Assessment of Safe Sleep: Validation of the Parent Newborn Sleep Safety Survey.
Leanne Whiteside-Mansell, Rosemary Nabaweesi, Alison Rose Caballero and 3 others
PMID 28728766WHAT IT FOUND
A new parent survey matched home observations for sleep position, surface, and location when using lenient scoring.
It failed for bedding and pacifiers. Nurses can use it to screen risk, but strict 'every time' answers misclassify safe practices.
Key findings
01The survey showed adequate agreement with home observations for sleep position, sleep surface, and sleep location when responses were scored leniently (e.g., 'most of the time' counted as safe).
02The survey did not agree well with observations for bedding safety, overheating, or pacifier use.
03Strict scoring based on AAP guidelines ('every time') led to poor agreement for sleep position and location, suggesting parents may not use extreme response options even when compliant.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study focused only on physical sleep environment factors and did not validate the survey for other AAP recommendations like smoke exposure or breastfeeding. The sample was limited to low-income and adolescent mothers in a rural area, so results may not generalize to other populations. The survey was developed by the study investigators and had no prior psychometric testing. Inter-rater reliability for the data collection staff was not assessed due to resource constraints. The study did not test the survey's ability to predict actual infant safety outcomes, only its agreement with concurrent observations.
The easy way to misread this
Do not assume the survey is accurate for all safe sleep recommendations. It failed to reliably detect bedding hazards, overheating, and pacifier use. Additionally, strict scoring based on AAP guidelines ('every time') significantly reduced accuracy for sleep position and location; using lenient scoring is necessary for the tool to be useful.