PEC innovation最新文献_第9页

“In some ways it feels like a specialism”: Exploring the lived experience of multilingual maternity professionals – A qualitative interview study “在某些方面，它感觉像是一种专业”：探索多语种产科专业人员的生活经验-一项定性访谈研究

PEC innovation

Pub Date : 2025-01-22 DOI: 10.1016/j.pecinn.2025.100378

Emma Brooks

Objective

This study aimed to investigate the experience of multilingual maternity staff working in UK NHS hospitals.

Methods

As part of an exploratory qualitative descriptive approach, semi-structured interviews were conducted with multilingual healthcare professionals, working in perinatal care in different NHS trusts across the United Kingdom. Interviews were audio-recorded, transcribed and subsequently analyzed using thematic analysis.

Results

Where practitioners were able to draw on their linguistic skills, they felt that multilingualism was a specialism and appreciated by colleagues. Practitioners also felt that the utilisation of shared languages could boost the confidence of women and birthing people, as well as improving their understanding and sense of wellbeing. Conversely, several practitioners felt an obligation to offer linguistic support, noting that it added to a workload burden, and fear of litigation, that was not experienced by monolingual colleagues.

Conclusion

Strategic utilisation of linguistically skilled NHS practitioners may hold the potential for advancing equity of care for migrant populations, who are regularly and disproportionately represented in data recording adverse outcomes.

Innovation

Investing in institutional support and formal accreditation for multilingual health professionals would enable them to be able to operate with confidence, redress (invisibilized) workloads and contribute to advancing parity of care for migrant patients.

目的本研究旨在调查在英国国民保健服务医院工作的多语种产科人员的经验。方法作为探索性定性描述方法的一部分，对在英国不同NHS信托机构从事围产期护理工作的多语种医疗保健专业人员进行了半结构化访谈。采访录音、抄写，然后利用专题分析进行分析。结果当从业者能够利用他们的语言技能时，他们觉得多语言是一种专长，并受到同事的赞赏。从业者还认为，使用共享语言可以增强妇女和分娩人员的信心，并提高他们的理解和幸福感。相反，一些从业人员感到有义务提供语言支持，注意到这增加了工作量负担和对诉讼的恐惧，这是单语同事所没有经历过的。战略性地利用语言熟练的NHS从业人员可能具有促进移民人口护理公平的潜力，移民人口经常不成比例地出现在记录不良结果的数据中。创新投资于多语种卫生专业人员的机构支持和正式认证，将使他们能够充满信心地开展工作，纠正（无形的）工作量，并有助于促进移徙患者的护理平等。

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引用次数: 0

Visuals versus textual scales: Optimizing reliability and user experience in observational assessment of parent-child interaction 视觉与文本量表：优化亲子互动观察性评估的可靠性和用户体验

PEC innovation

Pub Date : 2025-01-20 DOI: 10.1016/j.pecinn.2025.100376

Mirte L. Forrer , Carlo Schuengel , Mirjam Oosterman

Objective

Assessment of parent-child interaction by practitioners is of great importance but hindered by a lack of instruments that withstand the constraints daily practice places on usage. Visuals may offer an alternative format. Visualizations were tested on reliability, accuracy, and feasibility in observational assessment of parent-child interaction, as alternatives for textual rating scales.

Methods

In Study 1, 95 students rated parent-child interactions with a video or text anchor scale, and in Study 2, 217 professionals rated the same interactions with a decision tree including visual components or a text anchor scale.

Results

Students using the video anchor scale were less reliable and accurate, slower, and had a less positive user experience than students using the text anchor scale. Professionals using the decision tree did not differ in reliability and were comparable in user experience with professionals using the text anchor scale. Rater accuracy showed similar dependency on quality of parental behavior for both scales: ratings were less accurate when the quality of the parent-child interaction was low, and more accurate when the quality was high. However, professionals were less accurate and slower in using the decision tree than the text anchor scale.

Conclusion

With a first iteration of a decision tree performing the same to or only slightly worse, efforts to further develop decision trees might be worthwhile.

Innovation

These nonintuitive findings underscore the value of experimental testing in assessment design in daily practice.

目的：从业者对亲子互动的评估是非常重要的，但由于缺乏能够承受日常实践对使用的限制的工具而受到阻碍。视觉效果可能提供另一种格式。可视化测试的可靠性，准确性和可行性，在亲子互动的观察性评估，作为文本评定量表的替代品。方法在研究1中，95名学生用视频或文本锚量表对亲子互动进行评分，在研究2中，217名专业人员用包含视觉成分或文本锚量表的决策树对亲子互动进行评分。结果使用视频主播量表的学生与使用文本主播量表的学生相比，可靠性和准确性较低，速度较慢，用户体验较差。使用决策树的专业人员在可靠性方面没有差异，并且在用户体验方面与使用文本锚量表的专业人员相当。两种量表的评分准确度对父母行为质量的依赖性相似：当亲子互动质量较低时，评分准确性较低，而当亲子互动质量较高时，评分准确性较高。然而，专业人员使用决策树的准确性和速度比文本锚量表低。由于决策树的第一次迭代执行相同或仅略差，因此进一步开发决策树的努力可能是值得的。这些非直觉的发现强调了实验测试在日常实践评估设计中的价值。

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引用次数: 0

Patients' emotional expressions and clinicians' responses in oncology – From recognition to exploration of concerns 肿瘤患者的情绪表达和临床医生的反应——从认识到关注的探索

PEC innovation

Pub Date : 2025-01-17 DOI: 10.1016/j.pecinn.2025.100374

Fernanda Bittencourt Romeiro , Vanessa Garrido Pais , Gerry Humphris , Margarida Figueiredo-Braga

Objectives

The objective of this study was to analyze patient's emotional expressions during the consultations and the responses of their oncologists to these expressions.

Methods

The study employed a mixed-method, observational, descriptive, and explanatory design. A total of 31 adult patients at different clinical stages, undergoing cancer treatment and 8 oncologists were included. Thirty-one routine outpatient oncology consultations were analyzed, after being transcribed and coded, using the Portuguese version of the Verona Coding Definitions of Emotional Sequences (VR-CoDES).

Results

The oncologists elicited and recognized patients' emotional concerns but they did not explore them in a way that encouraged patients to continue verbalizing their feelings. Oncologists provided more directive and guidance-oriented responses, focusing on cues related to physical pain and symptoms. Multilevel logistic regression analysis modeled the probability of oncologists' responses showing reduction of space in relation to patients' emotional cues/concerns, controlling for clustering and patients' clinical and socio-demographic variables. The type of cue and treatment influenced the oncologists' responses.

Conclusions

Communication skills training focused on the ability to better explore patients' emotions may help oncologists to provide more explicit and empathetic responses that validate the emotional content expressed during consultations. Practice Implications: Oncologists do not use the same responses as a standard with patients, thus adjusting them individually.

目的本研究的目的是分析患者在会诊时的情绪表达以及肿瘤医生对这些情绪表达的反应。方法采用观察性、描述性和解释性设计相结合的方法。共纳入31名处于不同临床阶段、正在接受癌症治疗的成年患者和8名肿瘤学家。使用葡萄牙语版本的Verona编码定义的情感序列（VR-CoDES）进行转录和编码后，对31例常规门诊肿瘤会诊进行分析。结果肿瘤学家引起并认识到患者的情感担忧，但他们没有以鼓励患者继续用语言表达他们的感受的方式来探讨这些问题。肿瘤学家提供了更多的指导性和指导性的回应，重点关注与身体疼痛和症状相关的线索。在控制聚类和患者临床和社会人口变量的情况下，多水平逻辑回归分析模拟了肿瘤学家反应的概率，显示了与患者情绪线索/关注相关的空间减少。提示和治疗的类型影响肿瘤学家的反应。结论沟通技巧培训侧重于更好地了解患者情绪的能力，可以帮助肿瘤医生提供更明确、更感同身受的回应，从而验证患者在会诊时表达的情绪内容。实践意义：肿瘤学家不使用相同的反应作为患者的标准，因此单独调整它们。

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引用次数: 0

Are we offering palliative care and employing shared decision making in the neonatal intensive care unit? A 10-year retrospective chart review 我们是否提供姑息治疗，并在新生儿重症监护室采用共同决策？10年回顾性图表回顾

PEC innovation

Pub Date : 2025-01-16 DOI: 10.1016/j.pecinn.2025.100375

Sawyer Karabelas-Pittman , Helen Coo , Hannah Lee , Christine C. Moon , Gillian MacLean

Objective

Perinatal palliative care (PPC) supports families with a fetal diagnosis of a life-limiting condition or who are facing preterm labour at the limits of viability. Shared decision making (SDM) is the gold standard approach in PPC. The objectives of this study were to describe the Neonatal Intensive Care Unit (NICU) team's involvement in PPC and the extent of SDM at an academic hospital in southeastern Ontario, and the frequency with which PPC was offered, accepted and received for live births.

Methods

We retrospectively reviewed charts for births from January 2010–January 2020 where a life-limiting condition (LLC) had been prenatally diagnosed or there was threatened preterm labour (TPTL) at the limits of viability. Frequency distributions were used to summarize the NICU team's involvement, extent of SDM, and data related to PPC provision.

Results

The LLC group included 73 patients. The NICU team was consulted for 26 (36 %). Among the 10 consults that involved decision making, SDM was documented in 9 instances (90 %). PPC was offered to 9 of 60 LLC families (15 %) with a live birth and was accepted by 8 (89 %). The TPTL Group included 112 patients. Seventy (62 %) received a consult with the NICU team. SDM was documented in 34 of 39 consults (87 %) that involved decision making. PPC was offered to 28 of 90 families (31 %) who experienced a live birth and was accepted by 16 (57 %).

Conclusion

Our results demonstrate the need for standardized consultation and palliative care referral protocols to advance access to and quality of neonatal end-of-life care.

目的围产期姑息治疗（PPC）支持胎儿诊断为生命受限条件或面临生存能力极限的早产的家庭。共享决策（SDM）是PPC的黄金标准方法。本研究的目的是描述安大略省东南部一家学术医院新生儿重症监护病房（NICU）团队参与PPC和SDM的程度，以及为活产婴儿提供、接受和接受PPC的频率。方法回顾性分析2010年1月至2020年1月产前诊断为生命限制状况（LLC）或生存能力极限时存在威胁性早产（TPTL）的新生儿图表。频率分布用于总结NICU团队的参与、SDM的程度以及与PPC提供相关的数据。结果LLC组73例。NICU小组咨询26例（36%）。在涉及决策制定的10个咨询中，SDM在9个实例中被记录（90%）。60个活产的LLC家庭中有9个（15%）接受了PPC， 8个（89%）接受了PPC。TPTL组包括112例患者。70例（62%）接受了NICU小组的会诊。39例涉及决策的咨询中有34例（87%）记录了SDM。90个活产家庭中有28个（31%）接受了PPC， 16个（57%）接受了PPC。结论我们的研究结果表明，需要标准化的咨询和姑息治疗转诊协议，以提高新生儿临终关怀的可及性和质量。

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引用次数: 0

The effect of clinician-expressed empathy and nocebo-alleviating information on breast-cancer-patients' anxiety and side effects during active chemotherapy: A clinical feasibility study 临床表达的共情和反安慰剂缓解信息对乳腺癌患者积极化疗期间焦虑和副作用的影响：临床可行性研究

PEC innovation

Pub Date : 2025-01-15 DOI: 10.1016/j.pecinn.2025.100373

Lara C. Gröschel , Fiona T. Brosig , Marcel Soesan , Katherina T. Vourtsis , Mirte van der Spek , Elise Sluiter , Liesbeth M. van Vliet

Objective

We set up a pilot-study to investigate main and interaction effects of nocebo-alleviating information and clinician-expressed empathy delivered via a standardized information-video on breast cancer patients' psychological and side effect outcomes during chemotherapy. Additionally, we aimed to reflect on the feasibility of the intervention (acceptability, practicality and integration) to inform future – follow-up – studies.

Methods

Using a clinical proof-of-principle randomized controlled trial, female breast cancer patients undergoing chemotherapy viewed one of four videos, varying in the level of nocebo-alleviating information(+/−) and clinician-expressed empathy(+/−). Due to the small sample size (n = 27), descriptive and recruitment data were utilized to evaluate effects and reflect on feasibility.

Results

The interventions appeared to yield limited effects on our small sample. Feasibility reflections mainly focused on the practical level, such as the use of more generalizable videos and optimizing the flow.

Conclusion

The study showed limited effects of the video intervention. It revealed recruitment challenges, while acceptability was high after inclusion. Moving forward, face-to-face clinician-patient interactions remain important, while cautiously exploring the potential benefits of modern technological advancements, ensuring thorough testing of their effects before implementation.

Innovation

This study marks an innovative approach in utilizing digital interventions to enhance cancer patient outcomes within clinical settings.

目的通过标准化信息视频传递反安慰剂缓解信息和临床表达共情对乳腺癌患者化疗期间心理和副作用结局的主要作用和交互作用，建立一项试点研究。此外，我们旨在反思干预措施的可行性（可接受性、实用性和整合性），为未来的后续研究提供信息。方法：通过一项临床原理验证随机对照试验，接受化疗的女性乳腺癌患者观看了四个视频中的一个，这些视频的反安慰剂缓解信息（+/−）和临床医生表达的同理心（+/−）水平不同。由于样本量较小（n = 27），我们使用描述性和招募性数据来评估效果并反思可行性。结果这些干预措施在我们的小样本中似乎产生有限的效果。可行性思考主要集中在实践层面，如使用更具通用性的视频，优化流程等。结论本研究显示视频干预效果有限。它揭示了招聘的挑战，而在纳入后的可接受性很高。展望未来，面对面的医患互动仍然很重要，同时谨慎地探索现代技术进步的潜在好处，确保在实施前对其效果进行彻底的测试。这项研究标志着在临床环境中利用数字干预来提高癌症患者预后的创新方法。

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引用次数: 0

Supporting healthier food choices through AI-tailored advice: A research agenda 通过人工智能量身定制的建议支持更健康的食物选择：一项研究议程。

PEC innovation

Pub Date : 2025-01-10 DOI: 10.1016/j.pecinn.2025.100372

Alain D. Starke , Jutta Dierkes , Gülen Arslan Lied , Gloria A.B. Kasangu , Christoph Trattner

Objective

To develop a research agenda to investigate the effectiveness of AI-tailored advice to support healthier home cooking. It aims to support healthier food choice in the context of hypertension, allergies, and sustainable diets.

Methods

We describe an agenda that has been formed between 2019 and 2022, through multiple rejected grant applications to the Research Council of Norway. We focus on the case of tailored recipe advice for individuals, formulating research questions and methods for three topics: “Acceptance of Personalized Food Advice”, “Algorithm and Interface AI: App Development”, and “Nutrition Modeling & Clinical Trials”. The overall methodology focuses on mitigating health issues among individuals with hypertension.

Conclusion

The design of AI to support healthier home cooking should tap into computational principles, as well as (psychological) theories of behavioral change. The effectiveness of an AI-driven home cooking app can be evaluated in a clinical trial akin to ‘regular’ dietary intervention studies.

Innovation

The development of a research agenda requires an integrated effort between scientists from different domains, during both the development and writeup of ideas. The proposed project is innovative, as most food technology and AI approaches have yet to be tested in proper trials on changes in eating habits.

目的：制定一项研究议程，调查人工智能量身定制的建议对支持更健康的家庭烹饪的有效性。它旨在支持在高血压、过敏和可持续饮食的背景下选择更健康的食物。方法：我们描述了2019年至2022年之间形成的议程，通过向挪威研究委员会提交的多项被拒绝的拨款申请。我们以个性化食谱建议为案例，针对“个性化饮食建议的接受”、“算法与界面AI: App开发”、“营养建模与临床试验”三个主题，制定研究问题与方法。总体方法侧重于减轻高血压患者的健康问题。结论：支持健康家庭烹饪的人工智能设计应该利用计算原理，以及行为改变的（心理学）理论。人工智能驱动的家庭烹饪应用程序的有效性可以在类似于“常规”饮食干预研究的临床试验中进行评估。创新：研究议程的制定需要来自不同领域的科学家在想法的发展和撰写过程中共同努力。拟议中的项目具有创新性，因为大多数食品技术和人工智能方法尚未在饮食习惯变化的适当试验中得到检验。

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引用次数: 0

Evaluation of information available on the web to patients undergoing splenectomy in Japan 对日本脾切除术患者网上可用信息的评估

PEC innovation

Pub Date : 2024-12-29 DOI: 10.1016/j.pecinn.2024.100367

Masahiko Kita

Objective

To evaluate the medical information available on the Web in Japanese to patients undergoing splenectomy.

Methods

Japanese websites on splenectomy were identified by conducting a search on two Internet search engines. Scales were used to score readability, quality, understandability, and actionability. Correlation coefficients for the scale scores were calculated.

Results

31 Japanese websites were included in the analysis. “The increased lifetime risk of infection post-splenectomy” and “the requirement to carry a patient card or another form of identification indicating post-splenectomy” was mentioned in 90.3 % (28/31) and 3.2 % (1/31) of websites, respectively. The mean (±standard deviation) grade on the Japanese Readability was 9.8 (±0.9). The actionability of 22 websites was less than 30 %. Positive correlations were found between readability and DISCERN scores (γ = 0.37; 95 % confidence interval [CI], 0.01 to 0.64, p < 0.05) and between content score and actionability (γ = 0.49; 95 %CI, 0.07 to 0.69, p < 0.05).

Conclusions

Japanese information on websites available to patients undergoing splenectomy was insufficient. The dissemination of information on specific infection prevention measures is needed but must be available at an appropriate readability level.

Innovation

Creating patient education materials using content score items may promote splenectomy patients coping infection prevention behaviors in Japan.

目的评价网上日语医学信息对脾切除术患者的帮助。方法在两个网络搜索引擎上搜索有关脾切除术的日本网站。使用量表对可读性、质量、可理解性和可操作性进行评分。计算量表得分的相关系数。结果31家日本网站被纳入分析。90.3%（28/31）和3.2%（1/31）的网站分别提到了“脾切除术后感染的终生风险增加”和“要求携带患者卡或其他形式的脾切除术后证明”。日语可读性的平均（±标准差）评分为9.8（±0.9）。有22个网站的可操作性低于30%。可读性与DISCERN评分呈正相关(γ = 0.37；95%置信区间[CI]， 0.01 ~ 0.64, p <；0.05)，内容评分与可操作性之间(γ = 0.49；95% CI, 0.07 ~ 0.69, p <；0.05)。结论脾脏切除术患者在网站上获得的日文信息不足。需要传播关于具体预防感染措施的信息，但必须以适当的可读性提供。创新利用内容评分项目制作患者教育教材，可促进日本脾切除术患者应对感染预防行为。

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引用次数: 0

“Having providers who are trained and have empathy is life-saving”: Improving primary care communication through thematic analysis with ChatGPT and human expertise “拥有受过培训、有同理心的服务提供者可以挽救生命”：通过ChatGPT和人类专业知识的主题分析改善初级保健沟通。

PEC innovation

Pub Date : 2024-12-28 DOI: 10.1016/j.pecinn.2024.100371

Michelle A. Stage , Mackenzie M. Creamer , Mollie A. Ruben

In the rapidly evolving field of healthcare research, Artificial Intelligence (AI) and conversational models like ChatGPT (Conversational Generative Pre-trained Transformer) offer promising tools for data analysis. The aim of this study was to: 1) apply ChatGPT methodology alongside human coding to analyze qualitative health services feedback, and 2) examine healthcare experiences among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) patients (N = 41) to inform future intervention. The hybrid approach facilitated the identification of themes related to affirming care practices, provider education, communicative challenges and successes, and environmental cues. While ChatGPT accelerated the coding process, human oversight remained crucial for ensuring data integrity and context accuracy. This hybrid method promises significant improvements in analyzing patient feedback, providing actionable insights that could enhance patient-provider interactions and care for diverse populations.

Innovation: This study is the first to combine ChatGPT with human coding for rapid thematic analysis of LGBTQ+ patient primary care experiences.

在快速发展的医疗保健研究领域，人工智能（AI）和会话模型（如ChatGPT（会话生成预训练转换器））为数据分析提供了有前途的工具。本研究的目的是：1)应用ChatGPT方法和人类编码来分析定性的健康服务反馈，2)调查女同性恋、男同性恋、双性恋、变性人和酷儿（LGBTQ+）患者（N = 41）的医疗保健经历，为未来的干预提供信息。混合方法有助于确定与确认护理实践、提供者教育、沟通挑战和成功以及环境线索相关的主题。虽然ChatGPT加速了编码过程，但人为监督对于确保数据完整性和上下文准确性仍然至关重要。这种混合方法有望在分析患者反馈方面取得重大进展，提供可操作的见解，可以增强患者与提供者的互动和对不同人群的护理。创新：该研究首次将ChatGPT与人类编码结合起来，对LGBTQ+患者的初级保健体验进行快速主题分析。

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引用次数: 0

Training healthcare workers and untrained interpreters in remote collaboration amidst COVID-19 培训医务工作者和未经培训的口译员在COVID-19期间进行远程协作。

PEC innovation

Pub Date : 2024-12-26 DOI: 10.1016/j.pecinn.2024.100369

Yvan Leanza , Noelia Burdeus-Domingo , Kossigan Kokou-Kpolou , François René De Cotret

Objective

In the context of the public health emergency response to the COVID-19 pandemic in Quebec in 2020, remote public service interpreting has become, within a few days, an essential practice for maintaining services to migrants and allophone refugees, a particularly vulnerable population. This study aimed to measure the impact of two training courses on remote collaboration for mediated consultations developed for healthcare workers and untrained interpreters.

Methods

A total of 79 healthcare workers and 65 untrained interpreters from the province of Quebec were recruited. They completed the trainings, offered as webinars, and answered the two scales (knowledge and self-efficacy) of the Questionnaire de connaissances sur l'interprétation de service publique à distance [Remote Public Service Interpreting Knowledge Questionnaire]. The study employed paired t-tests to assess the effectiveness of both webinars.

Results

Findings reveal a positive impact immediately after completion and at a three-month follow-up. However, there was no significant enhancement in interpreters' self-efficacy over the medium term.

Conclusion

Given their modality (remote) and duration (30 min for healthcare workers and three hours for interpreters), the training courses are both effective and practical to implement.

Innovation

This study innovatively promotes interprofessional collaboration in public service interpreting and explores online training's potential to enhance both individual and collective efficacy in the field.

目的：在2020年魁北克省应对2019冠状病毒病大流行的突发公共卫生事件背景下，远程公共服务口译在几天内就成为维持对移民和异形难民这一特别弱势群体服务的基本做法。本研究旨在衡量两个培训课程对医疗工作者和未经培训的口译员远程协作调解咨询的影响。方法：从魁北克省招募79名卫生保健工作者和65名未经培训的口译员。他们完成了培训，以网络研讨会的形式提供，并回答了远程公共服务口译知识问卷（Remote Public service interpretation knowledge Questionnaire）中的知识和自我效能两个量表。本研究采用配对t检验来评估两个网络研讨会的有效性。结果：研究结果显示，在完成后立即产生积极影响，并在三个月的随访中。然而，从中期来看，口译员的自我效能感并没有显著的提高。结论：考虑到培训的方式（远程）和持续时间（医护人员30分钟，口译人员3小时），培训课程既有效又实用。创新：本研究创新性地促进了公共服务口译的跨专业合作，并探索了在线培训在提高个人和集体在该领域的效力方面的潜力。

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引用次数: 0

Safe sleep crib clinics: Promoting risk reduction strategies for sudden unexpected infant death 安全睡眠婴儿床诊所：促进降低婴儿意外猝死风险的策略。

PEC innovation

Pub Date : 2024-12-25 DOI: 10.1016/j.pecinn.2024.100370

Carolyn R. Ahlers-Schmidt , Christy Schunn , Ashley M. Hervey , Maria Torres

Objectives

Safe Sleep Community Baby Showers (CBS) provide group education to reduce risk factors of sudden unexpected infant death (SUID). Based on CBS success, Safe Sleep Crib Clinics were developed to provide individual education. This study assessed Crib Clinic outcomes and differences in Crib Clinics compared to CBSs.

Methods

Certified Safe Sleep Instructors facilitated CBSs and/or Crib Clinics in their communities and collected participant data related to safe sleep, tobacco avoidance and breastfeeding. Crib Clinic data was compared pre- to post-test; post-test results were compared between Crib Clinics and CBSs.

Results

Crib Clinic attendees exhibited significant increases in intention to have infant follow safe sleep recommendations, avoid secondhand smoke and breastfeed (all p < 0.001). Significant differences between Crib Clinic and CBS participants related to marital status, language, tobacco, education and insurance (all p < 0.01). CBS and Crib Clinic participants differed on items related to sleep environment, breastfeeding and tobacco (all p = 0.05).

Conclusions

Overall Crib Clinics appear to be effective in increasing knowledge, intentions and confidence related to safe sleep, tobacco avoidance and breastfeeding. Crib Clinics may offer flexibility (e.g., time, format) that increases accessibility to safe sleep education for families.

Innovation

Results suggest the ability to shift education delivery method based on group size was important in both rural and urban settings.

目的：安全睡眠社区婴儿淋浴（CBS）提供群体教育，以减少婴儿猝死（SUID）的危险因素。在CBS成功的基础上，安全婴儿床诊所得以发展，提供个人教育。本研究评估了婴儿床诊所的结果和婴儿床诊所与cbs的差异。方法：经过认证的安全睡眠指导员在其所在社区促进cbs和/或婴儿床诊所，并收集有关安全睡眠、避免吸烟和母乳喂养的参与者数据。将婴儿床诊所的数据与测试前后进行比较；比较婴儿床诊所和cbs的测试后结果。结果：婴儿床诊所的参与者表现出让婴儿遵循安全睡眠建议、避免二手烟和母乳喂养的意愿显著增加（均p p p = 0.05）。结论：整体婴儿床诊所似乎有效地提高了与安全睡眠，避免吸烟和母乳喂养有关的知识，意图和信心。婴儿床诊所可以提供灵活性（如时间、形式），增加家庭安全睡眠教育的可及性。创新：结果表明，在农村和城市环境中，根据群体规模改变教育提供方法的能力都很重要。

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