P2.185: Facilitators and Barriers to Safe Sleep Practice in Atlanta Refugee Communities

Background: Every year in the United States, 3500 previously healthy infants die from sudden unexpected infant death (SUID) or other sleep-related causes. Georgia loses 3 infants a week to sleep related causes and it is the leading cause of infant death for healthy infants. These deaths are preventable through evidence-based safe sleep practices.. Immigrant families face unique challenges in health care every day, such as barriers to transportation, access to medicine, and language barriers in utilizing health services. Co-sleeping practices are common in immigrant and refugee communities. However, safe sleep education resources are limited to English and Spanish in many areas. Common other preferred languages among our newborn population include Swahili and Amharic.

Project Description: This CATCH funded project aims to 1) understand knowledge, facilitators, barriers of safe sleep practices among Swahili and Amharic speaking communities in Atlanta through focus groups (FGs) and 2) co-design safe sleep resources to address identified gaps and barriers. Alongside interpreters and community champions from CPACS (Center for Pan-Asian Community Services), a community services outreach group and healthcare center for immigrants and refugees in Atlanta, we conducted Swahili and Amharic FGs.**#* Swahili speaking women with origins in Tanzania or Congo attended a FG. Key results included: distrust of providers over community (i.e. other mothers, grandmothers) expertise and desire to co-sleep out of concern for the baby's well being, especially temperature and breathing. **#* Amharic speaking women, all from Ethiopia originally participated in a FG. Key results included: preference for co-sleeping though with trust of health providers but lack of knowledge around safe sleep practices and difficulty understanding newborn education due to language. Data from FGs was used to co-design videos for both groups. Videos will be implemented at two area birth hospitals with a combined 9000 annual births and a children’s hospital primary care clinic. Evaluation of videos’ impact is the next step.

Discussion: While both communities practiced co-sleeping, they have different barriers to understanding and engaging in safe sleep practices. Using trusted messengers and exploring shared concern for newborn monitoring was key for Congolese families. Materials from health providers in Amharic were critical for the Ethiopian families. Tailoring education materials to meet vulnerable communities' unique needs is essential to addressing inequities.

Conclusion: Access to safe sleep education in preferred languages with cultural context is critical to meeting the needs of immigrant families. Videos will be open access. Scaling up resources to other communities nationally is a future step. The ultimate goal is these resources will empower families to make safe sleep decisions that help save newborn lives.