Infant Death Syndrome among African American women in two Mississippi communities.

Abstract: Purpose: Sudden Infant Death Syndrome (SIDS) is the third leading cause of Mississippi infant mortality with nonwhite infants dying of SIDS at two to three times the rate of white infants. The purpose of this study was to assess the level of SIDS related knowledge among African American women in two geographical areas of Mississippi and gain insight on improving methods for SIDS education and outreach. Design: An African American faculty was contracted to conduct six focus groups among African American women (n=57) in two geographical areas of the state. Findings: Themes were common among participants from both the metropolitan and rural Delta communities. Participants in both geographical areas were familiar with [or at least had previously heard] the term SIDS. Unfortunately, there was inconsistency among participants as to the source of information. Given the inconsistencies, it is not surprising that overall knowledge related to SIDS was incomplete and in some cases inaccurate. Discussion/Conclusion: Some information regarding SIDS is available in the various communities. Unfortunately, the information is not fully understood and is not consistently distributed resulting in a lack of knowledge among these women and thus, a continued risk for high rates of SIDS events in Mississippi. Key Words: SIDS, Infant Mortality, Crib Death, African American, Mississippi, Delta Sudden Infant Death Syndrome can be diagnosed when the cause of an infant death remains unexplained after a complete autopsy, review of the medical history, and death scene investigation. Although infants of all demographic and socioeconomic backgrounds are at risk for SIDS, the African American population tends to bear a disproportionate burden of SIDS, a phenomenon noted across the nation and throughout the world. Mississippi infants share in that phenomenon. BACKGROUND Mississippi vital statistics demonstrate that a disparity exists between Caucasian and African American infant mortality in Mississippi (Graham, Zhang, & Schwalberg, 2007). Notably, SIDS is the third leading cause of Mississippi infant mortality with nonwhite infants dying of SIDS at two to three times the rate of white infants (Langsten, Graham, & Zhang, 2009). Although the nonwhite rates have historically been much higher, SIDS rates among white and nonwhite Mississippi infants have experienced significant increases in recent years (see Figure 1). During the years 1996 to 2005, the white SIDS rate increased by 42.8% and the nonwhite SIDS rate increased by 15.0% (Zhang et al, 2006). According to the Interagency Panel on SIDS, the risk of SIDS peaks during the second through fourth months of life, rarely occurring during the first month of life and declining after the sixth month. The specific cause of SIDS remains unknown but certain risk factors have been identified, mostly relating to maternal, infant, and environmental factors. The most common associated risks reported include low maternal education, young maternal age, unmarried mothers, late /no prenatal care, no breast-feeding, infant sleeping positions, male gender, and smoking exposure. Approximately 90% of United States (U. S T) cases of SIDS occur at less than six months of age; and, SIDS more often occurs during winter months than summer months (CDC, 1996). In 2001, a study group sought to review current literature related to SIDS and to apply that information to determine strategies for reducing nigh rates of SIDS in Mississippi Delta Counties. The study group recommended three strategies for reducing SIDS occurrences in northwestern Mississippi. The group proposed that enhancing Delta women's access to information regarding the Back to Sleep program; decreasing second hand smoke exposure; and increasing breastfeeding practices among Mississippi women would all be helpful in reducing SIDS (Kum-Nji, Mangrem, & Wells, 2001). A survey assessing the consistency of Mississippi coroners in identifying and accurately diagnosing SIDS revealed considerable variation in the methods Mississippi coroners use to diagnose SIDS cases. …